Region:	Date:	State-Owned Land Project No.:	- - -
SECTION 1 – Owner Agency, Department or Institution Contact Information
Agency/Department/Institution Name:
State Contact Person:	Title:
Phone No.:	Email:
Mailing Address:
City:	Zip Code:
Local Contact Person:	Title:
Phone No.:	Email:
Mailing Address:
City:	Zip Code:
SECTION 2 – Property Information
County:	IFRIS Tract Number:
Property Address:
City:	Zip Code:
SECTION 3 – Forest Management Project Recommendations
Project Type:
Type of Timber Harvest Project: (Indicate total acreages on all that apply and explain in recommendations)
Proposed Harvest:	acres
(Any project involving a proposed timber harvest requires approval by the Department of General Services in Section 8 of this form.)
Type of Management Project: (Indicate total acreages on all that apply and explain in recommendations)
Site Preparation:	acres	Planting:	acres	Pine Release:	acres
TSI:	acres	Other:	acres	(explain)
Recommendations: (Indicate stand identifiers)
Planned Completion Date:
SECTION 4 – VDOF Forester Approval
I certify that the above project is needed and recommendations have been made in compliance with the Forest Management of State-Owned Lands Fund Act (§10.1-1120 through §10.1-1123 of the Code of Virginia.)
VDOF Forester Name (Print)	VDOF Forester Signature	Date
SECTION 5 – Agency/Department/Institution Approval
I certify that I am an authorized representative of this agency, department or institution and have agency authorization to sell and/or utilize state-owned assets. I verify the ownership of this property and certify that there are no covenant restrictions that would hinder the recommended management activities. I hereby authorize the Virginia Department of Forestry to proceed with the forestry work as outlined in the recommendations of this State-Owned Land Forest Management Project Request.
Agency/Department/Institution Representative Name (Print)	Agency/Department/Institution Representative Signature	Date
SECTION 6 – VDOF State-Owned Lands Coordinator Approval
I have reviewed and approve the forest management recommendations for the state-owned land property as outlined in this State-Owned Land Forest Management Project Request.
VDOF State Lands Coordinator Name (Print)	VDOF State Lands Coordinator Signature	Date
SECTION 7 – VDOF Management Approval
I have reviewed and approve the forest management recommendations for the state-owned land property as outlined in this State-Owned Land Forest Management Project Request.
VDOF Deputy State Forester Name (Print)	VDOF Deputy State Forester Signature	Date
SECTION 8 – Timber Harvest Approval by the Department of General Services
(Only required for projects that include timber harvests.)
I agree with the Virginia Department of Forestry that the forestry work outlined should be undertaken at the present time.
Director of General Services Approver Name (Print)	Director of General Services Approver Signature	Date