ARM-LWR-209 (rev. 07/21)	DATCP USE ONLY:
Wisconsin Department of Agriculture, Trade and Consumer Protection Division of Agricultural Resource Management PO Box 8911, Madison, WI 53708-8911 (608)224-4632	RECEIVED DATE: ______________
PERPETUAL EASEMENT APPLICATION Wis. Stat. §93.70

Personal information you provide may be used for purposes other than that for which it was originally collected. Wis. Stat. § 15.04(1)(m).

SECTION 1A. COUNTY INFORMATION:
Separate applications must be made for enrolling lands in two or more counties.
RESPONSIBLE COUNTY AGENCY:
AUTHORIZED COUNTY REPRESENTATIVE:
ADDRESS:	CITY:	STATE:WI	ZIP CODE:
TELEPHONE NUMBER: ( ) -	EMAIL:
EASEMENT HOLDER
Perpetual conservation easement is to be held by: (choose one)
County DATCP Other
SECTION 1B. LANDOWNER and FEDERAL CONTRACT INFORMATION
All legal owners as indicated on the deed(s) for the land identified in Section 3 must be listed below along with contact information.
Primary Landowner Type (check one) Individual Corporation Partnership Trust Other
1.) NAME OF LANDOWNER (Primary): (Individual, Corporation, Partnership etc. Spouse of an individual owner must be included)
ADDRESS:	CITY:	STATE:	ZIP CODE:
TELEPHONE NUMBER: ( ) -	EMAIL:	PERCENT OF PAYMENT:
2.) NAME OF LANDOWNER:
ADDRESS:	CITY:	STATE:	ZIP CODE:
TELEPHONE NUMBER: ( ) -	EMAIL:	PERCENT OF PAYMENT:
3.) NAME OF LANDOWNER:
ADDRESS:	CITY:	STATE:	ZIP CODE:
TELEPHONE NUMBER: ( ) -	EMAIL:	PERCENT OF PAYMENT:
4.) NAME OF LANDOWNER:
ADDRESS:	CITY:	STATE:	ZIP CODE:
TELEPHONE NUMBER: ( ) -	EMAIL:
5.) NAME OF LANDOWNER:
ADDRESS:	CITY:	STATE:	ZIP CODE:
TELEPHONE NUMBER: ( ) -	EMAIL:
6.) NAME OF LANDOWNER:
ADDRESS:	CITY:	STATE:	ZIP CODE:
TELEPHONE NUMBER: ( ) -	EMAIL:
NOTE: Payments can only be made to up to three separate legal landowners and will be made in the manner indicated by the percentages listed above.

SECTION 1B. LANDOWNER and FEDERAL CONTRACT INFORMATION CONTINUED
FEDERAL CONTRACT INFORMATION
CRP-1 CONTRACT NUMBER(S): , ,	CRP SIGN-UP NUMBER:	CREP Reenroll:
CRP-1 EFFECTIVE DATE: (CRP-1, Box 9)	AGREEMENT EXPIRATION DATE: (CRP-1, Box 9)	PRIOR STATE AGREEMENT(s) #: (Reenrolls only)

SECTION 2. NOTICE TO MORTGAGE HOLDER & LAND CONTRACT VENDOR
ALL MORTGAGE HOLDERS OR LAND CONTRACT VENDORS MUST SIGN THIS APPLICATION. I hereby acknowledge receipt of notice that the parcels listed in this CREP application, as applicable, are applying for a perpetual conservation easement and understand that I will be required to sign the easement. The signature of the mortgage holder/lender or Land Contract Vendor shall not be construed as a subordination of its mortgage lien or land contract rights nor as of any other significance beyond receipt of the notice herein.
1.) Mortgage Land Contract
LENDER/VENDOR NAME:
REPRESENTIVE NAME:	REPRESENTATIVE TITLE:
REPRESENTIVE SIGNATURE: ________________________________________ DATE: _____________
2.) Mortgage Land Contract
LENDER/VENDOR NAME:
REPRESENTIVE NAME:	REPRESENTIVE TITLE:
REPRESENTIVE SIGNATURE: ________________________________________ DATE: _____________
3.) Mortgage Land Contract
LENDER/VENDOR NAME:
REPRESENTIVE NAME:	REPRESENTIVE TITLE:
REPRESENTIVE SIGNATURE: ________________________________________ DATE: _____________
4.) Mortgage Land Contract
LENDER/VENDOR NAME:
REPRESENTIVE NAME:	REPRESENTIVE TITLE:
REPRESENTIVE SIGNATURE: ________________________________________ DATE: _____________
Other Parties with Interest in the Land: (List below the type of interest, name of party and contact information if available of other known parties with legal interest in the land. Such as mineral rights, rail road corridors, pipelines, right of first refusal, etc)

SECTION 3. LOCATION and PAYMENT ESTIMATE (Attach additional sheets as necessary)
Lands indicated on the Conservation Plan must match lands listed in this section. A completed conservation plan is required prior to executing a perpetual conservation easement.

Table I

A. CP (One practice per section)	TRACT#:	FIELD #’s:	IN GRASSLAND PROJECT AREA
MUNICIPALITY	¼ ¼	1/4	SECTION	TOWNSHIP	RANGE	PARCEL TAX ID	ACRES
TILLABLE	ACRES X Rate1 X 12 = B. $0.00
NON-TILLABLE	ACRES X Rate1 X 12 = C. $0.00
D.TOTAL ACRES (Till+Non-Till) 0.00	E. INCENTIVE PAYMENT (B+C) $0.00	F. ESTIMATED (.40 x Practice cost) PRACTICE PAYMENT2

Table II

A. CP (One practice per section)	TRACT#:	FIELD #’s:	IN GRASSLAND PROJECT AREA
MUNICIPALITY	¼ ¼	1/4	SECTION	TOWNSHIP	RANGE	PARCEL TAX ID	ACRES
TILLABLE	ACRES X Rate1 X 12 = B. $0.00
NON-TILLABLE	ACRES X Rate1 X 12 = C. $0.00
D.TOTAL ACRES (Till+Non-Till) 0.00	E. INCENTIVE PAYMENT (B+C) $0.00	F. ESTIMATED (.40 x Practice cost) PRACTICE PAYMENT2

A. CP (One practice per section)	TRACT #:	FIELD #’s:	IN GRASSLAND PROJECT AREA
MUNICIPALITY	¼ ¼	1/4	SECTION	TOWNSHIP	RANGE	PARCEL TAX ID	ACRES
TILLABLE	ACRES X Rate1 X 12 = B. $0.00
NON-TILLABLE	ACRES X Rate1 X 12 = C. $0.00
D.TOTAL ACRES (Till+Non-Till) 0.00	E. INCENTIVE PAYMENT (B+C) $0.00	F. ESTIMATED (.40 x Practice cost) PRACTICE PAYMENT2
TOTAL EASEMENT ACRES: 0.00 1 based on information from the appropriate form CRP-2C, Block #14 2 based on information in federal form CRP-1, Block #10E (Add all Section 3. D’s)	TOTAL ESTIMATED INCENTIVE PAYMENT: $0.00 (Add all Section 3. E’s)

Table III

SECTION 4. SIGNATURES

This application is for a perpetual conservation easement from the Wisconsin Conservation Reserve Enhancement Program (WI CREP). The purpose of this program is to improve water quality and enhance wildlife habitat. A complete application includes the following forms and materials:

W-9 (Signed by landowner for those requesting payment as indicated in Section 1B)

Map (Clearly delineating the CREP area enrolled under the agreement along with other natural or man-made features such as lakes, ponds, swamps, rivers, streams, wood lots, roads, power lines, fences, lot lines, field boundaries and numbers, and structures including barns, houses and storage facilities)

GPS Data of Monument Locations (WISCRS Coordinates)

CRP-1 (Signed by FSA)

CRP-2C

CRP-23/24 (FSA approval letter to landowner)

Property Tax Bills (for all parcel(s) indicated in Section 3)

Title Search (for all parcel(s) indicated in Section 3. See TS Attachment for details)

Ownership Documents (to identify ownership such as deeds)

Signing Authority Documents (to identify signature authority for trusts, corporations, partnerships, POA, etc)

Environmental Benefit Report Summary (LWR-284)

Prior to executing a perpetual conservation easement, I must have completed a CRP-1, CRP-2C, a Conservation Plan, and a full title search of the property. The title search must go back to the first entry and disclose ownership and encumbrances on the lands submitted in this application. All parties with a legal interest in the land are required to sign the final easement document.

By submitting my application I authorize the WI CREP to begin the eligibility determination process for my property. I understand that the Farm Service Agency (FSA) will determine my initial eligibility and that my signature below does not constitute an eligibility determination. I also understand that my signature below does not obligate me to participate in the program nor does it obligate the WI CREP to make payments to me until a valid agreement and easement is executed; however, should I withdraw my application at any time during the title search, I understand that I am obligated to pay for all title search costs.

My signature below indicates that I have examined the application and all attached forms and materials and I certify that to the best of my knowledge and belief the application is true and correct.

_________________________________________________ _____________ SIGNATURE OF LANDOWNER DATE ____________________________________________________________________________________________________________________________________________________________________________________________________ PRINT NAME ____________________________________________________________________________________________________________________________________________________________________________________________________ TITLE or REPRESENTATIVE CAPACITY	_________________________________________________ _____________ SIGNATURE OF LANDOWNER DATE ____________________________________________________________________________________________________________________________________________________________________________________________________ PRINT NAME ____________________________________________________________________________________________________________________________________________________________________________________________________ TITLE or REPRESENTATIVE CAPACITY
_________________________________________________ _____________ SIGNATURE OF LANDOWNER DATE ____________________________________________________________________________________________________________________________________________________________________________________________________ PRINT NAME ____________________________________________________________________________________________________________________________________________________________________________________________________ TITLE or REPRESENTATIVE CAPACITY	_________________________________________________ _____________ SIGNATURE OF LANDOWNER DATE ____________________________________________________________________________________________________________________________________________________________________________________________________ PRINT NAME ____________________________________________________________________________________________________________________________________________________________________________________________________ TITLE or REPRESENTATIVE CAPACITY
_________________________________________________ _____________ SIGNATURE OF LANDOWNER DATE ____________________________________________________________________________________________________________________________________________________________________________________________________ PRINT NAME ____________________________________________________________________________________________________________________________________________________________________________________________________ TITLE or REPRESENTATIVE CAPACITY	_________________________________________________ _____________ SIGNATURE OF LANDOWNER DATE ____________________________________________________________________________________________________________________________________________________________________________________________________ PRINT NAME ____________________________________________________________________________________________________________________________________________________________________________________________________ TITLE or REPRESENTATIVE CAPACITY

ARM-LWR-209 TS Attachment (rev. 02/20)	TS ATTACHMENT
Wisconsin Department of Agriculture, Trade and Consumer Protection Division of Agricultural Resource Management PO Box 8911, Madison, WI 53708-8911 (608)224-4632
CREP Title Search Contracting Request Form	SUBMIT THIS DOCUMENT TO TITLE COMPANY

Date: 2/21/2020

Estimated Cost of Title Search: $ ______________

Name:	Address: ,
I am requesting a title search of the parcel(s) indicated below:
County:
¼ ¼	¼	Sec	Twn	Rng	Parcel Number(s):	Municipality

The title search should:

Be a full title search that is unrestricted as to the time back to the 1st entry. (Title search document should clearly identify that the search was back to “1st entry” or “Patent”.)

Provide a title insurance policy commitment (specifically, a “Minimum Title Insurance Commitment of $15,000”) including but not limited to the following:

Names of all present owners.

Tax statement of property from assessors office.

Last deed of record including legal description and any exceptions.

All easements of record and other encumbrances such as utilities, secondary roads and dedications unrestricted as to time.

All land contracts unrestricted as to time.

Judgments, Liens, Mortgage information, delinquent real estate taxes, state and federal tax liens unrestricted as to time.

CSMs and Subdivision Plats if applicable.

Include copy of deeds, land contracts, easements of record and other encumbrances listed in the search results.