County	Excess Parcel No.
Route	Unique Identification No.
Job No.	Effective Date of Value
1.	Requester:
2.	Requester’s Proposed Use:
3.	Ownership Interest:
Has Legal Determination Been Made?	Yes No
4.	Location of Realty Asset:
5.	Description of Realty Asset:
6.	Potential Highest & Best Use - Determination of Assemblage or Stand Alone
Assemblage to Adjoining Property:
Use of Adjoining Land:
Unit Value of Adjoining Land: $
Potential Contribution to Adjoining Land:
Stand Alone:
Potential Use:
Use of Comparable Land:
Unit Value of Comparable Land: $
7.	Calculation of Land Value to be Sold:
Sq. Ft. Acres	@	$	per unit =	$	0.00
Prepared By:	Date
Approved By:	Date
Value Assumptions:	MHTC has full fee interest Parcel can be developed or marketed for its highest and best use
Parcel will be marketed to a party expected to pay the full-appraised amount