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2023 AgriStability Interim Application Schedule 1 – Additional Information (PDF Version, 166 KB)
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 a, b, c.
- 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 number:
- 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 from (Year/Month/Day) to 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
- 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)