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2. Conservation Use Application Fee Submission Form
4. IMPORTANT:
   This does NOT take the place of the original PT-283A. The original document must be submitted to the Assessor's office via hand delivery or postmarked by April 1st. You can use this form to pay your fee in lieu of cash or check.
6. Select Year
   -- Select One --20192020202120222023
8. Applicant Name
10. Mailing Address
12. City
13. State
14. Zip Code
16. Phone Number
17. Parcel ID
21. Date
    Date
22. Upon submission:
    A print and submit function is enabled on this form. To pay by credit card, please close the form after printing for your records and you will be automatically directed to the payment portal.
24. Lumpkin County uses a third party to process card payments. If you choose to pay by card, you will be directed from our site to NMI's payment gateway.
Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit Submit and Print

* indicates a required field