A.__The name, address and phone number of the landowner, any designated agent and, if known, any harvester or harvesters;

B.__The name and address of any licensed professional forester consulting the landowner on forest management or harvesting practices;

C.__The municipality or township and county of harvest;

D.__The name of the nearest public or private all-weather road;

E.__The approximate dates the harvest will begin and finish;

F.__The anticipated acreage to be harvested;

G.__An indication whether the land being harvested is taxed under the Maine Tree Growth Tax Law.__If the land being harvested is taxed under the Maine Tree Growth Tax Law, the notification must include a statement, signed by the landowner, indicating that the harvest is consistent with the forest management and harvest plan required by Title 36, section 574-B, subsection 1.__A licensed professional forester who has a fiduciary responsibility to the landowner may sign the statement required in this paragraph.

Failure to indicate that the harvest is consistent with the forest management and harvest plan constitutes a withdrawal from taxation under the Maine Tree Growth Tax Law of the land being harvested in a manner that is not consistent with the forest management and harvest plan.__When such failure is indicated, the director shall notify the assessor for the jurisdiction in which the parcel is located that the land or a portion of the land no longer meets the requirements of Title 36, chapter 105, subchapter 2-A and must be withdrawn in accordance with Title 36, section 581;

H.__Whether the land is being harvested to convert to another use within 2 years and, if so, what that use is to be.

If the land being converted to another use is taxed under the Maine Tree Growth Tax Law, notification of a change of land use under this subsection constitutes a withdrawal from taxation under the Maine Tree Growth Tax Law of that portion of land being converted to another use.__When a change in