FFPA COMBINATION INSTRUCTIONS

Per RCW 76.04.610 Section 2.2b

Property owners with six (6) or more parcels in a single county, who qualify for a refund under this section, may apply to the department to have the assessment combined onto a single parcel.

1. LANDOWNER - Attach copies of current tax statements to application and submit to the Department of Natural Resources at the address below.

2. DNR will verify accuracy of acreage and assessment with County Assessor as needed.

3. DNR will compute the combined assessment and submit information to the County Assessor to apply assessment to the allocated parcel.

4. COUNTY will then apply the forest fire protection assessment on the allocated parcel.

5. LANDOWNER is responsible for notifying DNR of any changes in parcel ownership.

SUBMIT APPLICATION TO: Department of Natural Resources Resource Protection Division P O Box 47037 Olympia, WA 98504-7037

In order to ensure these changes affect the following year tax rolls, DNR must receive the application by September 1. Applications may be received after this date, but may not take affect for up to 2 years.

Questions or concerns, contact the Department of Natural Resources, Resource Protection Division at: 1-360-902-1300 Page ___ of ___ FFPA COMBINATION State of Washington Department of Natural Resources Application to Combine Forest Fire Protection Assessment (FFPA)

COUNTY ______

Name: (As shown on Tax statement. To qualify, the name must be the same on each parcel listed.)

______

Mailing Address ______

City ______State ______Zip ______

Phone Number ______Email ______Please print, type or attach a computer list. (List only parcels less than 50 acres each.)

Parcel Number FPA Acres Parcel Number FPA Acres

* Landowner – Identify preferred parcel to apply total assessment.

By signature below, the landowner verifies all information is correct. Inaccurate information may be cause for rejection. Notice of any changes to the ownership of the above listed parcels must be submitted to the Department of Natural Resources.

Landowner Signature ______Date ______

FOR COUNTY ASSESSOR: By signature below, the County Assessor verifies the parcels listed are assessed the Forest Protection Assessment and the FPA acres are as noted on the county tax rolls, or corrections have been made as noted above.

Assessor ______Date ______Stamp or Signature of County Assessor