2019 AgriStability Interim Payment Application
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.
By submitting this Interim Application, you agree to meet all participation requirements of the AgriStability program for the 2019 program year. This application allows you to estimate your income and production for the 2019 program year. The Administration can then issue a payment based on a percentage of your estimated program year benefits. If your final 2019 payment differs for any reason from the 2019 Interim Payment, any overpayments must be repaid by you, and any underpayments will be paid to you.
Name (Individual or Entity):
Participant Identification Number (PIN):
- 1a) Are you a new participant? If the answer is "Yes", complete Schedule 1 (sections a, b, c) and Schedule 2. Yes/No
1b) Since your last application have you:
- Changed your address or telephone number? If "Yes", provide the new information on Schedule 1, section a. Yes/No
- Changed your contact person information? If "Yes", complete Schedule 1, section b. Yes/No
- Changed your business structure? If "Yes", complete Schedule 1, sections c and d. Yes/No
2a) Did you complete a production cycle on at least one of the commodities you produce? Yes/No
If "No", was at least half of your farm's total production not completed due to disaster circumstances? Yes/No
- 2b) Are you, or anyone who helped you complete your form, a current or former federal public office holder or employee of Agriculture and Agri-Food Canada? Yes/No
2c) Did you produce commodities that were, or could have been, insured under AgriInsurance (production or crop insurance)? Yes/No
Are the majority (more than half) of your insurable crop acres insured at 70% or higher?
- 2d) Have you submitted a complete 2018 AgriStability application? If "No", complete Schedule 2. Yes/No
3a) Is this farming operation part of a Whole Farm? If yes, please provide PINs for all operations. Yes/No
- 3b) If you are a partner in a partnership, enter your share of the partnership and complete the fields for the other partners. Attach a separate sheet if you require additional space.
Partnership information (if applicable)
Note: Enter a Participant Identification Number (PIN) for each of your partners. Enter the first and last names for individual partners. Enter the corporation's name for corporate partners. Your partnership's total shares must equal 100%.
- Your % share of the partnership:
|AgriStability PIN||Individual's first name||Individual's last name||Corporation name||% share|
Confidential information and participant consent
The information on this form is collected under the authority of Section 4 of the Farm Income Protection Act (FIPA) and will be used for the purposes of administering your participation in the AgriStability program; determining your eligibility for benefits; verifying the information submitted; issuing tax receipts; administering benefits under other farm income and special assistance programs; and for the purposes of audit, analysis and evaluation of the AgriStability and other farm income and special assistance programs by the Administration, AAFC, the provincial/territorial governments or third parties engaged for that purpose.
The Privacy Act protects information you give on this form which is kept in personal information bank number AAFC PPU 183.
By submitting this application form, you:
- certify that the information you provided on this form is complete and accurate. You understand that it is a criminal offense to make a false statement in application for program benefits and any declarations made are subject to audit;
- certify that you have completed at least six months of farming activity and a production cycle in the Program Year, or could not for reasons beyond your control;
- understand and agree that as a condition of receiving an Interim payment, you must participate in AgriStability and submit a complete 2019 AgriStability form by the deadline to be entitled to any AgriStability benefits;
- understand that any Interim payment of AgriStability program funds will be deducted in the calculation of your final AgriStability program payment;
- agree to repay any overpayment amount received as an Interim payment if the amount exceeds your final 2019 AgriStability program payment. You understand thatinterest will be charged on overpayments;
- understand any amount you owe to the Crown will be subtracted from an Interim payment;
- understand and agree that the person you identified as your contact person may receive information relating to your form from the Administration and may instruct the Administration to modify the information on your form;
- consent to the use and disclosure of the information contained in this form to officials from Agriculture and Agri-Food Canada and the provincial/territorial department responsible for agriculture to administer your application for AgriStability, and for the purposes of audit, analysis and evaluation of the AgriStability program;
- consent to the use of any information you submitted to the AgriStability or AgriInsurance (production or crop insurance) agencies to administer this application;
- understand and agree that the information you submitted may be combined with information of other participants to determine your Interim payment; and
- consent to the disclosure of information pertaining to you and your financial affairs to the other participants being combined with your information.
Program year farming activity
4a) Program year payments
For each of the following, provide the amounts you have received or expect to receive for the 2019 program year:
- AgriInsurance (production or crop insurance) payments: $
- Program payments (see Interim Guide list of program payments): $
4b) Allowable expenses
If you had no significant change to the expenses listed, check the “no significant change” box.
If you had a significant change to the expenses listed, provide the total amount of the expense (not just the amount of the increase or decrease).
Expenses Expense categories No significant change Total expected expense amount Seed purchases Feed purchases Fertilizers and soil supplements Pesticides and chemical treatments Machinery (gasoline, fuel, oil) Arm's length salaries
4c) Did your productive capacity decrease during the program year due to disaster circumstances?
- For Crops Yes/No
- For Livestock Yes/No
4d) Crop Production
Code Crop description Acres Unseedable acres Production (tonnes)
Production intended for sale (tonnes) Price per tonne ($) $ $ $ $ $ $ 17 Summerfallow Acres 18 Pasture Acres 19 Wasteland Acres
4e) Livestock Production
Livestock - Cattle/Hogs - Production Code Productive animals 2019 Productive capacity 2019 Production Average wean weight 8004 Cow/Calf Number of cows that calved Number of calves born 8004 Cow/Calf Number of cows that calved Number of calf feed days N/A 8751 Hogs, Farrowing Number of sows that birthed Number of animals born 8760 Hogs, Farrow to Finish Number of sows that birthed Number of animals born N/A N/A = not available Livestock - Cattle/Hogs - Feeder Code Feeder livestock 2019 Productive capacity 2019 Production 8066 Feeder Cattle, fed up to 900 lbs Number of animals fed Number of animal feed days 8068 Feeder Cattle, fed over 900 lbs Number of animals fed Number of animal feed days 8762 Hogs, Nursery up to 50 lbs Number of animals fed Number of animal feed days 8761 Hogs, Feeders fed over 50 lbs Number of animals fed Number of animal feed days Custom Fed Livestock Code Custom Fed Livestock 2019 Productive capacity 8133 Cattle Number of animal feed days 8749 Hogs Number of animal feed days Supply Managed Commodities Code Supply Managed Commodities 2019 Productive capacity 2019 Production Estimated Price ($) 7650 Chickens, Broilers kilograms of quota kilograms produced $ 7862 Turkey, Broilers kilograms of quota kilograms produced $ 7663 Chicken,layers,broilers,eggs for hatching Number of hens producing dozens of eggs produced $ 7664 Chicken,layers,eggs for consumption Number of hens producing dozens of eggs produced $ Other Production Code Other Production: Specify 2019 Productive capacity 2019 Production Estimated Price ($) $ $ $ $
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