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2019 AgriStability Interim Application Schedule 1 — Additional Information

This HTML document is not an application form. Its purpose is to display the information as found on the form for viewing purposes only. If you wish to submit an application form, please use the PDF version. If you cannot access the PDF version or require printed copies of this publication, please contact us at 1-866-367-8506.

  • If you answered "Yes" to question 1a on the Interim application, complete all sections of this form.
  • If you answered "Yes" to question 1b on the Interim application, only complete the sections that have changed from your last application

The Privacy Act protects information you give on this form which is kept in personal information bank number AAFC PPU 183.

Participant Identification Number (PIN):

a) Participant identification

  • Name (individual or entity)
  • Address:
  • City/Town:
  • Province/Territory:
  • Postal Code:
  • Telephone:
  • Fax number:
  • Email address:
  • Social Insurance Number (SIN):
  • Business number:
  • Trust number:

b) Contact person information

If you would like someone else to provide additional information on your behalf, provide all details in this section.

  • Name (individual):
  • Business name:
  • Address:
  • City/Town:
  • Province/Territory:
  • Postal Code:
  • Telephone:
  • Fax number:

By providing a contact person's name, you are authorizing the AgriStability Administration to receive information from and to disclose information to the contact person, and to make changes to your applications as directed by the contact person.

c) Business structure

  • Fiscal Period Start (Year/Month/Day):
  • Fiscal Period End: (Year/Month/Day):
  • Main Farmstead Location:
    • Province/Territory:
    • District/County/Municipality number:
    • District/County/Municipality/Name:
  • Farm type:
    • individual
    • corporation
    • limited partnership
    • communal organization
    • co-operative
    • trust
    • member of a partnership
    • a Status Indian farming on a Reserve
    • Band farm
      Band number:

d) Change to business structure

Please identify how your business structure has changed:

  • incorporated
  • formed a partnership
  • changed your fiscal year end
  • changed your method of accounting
  • other (please provide details)

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2019 AgriStability Interim Application Schedule 1 – Additional Information (PDF Version, 132 KB)

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