1.  A timberland conversion certificate shall include:

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(a) The name and address of the holder.

(b) The legal description of the land to which it is applicable.

(c) The period of time for which it is valid.

(d) Any exemption granted from any provision of this chapter or any forest practice rule or regulation.

(e) Any additional conditions or requirements imposed.

2.  Such certificate is not transferable or assignable, but may be renewed by the holder upon a satisfactory showing of cause and necessity.