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In the section that says "Completed by Requestor and Tax Collector," enter the name of the person requesting the cutout, the parcel number that is having a piece removed (or "cut out"), the property/legal description, who it is currently assessed to and their mailing address.
In the next section, you must enter the description of the piece of property that is to be cut out, who it should be assessed to and their mailing address. Leave the remainder of the form blank. (The parcel number for the cutout property will be issued during the cutout process.)
Sign where it says "Signature of person requesting cutout."