Wayne County Agricultural Land Preservation Easement Application

Production Information

Please provide crop production information for the two most recent years

County Average Yields

The following information is provided to assist in completing the Production Information

Crop Year	Crop	Tons per Acre	Crop Year	Crop	Tons per Acre
2018	Corn silage	20 tons	2019	Corn Silage	18.5 tons
	Hay	2.05 tons		Hay	2.21 tons
	Alfalfa	1.47 tons		Alfalfa	1.47 tons

Crop report for the year:*
Total gross receipts for reported year:*
Enter 0 if there were no gross receipts
Crops Grown
No crops were grown
Crop report for the year:*
Total gross receipts for reported year:*
Enter 0 if there were no gross receipts
Crops Grown
No crops were grown
Livestock Information

Please provide livestock production information for the two most recent years
Livestock report for the year:*
Total gross receipts for reported year:*
Enter 0 if there were no gross receipts
Livestock Raised
No livestock was raised
Livestock report for the year:*
Total gross receipts for reported year:*
Enter 0 if there were no gross receipts
Livestock Raised
No livestock was raised
Gross Farm Receipts

Please total crop and livestock receipts for the two most recent years
Year:*
TOTAL GROSS RECEIPTS*
crop and livestock production
Year:*
TOTAL GROSS RECEIPTS*
crop and livestock production
If the TOTAL GROSS FARM RECEIPTS listed above are LESS than the minimum of $25,000, list additional sources of farm receipts for this operation that can be combined with the crop and livestock receipts to make a total of at least $25,000.
Additional sources of farm receipts:
If the ANNUAL GROSS RECEIPTS of the farm operation, of which the tract is a part, are LESS than $25,000, justification must be provided, to the satisfaction of the County and State Boards, that the farm operation is capable of generating at least $25,000 in annual gross revenue.
Is farm capable of generating at least $25,000 annual gross revenue?
Your main interest in applying for a conservation easement on your farm:
Please list any innovative farming practices that are currently being implemented on the farmland tract:

Purchase / Selling Price

Please select one
I / We would consider selling an Agricultural Conservation Easement to the County of Wayne and the Commonwealth of Pennsylvania for:
entire tract
For the entire farmland tract
tract of farmland submitted
For the tract of farmland submitted
per acre
Per acre
Amount to be determined by appraisal

Required Maps and Forms

The following MUST be mailed after the application has been submitted. Your application will be DENIED if any of the following forms are incomplete or missing.
IMPORTANT

Within 7-10 working days after the submission of your application, you will be mailed a handbook and other forms pertaining to your easement application.

Please read the instructions included in the mailing and submit all the required documents by the deadline indicated.

A one-time, non-refundable application fee of $100 must be submitted with the required documents.

Failure to submit the required documents or application fee by the deadline indicated will result in your application being denied.

* Tax map may be obtained, for a fee, from the Wayne County Tax Assessment Office at the courthouse (570) 253-5970

** Copy of the recorded ASA may be obtained, for a fee, from the Wayne County Recorder of Deeds Office at the courthouse (570) 253-5970

*** Contact the NRCS Mayfield office at (570) 280-3346
Modifications to Submitted Acreage

All parcels of land to be withheld from this easement application shall be delineated on the submitted tax map.
Execution of Application
Landowner Acknowledgment
Permission to Contact Applicant(s)
By selecting the "Submit" button below, you are giving the Wayne County Agricultural Land Preservation Board permission to contact you using any and all contact information you provided in the General Information section of this application. This contact information may include phone number, fax number, mobile number, email address and mailing address.
Required Information
Your application will be DENIED if the requested information is incomplete or missing.

Your application will be DENIED if the required forms are incomplete or missing.

Your application will be DENIED if the non-refundable application fee is not submitted.

Your application will be DENIED if the required forms and/or non-refundable application fee are not submitted by the indicated deadline.
ELECTRONIC SIGNATURE AGREEMENT
1st Applicant's Electronic Signature*

First NameLast Name
2nd Applicant's Electronic Signature

First NameLast Name
Should be Empty:

Wayne County Agricultural Land Preservation Easement Application

Production Information

Livestock Information

Gross Farm Receipts

Purchase / Selling Price

Required Maps and Forms

Modifications to Submitted Acreage

Execution of Application

Landowner Acknowledgment

Permission to Contact Applicant(s)

Required Information

ELECTRONIC SIGNATURE AGREEMENT