Foreign-Owned Agricultural Land Application and Report

11) Is this land acquired with the intention of gaining residency?

Yes

If yes, what is the projected date your residency will be obtained?

12) Is any portion of the tract(s) within ten miles of a military facility?

Yes

Unknown

13) Is this an acquisition or transfer?

Date of acquisition or transfer?

Is this a transfer?

Yes

If a transfer, list name(s) and address(es) of person(s) to whom the tract(s) are potentially transferred and their citizenship if an individual. If not, an individual or government, the nation in which the potential transferee is created and organized, and the principal place of business of the transferee

14) Land value, inluding improvements in US Dollars (If acquisition, purchase price of alnd. If transfer, selling price of land)

Other Considerations

15) Will any state or local government financial assistance be utilized for the acquisition or transfer of the land?

Yes

Signature

Submission Date

Title