The Carbon Fund

Application For Long-Term Contracted Assistance

Last Name: ___________ First Name: __________ Middle Initial: ___

Address: ________________________________________________________

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City: ________________ State: _______________ Zip Code: _________

Telephone: _______________________ Fax: _________________________

Email Address: __________________________________________________

I (We) ____________________ hereby apply for application in this program and submit the following information in support of the application.

PART 1. OWNERSHIP, LOCATION AND SIZE

I (We) hereby attest that the name(s) listed directly above, have complete control of the property and said title described in (1) and (2), respectively, below.

(1) Do you have an unencumbered title to the property? yes ______________ no _____________ If no, what are the encumbrances? ___________________________________________________

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(2) Description and location of the farm or land:

County(ies): ____________________________________________________

Section: _____________ Township: ____________ Range: ____________

Acreage of land committed with this application (100 acre minimum): _______________________________________________________

Attach U.S. Geological Survey Quadrangle Map with boundary lines drawn on map.

PART 2. FEDERAL/STATE CONSERVATION PROGRAMS

(1) Is the land now enrolled in such programs as the Conservation Reserve Program, Wetland Reserve Program, Forestry Incentives Program, Partners For Fish And Wildlife or other federal or state conservation programs? If yes, what is the remainder of the contract/easement period? _____________________ What is the expiration date of the contract/easement? _______________________

(2) Would the applicant prefer that the land remain eligible for enrollment in such programs? yes ______________ no _____________

PART 3. SOIL TYPE/CONDITION AND FLOODING/DRAINAGE

(1) What are the dominant soil types on the property? Attach Natural Resource Conservation Service Soil Maps (from County Soil Survey) with boundary lines drawn on map. Attach copy of the definitions of each soil type from the map book. ________________

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(2) Are there any soil conditions (i.e., hard pan, salt residue, etc.) that could reduce forest productivity? ____________________ _________________________________________________________________

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(3) What is the frequency and duration of flooding on the property? _______________________________________________________

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(4) What, if any, hydrology modifications (i.e., ditches, drains, dikes, pumps, etc.) have been made to the land following the clearing of the land in question? _______________________________ _________________________________________________________________

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PART 4. CURRENT LAND USE

(1) How is the land currently being used? (i.e. row crop, fallow, rice, catfish, pasture, cottonwood plantations, etc.) ___________

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(2) Describe the current percentage of tree cover. ______________ _________________________________________________________________

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PART 5. LAND USE HISTORY

(1) Was the land cleared for agricultural or aquacultural production prior to 1990? yes ______________ no ________________

(2) How has the land been used since 1990? ______________________ _________________________________________________________________

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PART 6. FUTURE LAND USE CONSIDERATIONS

If the land can not be a part of any of the state/federal conservation program nor The Carbon Fund's Carbon Sequestration Management Program, how will the land be used in the future? (i.e., continue current land use, sale for development, etc.)

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PART 7. APPLICATION FEE

Enclosed is a check in the amount of $2.50 per acre as the application fee for this program. The application fee will be refunded: 1) if you do not qualify, 2) after your carbon credits are sold, or 3) in the event they are not sold. If you apply and retract your proposal, they may not be refunded. Please mail the application to: The Carbon Fund, PO Box 100, Stoneville, MS 38776.

For more information, call The Carbon Fund at (662) 686-3375 or log onto www.thecarbonfund.org.