Assistance - Template

Site Name:

Address:

City:

County:

State:

Zip:

Directions:

Section:

Tier:

Range:

Long:

Lat:

Assistance ID:

Staff Assisting:

Program Type:

Contact:

Action Date:

Report

Attached Files/Reports

File Name	File Type	File Date	Note

Comments

Date	Comment	Commenter
7/17/2018	Name change and partial owner change. Need to pay $250 only because they have already paid indemnity and done new plan last year when change occurred. Our error.	LOIS BENSON

Assistance Details:

Field Office Compliance - Assistance