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AgriStability and AgriInvest: 2019 Statement A – Corporation/Co-operative and Special Individual (AgriStability)

This Web document is not a form. Its purpose is to display the information as found on the form for viewing purposes only. If you wish to submit a form, you must use the PDF Version (294 KB).

If you cannot access the alternative format, please call 1-866-367-8506.

Protected B when complete

Participant information

Participant indentification

Contact person information

If you would like someone else to provide additional information on your behalf, provide all details in this section. This applies only to the AgriStability and AgriInvest programs.

Do you want a copy of your Calculation of Program Benefits (COB) for the AgriStability program sent to your contact person? (Yes/No)

Note - If you have a contact person, you must complete this section each time you submit this form. The AgriStability and AgriInvest Administrations will replace any previous contact person you may have designated with the name you provide here.

By providing a contact person's name, you are authorizing both the AgriStability and AgriInvest Administrations 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.

Your farming information

Federal public office holder or employee of Agriculture and Agri-Food Canada

Are you, or anyone who participated in the preparation of this form on your behalf, a current or former federal public office holder or employee of Agriculture and Agri-Food Canada? (Yes/No)

Farm Type

(check all the applicable boxes)

Other farming information

Location of main farmstead, indicate your district, county or municipality name and number:

Combined operations

Based on the AgriStability combining criteria outlined in the guide, should this operation be combined with another operation for the 2019 program year? (Yes/No)

Note: If you were combined in your last year of participation, you will automatically be combined for 2019, unless you answered “No” to the above question.

Identification – Complete a Statement B for each additional farming operation

Income

Enter the applicable code for each entry on the form. The codes are listed in the Commodity list and in the Program payment lists included in the Harmonized Guide.

Round all income amounts to the nearest dollar.

Commodity sales and program payments
Commodity sales and program payments Code Amount
Total A 9950 $
Other farming income
Other farming income Line Amount
Other program payments 9540
Business risk management (BRM) and disaster assistance program payments 9544
Resales, rebates, GST/HST for allowable expenses 9574
Resales, rebates, GST/HST for non-allowable expenses, recapture of capital cost allowance (CCA) 9575
Agricultural contract work 9601
Patronage dividends 9605
Interest 9607
Gravel 9610
Trucking (farm-related only) 9611
Resales of commodities purchased 9612
Leases (gas, oil well, surface, etc.) 9613
Machine rentals 9614
Other (specify): 9600
Total B $
Summary of income
Total A
Total B +
Gross farming income (enter on line 9959 on page 4) $

Expenses

Enter the applicable code for each entry on the form. The codes are listed in the Commodity list and in the Program payment lists included in the Harmonized Guide.

Round all expense amounts to the nearest dollar.

Commodity purchases and repayment of program benefits
Commodity purchases and repayment of program benefits Code Amount
Point of sale adjustments 575
Total C 9960 $
Allowable expenses
Allowable expenses Line Amount
Containers and twine 9661
Fertilizers and soil supplements 9662
Pesticides and chemical treatments 9663
Insurance premiums (crop or production) 9665
Veterinary fees, medicine, and breeding fees 9713
Minerals and salts 9714
Machinery (gasoline, diesel fuel, oil) 9764
Electricity 9799
Freight and shipping 9801
Heating fuel 9802
Arm's length salaries 9815
Storage/drying 9822
Commissions and levies 9836
Private insurance premiums for allowable commodities 9953
Total D $
Non-allowable expenses
Non-allowable expenses Line Amount
Machinery (repairs, licenses, insurance) 9760
Machinery lease/rental 9765
Advertising and promotion costs 9792
Building and fence repairs 9795
Land clearing and draining 9796
Agricultural contract work 9798
Other insurance premiums 9804
Interest (real estate, mortgage, other) 9805
Memberships/subscription fees 9807
Office expenses 9808
Legal and accounting fees 9809
Property taxes 9810
Rent (land, buildings, pastures) 9811
Non-arm's length salaries 9816
Motor vehicle expenses 9819
Small tools 9820
Soil testing 9821
Licenses/permits 9823
Telephone 9824
Quota rental (tobacco, dairy) 9825
Gravel 9826
Purchases of commodities resold 9827
Motor vehicle interest and leasing costs 9829
Capital cost allowance 9936
Mandatory inventory adjustments - prior year 9937
Optional inventory adjustments - prior year 9938
Other (specify): 9896
Total E $
Summary of expenses
Total C
Total D +
Total E +
Total expenses (enter on line 9968 on page 4) $

Statement of farming activities (if applicable)

Other items
Other items Code Amount
Gross farming income (enter total from "Summary of income" on page 2) 9959
Minus: Total expenses (enter total from "Summary of expenses" on page 3) 9968
Net income (loss) before adjustments (line 9959 minus line 9968) 9969
Add: Optional inventory adjustments - current year (if applicable) 9941
Add: Mandatory inventory adjustments - current year (if applicable) 9942
Total (Optional inventory adjustments + Mandatory inventory adjustments)
Net income (loss) after adjustments 9944
Net farming income (loss) 9946
Shareholder/Member information
Name of shareholder/member AgriStability/AgriInvest Participant Identification Number (PIN)

Partnership information

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%.

Partnership Information
AgriStability/AgriInvest PIN Individual's first name Individual's last name Corporation name % share
%
%
%
%
%
%
%

This page to be completed by AgriStability participants only

Crop inventory valuation and productive capacity

Code Crop/Grade Units Acres Unseedable acres Quantity produced Ending inventory End of year price $
17 Summerfallow acres
18 Pasture acres
19 Wasteland acres

Livestock inventory valuation

Code Description Ending inventory End of year price $

Livestock productive capacity

Productive animals
Productive animalsUnits 2019
104 Cattle Number of cows that calved
123 Hogs, farrow to finish Number of sows that farrowed
145 Hogs, farrowing Number of sows that farrowed
Number of feeder livestock
Number of feeder livestock Units 2019
105 Feeder cattle (fed up to 900 lbs) Number of animals fed
106 Finished cattle (fed over 900 lbs) Number of animals fed
125 Hogs, nursery (fed up to 50 lbs) Number of animals fed
124 Hogs, feeders (fed over 50 lbs) Number of animals fed
Custom fed livestock
Custom fed livestock Units 2019
141 Custom fed cattle Number of animal feed days
142 Custom fed hogs Number of animal feed days
Supply managed commodities
Supply managed commodities Units 2019
113 Dairy Kilograms butterfat/day
108 Chickens, layers, broiler eggs for hatching Number of producing hens
109 Chickens, layers, eggs for consumption Number of producing hens
143 Chickens, broilers Number of kilograms produced
144 Turkeys, broilers Number of kilograms produced
Other (specify below)
Other (specify below) Units 2019

Purchased inputs

Code Description End of year amount ($)

Deferred income and receivables

Code Description Ending receivables and income deferred to 2020 ($)
4020 Expected grains and oilseeds pool payments

Accounts payable

Code Description End of year amount ($)

Confidential information and participant consent

Agriculture and Agri-Food Canada (AAFC) and the Canada Revenue Agency (CRA) are committed to protecting the privacy of your information. The information on this form, including your Social Insurance Number (SIN) and Participant Identification Number (PIN) is collected under the authority of Section 4 of the Farm Income Protection Act (FIPA) and will be used exclusively for the following purposes:

By completing this form you authorize the Administration, the provincial and territorial governments, administrators of other farm income and special assistance programs, and third parties possessing information relevant to the administration of, and your participation in, the AgriStability and AgriInvest programs to share such information with AAFC.

All applicants except Status Indians and Band farms: by completing this form, you authorize the CRA to share information from this form with AAFC, and you authorize AAFC, where relevant, to share the information on the form and any additional information that is provided as the application is processed, with the CRA, the Administration, provincial and territorial governments and with the administrators of other federal/provincial farm programs.

Status Indians and Band farms: AAFC agrees that information provided by Status Indians and Band farms to the AgriStability and AgriInvest programs will not be disclosed to CRA by the Administration, unless disclosure is required by law. By completing and submitting this form you authorize the Administration to share information from this form with AAFC, and authorize AAFC to share the information on the form and any additional information that is provided as the application is processed, with provincial or territorial governments and with the administrators of other federal/provincial farm programs.

If you do not consent to the sharing of information described herein you may be ineligible to participate in the AgriStability or AgriInvest programs or receive benefits or adjustments to benefits under the AgriStability and AgriInvest programs.

You have the right to access the personal information held by federal departments and to request changes to incorrect personal information. For more information about your rights regarding the Privacy Act contact the Access to Information and Privacy Directorate at the Canada Revenue Agency at ATIP-AIPRP@cra-arc.gc.ca or the AAFC Access to Information and Privacy Coordinator at aafc.atip-aiprp.aac@canada.ca and reference CRA PPU 005, CRA PPU 025 and/or AAFC PPU 183.

In addition, by submitting this form for benefits under the AgriStability and AgriInvest programs, you:

  1. certify that the information provided is complete and correct
  2. declare that the structure of this farming operation has not been altered or created for the purpose of manipulating program benefits or avoiding prescribed maximum limits on program payments
  3. understand and agree that any interim or targeted advance payment of AgriStability program funds will be deducted in the calculation of a final AgriStability program payment
  4. agree that you will repay any amounts paid to you by the AgriStability and AgriInvest programs that are in excess of the amount calculated under the program rules and understand that any amount you owe to the Crown may be subtracted from any payments to be sent to you by the Crown
  5. understand that interest will be charged on overpayments
  6. understand and agree that the information you submit may be combined with the information of other participants for the purposes of determining AgriStability and AgriInvest benefits, and consent to the disclosure of information pertaining to you or your financial affairs to the other participants who are being combined with your information
  7. understand and certify that where you have provided information about other individuals or entities you have been authorized by those individuals or entities to provide that information
  8. understand and agree that where you have provided information about other individuals or entities, if they request to see the information you have submitted about them, the Administration will give them access to that information
  9. understand and agree that the person you identified on this form as your contact person may receive information relating to your application from the Administration and may instruct the Administration to modify information relating to your application
  10. consent to third parties, CRA and other government programs disclosing to the Administration, upon its request, any information pertaining to you or your financial affairs which the Administration considers necessary for the purpose of verifying the AgriStability and AgriInvest benefit or the information provided on this form
  11. understand that it is a criminal offence to make a false statement in application for program benefits and any declarations made are subject to audit.
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