Forest and Land Use Declaration Form

Applicant Full Name

First NameLast Name

Organization/Company Name (if applicable)

Contact Email Address

example@example.com

Contact Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Property Address / Location

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Parcel or Lot Number

Size/Area of Land (in acres or hectares)

Ownership Status

Other (please specify)

Intended Use of Land

Describe Current Land Cover/Use

Proposed Duration of Use (e.g., years, months)

Are there any anticipated environmental impacts?

If yes, please describe the anticipated environmental impacts and proposed mitigation measures.

Upload Supporting Documents (e.g., land maps, plans, permits)