Have you pursued, or are you pursuing, any subdivision or development approvals on the property? Yes No
If yes, please describe:
Dates of Prel. & Final Approvals: (Provide documentation of approvals)
Is the property currently listed for sale with a realtor? Yes No
If yes, please provide name and phone #:
Email Address:
What is your asking price for this property (required)?
*NOTE
While the asking price is a key element in the evaluation of this property, it is non-binding, and is not a commitment on the part of the
State of New Jersey to pay this amount should this
property be selected for acquisition.
Please tell us about your property, including any unique or special environmental features, known historical associations, and
any bodies of water on the property or bordering the property. (Use back of application if more space needed.)
Representative Information
Do you authorize a person to act as your representative in all matters pertaining to this application? Yes No
What is this person’s relationship to you (i.e., family member, realtor, attorney)?
Name of Representative:
Representative’s Street Address:
City, State, Zip Code: Telephone:
Email Address:
Signature of Representative:
Note: Any Agreement for sale / purchase shall be signed by the Owner.
Attachments
Copies of the following documents are requested though not required for application:
Tax Map: Yes No Title Insurance Policy: Yes No
Deed of Property: Yes No Survey: Yes No
Structure Photos: Yes No
Owner Certification
I hereby certify that the information included in this application is true, that I am the legal owner of the property
described above, that I have marketable title to the property and that I have the legal right to sell the property. I
hereby authorize the staff of the Green Acres Program to conduct such site inspections on the property as are
necessary to this application.
Note: All persons having an ownership interest must sign as owners (Use back of application if more space needed). Pursuant to P. L.
2005, C.51; certain political contributions exceeding $300 may preclude the State from purchasing the landowner’s property. For more
information, please consult
www.state.nj.us/treasury/purchase/execorder134.htm
Signature of Owner (Applicant) Date Signature of Owner (Co-Applicant) Date