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To explore further the permanent protection of your land by the Humane Society Wildlife Land Trust, please complete this form.

Completing the Land Preservation Information Form is the first step in the process of establishing protection for your property. Using this form, please describe your property and any particular concerns you may have to us. This step helps initiate the conversation between you and the Trust to explore protection options for your land. Submitting this form does not create any obligation for you or the Trust.

Note: All fields are required. Please answer the following questions as completely as you can from your own personal knowledge. Where the answer to a question is unknown, so indicate.

First Name
Last Name
Email
Street 1
Street 2
City
State/Province
County
ZIP/Postal Code
Country
Home Phone
Fax Number
Mobile Phone
Are there any other owners of the property?
   
If Yes, please list name(s) and address(es):
Address/location of property
Acres
Zoning Class
Nearest City:
General Description of Property
Prominent natural features:
 
Known wildlife inhabitants:
 
Buildings, structures, or other features on the property:
 
Existing or planned uses of the property (agriculture, business, recreation, etc.)
 
What surrounds the property? (development, roads, easements, wildlife habitat, rivers, streams, wetlands, forests, meadows, etc.)
 
What are your wishes regarding protection and future uses of the property? (i.e. what are you interested in doing with this property?)
 
What's the property's approximate present value? What is the estimate based upon? (i.e. recent appraisal, recent sale of similar property, etc.)
 
Is there a mortgage or lien on the property?
    
If yes, indicate amount of unpaid mortgage or lien:
 
Is the property currently leased to any other party?
    
If yes, name of tenant(s), tenant's use of property and length of time remaining in the lease term (including any extension that cannot be cancelled by landlord):
 
Are all property taxes, utility fees, and maintenance expenses up-to-date?
    
If no, please explain:
 
List the amounts of annual taxes and other fees and expenses associated with the property:
 
Has there been any developer interest or other interest in your property or surrounding properties?
    
If yes, briefly describe:
 
Does the property produce income?
    
If yes, indicate the specific source and amount:
 
Has the property been for sale at any time during the last three years?
    
If yes, please indicate when and offering price:
 
When and how did you acquire the property and what is your basis in property? (i.e. what was its purchase price?)
 
Are there any problems unique to the property that have not been discussed? (i.e. zoning questions, neighbor disputes, property upkeep, controversial development planned for the area, etc.)
    
If yes, please explain:
 
Are any of the properties adjacent or near your property protected from development through an association with a governmental agency or land trust?
    
If yes, please identify:
Other relevant information/comments: