AgriAssurance - Small and Medium-sized Enterprise Component - Signature of Applicant Authorized Representative

For your convenience, this form is available in the following format: PDF (1,140 KB)

I confirm that I have read, understood and agree with the Program Applicant Guide.

I acknowledge that the submission of this Project Application Form by the applicant creates no obligation on the part of Agriculture and Agri-Food Canada to provide funding for the Applicant's Project proposed therein.

The information given in and with the Project Application Form for

is to the best of my knowledge complete, true and correct.

The applicant authorises its representative(s) to submit and sign this Representative Form to be submitted to AAFC as part of the Project Application Form.

The signatories below hereby represent and declare that they are duly authorized to act on the Applicant’s behalf to sign this form and bind the applicant.

For Organizations


For Individuals