QUALIFICATIONS
FOR THE
FARM AND RANCH PROGRAM
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To qualify as a Centennial Farm or Ranch, your property must meet the following criteria:
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1. Does your farm or ranch meet these qualifications? __ Yes __ No
2. Name(s) of farm or ranch owner(s): ________________________________
Address: ____________________________________________________
City/State/Zip: ________________________________________________
Telephone: (_____)_________________________
Farm Address (if different): ___________________________________
City/State/Zip: _____________________________________________
3. Name of farm or ranch to appear on your certificate. The name must be limited to
twenty (20) characters, including spaces and punctuation:
__________________________________________________________
4. The metal sign you receive should be for a __ farm or a __ ranch.
5. Name of the person who farms or ranches on your property if not yourself:
___________________________________________________________
6. If you listed a person in Item #5, how is that individual related to you?
___________________________________________________________
7. If the person who leases your land is not a member of your family,
do you live on the farm or ranch? __ Yes __ No
Are you over age 65? __ Yes __ No
8. What are the major crops or products of your farm or ranch?
_____________________________________________________________
_____________________________________________________________
9. In what county is your farm or ranch located? _________________________
10. What is the legal description of your farm or ranch (Section, Township, Range)?
___________________________________________________________
___________________________________________________________
11. Provide directions for finding your farm or ranch beginning in the nearest city/town.
___________________________________________________________
___________________________________________________________
12. How many acres does your farm or ranch include? ________________
13. State House of Representatives District Number: _____________________
14. State Senate District Number: ____________________________________
15. In what year did a member of your family originally occupy your farm or ranch?
_________________
16. List all family members, from the original to the present, who have occupied your
farm or ranch:
(Name) (Relationship to Present Owner)
____________________________ _____________________________
____________________________ _____________________________
____________________________ _____________________________
____________________________ _____________________________
____________________________ _____________________________
____________________________ _____________________________
17. Provide copies of documents that contain date of original occupation, original
claimant’s name and legal description of original claim. Attached are:
__ Abstracts __ Grants __ Titles
__ Records of Indian
Agencies __
__ Federal Tract Book Information __ Other
18. Please provide the following historical information about your farm or ranch:
a. How many acres were in the original farm or ranch? ______________
b. What crops and/or livestock were produced on the original farm or ranch?
______________________________________________________
______________________________________________________
c. How did your family acquire the farm or ranch?
______________________________________________________
d. Briefly summarize one or two interesting stories about your farm or ranch.
(Add extra sheets if needed)
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
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____________________________________________________________
____________________________________________________________
19. If your farm or ranch includes buildings or structures over 50 years old, you may
qualify for a special Centennial Farm and Ranch Historic Structures Award.
In order to be eligible for the Historic Structures Award, a farm or ranch must
have four (4) standing buildings (house, granary, barn, chicken coop, etc.) or
structures (windmill, corral, ditch, etc.) that are more than 50 years of age and
have not been significantly altered.
Please complete the Oklahoma Historical Society, State Historic Preservation
Office’s “Historic Preservation Resource Identification Form” for each building
or structure and provide the photographs as detailed in the instructions
accompanying the form. (The form and instructions are available on our website
under under the National Register, “Preliminary Opinion” section, or you may
request them from our office at the address below or by calling 405/521-6249.)
Please list buildings and structures on your farm or ranch (farmhouse, barn, sheds,
windmill, etc.) and give the approximate date of construction and current use.
(Buildings) (Date of Construction) (Current Use)
______________________ _______________________ ____________________
______________________ _______________________ ____________________
______________________ _______________________ ____________________
______________________ _______________________ ____________________
Check here __ if you are applying for the Centennial Farm and Ranch Historic
Structures Award.
I declare that the statements made in this application are accurate and correct to the best
of my knowledge.
_____________________________________________ ________________
Signature Date
………………………………………………………………………………………………
Return application and
$10.00 registration fee to:
State Historic Preservation
Office
(Application Revised 10-2001)