PTAX – 334 Application for Open Space Purposes Assessment Who should complete this form? You should complete this form to request an alternate assessment if your property is more than 10 acres in area and is used for open space purposes. You must be liable for the property taxes and the property must have been used for open space purposes for the 3 years immediately preceding the assessment year. Property is considered used for open space purposes if it: • is actually and exclusively used for maintaining or enhancing natural or scenic resources, • protects air or streams or water supplies, • promotes conservation of soil, wetlands, beaches, or marshes, including ground cover or planted perennial grasses, trees, shrubs, other natural perennial growth, and any body of water, whether man-made or natural, • conserves landscaped areas, such as public or private golf courses, • enhances the value to the public of abutting or neighboring parks, forests, wildlife preserves, nature reservations, sanctuaries, other open space, or • preserves historic sites. You must file this form with the supervisor of assessments, at the address shown below, by January 31 of each assessment year. Note: When any portion of this property is no longer used for open space purposes, the person liable for taxes must immediately notify the Supervisor of Assessments in writing, and will also be required to pay the county treasurer the difference in taxes based on the fair cash value of the property in each of the 3 preceding assessment years, plus 5 percent interest. Payment is due by the following September 1st. Step 1: Complete the following information 5. Has this property been used for open 1. space purposes for three years preceding this assessment year? Property owner’s name No Yes 6. Write the parcel number of the property for which you are requesting this open space purposes assessment. Your parcel number is listed on your property tax bill or you may obtain it from the supervisor of assessments. If you are unable to obtain your parcel number, write the legal description on Line b. Street address City State Zip a b Write the legal description only if you are unable to obtain your parcel number. Phone Send notice to (if different from above) 2. Name Mailing address 7. Write the total acreage of the property, to the nearest tenth of an acre. City State 7. Zip 8. Write the street address of the property, if different than the address in Item 1. Phone 3. Write the assessment year for which you are requesting this open space purposes assessment. 3 Street address 4. Write the date the property began to City State Zip be used for open space purposes. Month Day Year Step 2: Sign below Under penalties of perjury, I state that, to the best of my knowledge, the information contained in this application is true, correct, and complete. Property owner’s or authorized representative’s signature Date Subscribed and sworn to before me this day of , If you have any questions, please call: (309) 558-3660 Notary public Mail your completed form PTAX-334 to: Supervisor of Assessments 1504 3rd Ave Rock Island, IL 61201 Date American LegalNet, Inc. www.USCourtForms.com