Bastrop County, TX · Bastrop County
LPHCP Declination of Coverage
Bastrop County property owners use this form to decline incidental take coverage through participation in the Lost Pines Habitat Conservation Plan.
At a glance
- Issued by
- City of Bastrop County · Bastrop County, Bastrop County, Texas
- Notarization
- Not required: file this form without a notary.
- Official source
- bastropcounty.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This form records a property owner’s decision to decline incidental take coverage through the Lost Pines Habitat Conservation Plan. It explains potential sanctions and loss of eligibility for certain wildlife management tax appraisal privileges, and asks for the owner’s name, signature, property ID number, and date. The form also has fields for county administrative use, including project address and processing dates.
Who needs it
A property owner who chooses to decline incidental take coverage through the Lost Pines Habitat Conservation Plan completes and signs this form.
How to submit it
The form lists the LPHCP Administrator at 1041 Lovers Ln, Bastrop, Texas 78602, and phone numbers 512-332-7284 and 512-332-7285. It does not specify a submission method.
About notarization
This document is signed without a notary; it contains no notarized or sworn attachment, so the property owner signs and dates it.
How to submit this form
- 1
Download the Form
Download the LPHCP Declination of Coverage PDF.
- 2
Complete the Owner Fields
Print your name and enter your property ID number and date.
- 3
Review Before Signing
Read the form’s statements about declining coverage and the consequences described.
- 4
Sign the Form
The property owner signs the document; the form does not list an attachment to gather.
- 5
Contact the LPHCP Administrator
The form lists the administrator’s Bastrop address and phone numbers but does not specify a submission method.
Frequently asked questions
- What does the LPHCP Declination of Coverage do?
- It records a property owner’s decision to decline incidental take coverage through the Lost Pines Habitat Conservation Plan and explains related consequences.
- Who completes this form?
- The document says only the property owner can sign it. It requests the owner’s printed name, signature, property ID number, and date.
- Do I need a notary for the LPHCP Declination of Coverage?
- No. The form has no notary block or notarized attachment; the property owner signs and dates it.
- How do I submit the LPHCP Declination of Coverage?
- The form lists the LPHCP Administrator at 1041 Lovers Ln, Bastrop, Texas 78602, and two phone numbers, but does not state how to submit the form.