Southern Pine Beetle (Cost Share Program) Restoration - Tree in the Right Place” “Right FORESTRY COMMISSION 2014 APPLICATION & CONTRACT Property (As listed on Tax Records): Mailing Address: City: State: Zip Code E-Mail: Home Phone: Cell Phone: Fax No: Land Location - Land Location - County: Description Longleaf Pine Planting Slash Pine Planting White Pine Planting Loblolly Pine Planting Shortleaf Pine Planting Practice Requested: acres acres acres acres Primary Contact (if different from above) Phone No.: NOTE: ALL COST DOCUMENTATION IS REQUIRED TO BE TURNED IN TO GFC WHEN PRACTICE IS COMPLETE Georgia Forestry Commission Official Use Only Acres Acres Rate C / S Acres C / S Requested Component Name Organization # Approved $ / acre Approved Performed Earned Slash, Loblolly, Shortleaf & White Pine Establishment Longleaf Pine Establishment 4203100235 Hardwood Establishment TOTALS** Tract Ranking: Select applicable boxes & enter multiplier Practice Rates Per Acre Date Practice to be Completed: Initial Needs Approval: GFC Forester Signature Date Performance Check Approval: GFC Forester Signature Date Explain any amendments approved by GFC Forester: Approved for Payment by: Administrative Representative Date Received I have read, understand and agree to all terms and conditions in this application and contract, as attested to by my below signature. Applicant Name (Print): _______________________________ Applicant Signature: _________________________________________ Witness Signature: Date: ________________________________________ ___________________________________ SPBPR-245 04/2014 An original, signed contract, a copy of the lawful presence affidavit and a completed request for payment form should be mailed to GFC Macon Management Department, Mandy Elliott, for payment once the performance check has been completed.
Southern Pine Beetle (Cost Share Program) Restoration - “Right Tree in the Right Place” FORESTRY COMMISSION 2014 APPLICATION & CONTRACT Property (As listed on Tax Records): Mailing Address: City: State: Zip Code E-Mail: Home Phone: Cell Phone: Fax No: Land Location - County: Land Location - Description Practice Requested: Longleaf Pine Planting Slash Pine Planting acres White Pine Planting acres Loblolly Pine Planting acres Shortleaf Pine Planting acres Primary Contact (if different from above) Phone No.: NOTE: ALL COST DOCUMENTATION IS REQUIRED TO BE TURNED IN TO GFC WHEN PRACTICE IS COMPLETE Georgia Forestry Commission Official Use Only Acres Requested Component Name Organization # Acres Approved Rate $ / acre C / S Approved Acres Performed C / S Earned Slash, Loblolly, Shortleaf & White Pine Establishment Longleaf Pine Establishment 4203100235 Hardwood Establishment TOTALS** Tract Ranking: Select applicable boxes & enter multiplier Practice Rates Per Acre Date Practice to be Completed: Initial Needs Approval: GFC Forester Signature Date Performance Check Approval: GFC Forester Signature Date Explain any amendments approved by GFC Forester: Approved for Payment by: Administrative Representative Date Received I have read, understand and agree to all terms and conditions in this application and contract, as attested to by my below signature. Applicant Name (Print): _______________________________ Applicant Signature: _________________________________________ Witness Signature: ________________________________________ Date: ___________________________________ SPBPR-245 04/2014 An original, signed contract, a copy of the lawful presence affidavit and a completed request for payment form should be mailed to GFC Macon Management Department, Mandy Elliott, for payment once the performance check has been completed.
SPB%20-%20Contract%20(Reforestation)%20-%202014.docx