2013 year-end application - agri-corp
TRANSCRIPT
2013 Year-end application – AgriStability Page 1 of 13
Submit a separate application for each business where all aspects of the farm operations (e.g., accounting, bank accounts, income tax filing, crop harvest and storage) are completely separate. Each partner in a partnership must also complete separate forms.
To make any changes to the information on this form, indicate in the Notes section at the end of this form or contact Agricorp at 1‑888‑247‑4999.
An online version of this form is available on agricorp.com.
Section A: Customer information
Participant type (select one) Sole proprietor or individual in a partnership Corporation
Are you involved in any other farming business? Yes (complete Section E) No
Agricorp ID Business Number (BN) (if applicable) Preferred language of correspondence English French
AProduction Insurance customer number (if applicable)
AgriStability PIN
Name of corporation (if applicable)
Name of sole proprietor or individual in a partnership (if applicable) First name Middle name Last name
Mailing address (civic number and road name) Business email address (optional)
City/Town Province Postal code
Primary business telephone number Alternate business telephone number Business fax number (optional)
Section B: Main farm locationCounty/District/Region Municipality
Geographical township Lot Concession
For office use only
2013 Year-end applicationAgriStability
2013
-08-
13
2013
Yea
r-en
d ap
plic
atio
n –
Agr
iSta
bilit
y
Pag
e 2
of 1
3
Agr
iSta
bilit
y P
IN
DRAF
T
Sect
ion
C: F
or c
orpo
ratio
nsR
ecor
d yo
ur s
hare
hold
er in
form
atio
n be
low
. Com
plet
e se
ctio
n E
if th
e sh
areh
olde
rs o
f you
r bus
ines
s ha
ve in
tere
st in
any
oth
er fa
rm b
usin
ess
othe
r tha
n th
e bu
sine
ss
com
plet
ing
this
app
licat
ion.
Nam
e of
sha
reho
lder
Individual
Corporation
Ontario resident
Perc
enta
ge
of c
omm
on
shar
es
Perc
enta
ge
of v
otin
g sh
ares
Agr
icor
p ID
(if a
pplic
able
)A
griS
tabi
lity
PIN
(if a
pplic
able
)Pr
oduc
tion
Insu
ranc
e nu
mbe
r(if
app
licab
le)
Is th
is
shar
ehol
der
invo
lved
in
any
othe
r fa
rmin
g bu
sine
ss?
(if y
es c
ompl
ete
sect
ion
E)
YN
%%
%%
%%
%%
%%
Atta
ch a
dditi
onal
pag
es a
s re
quire
d.
Sect
ion
D: F
or p
artn
ersh
ips
Rec
ord
your
par
tner
ship
info
rmat
ion
(incl
udin
g yo
ur o
wn
nam
e) b
elow
. Com
plet
e se
ctio
n E
if a
ny p
artn
ers
have
inte
rest
in a
ny o
ther
farm
ing
busi
ness
oth
er th
an th
e bu
sine
ss
com
plet
ing
this
app
licat
ion.
Nam
e of
par
tner
(incl
ude
your
self
in th
e lis
t of p
artn
ers)
Part
ners
hip
perc
enta
geA
gric
orp
ID(if
app
licab
le)
Agr
iSta
bilit
y PI
N(if
app
licab
le)
Prod
uctio
n In
sura
nce
num
ber
(if a
pplic
able
)
Is th
is
part
ner
invo
lved
in
any
othe
r fa
rmin
g bu
sine
ss?
(if y
es c
ompl
ete
sect
ion
E)
YN
% % %A
ttach
add
ition
al p
ages
as
requ
ired.
2013
Yea
r-en
d ap
plic
atio
n –
Agr
iSta
bilit
y
Pag
e 3
of 1
3
Agr
iSta
bilit
y P
IN
DRAF
T
Sect
ion
E: In
volv
emen
t in
othe
r far
min
g bu
sine
ssR
ecor
d th
e in
form
atio
n be
low
for t
he b
usin
ess
com
plet
ing
this
app
licat
ion,
any
sha
reho
lder
s an
d/or
par
tner
s w
ho h
ave
inte
rest
in a
ny o
ther
farm
ing
busi
ness
oth
er th
an th
e bu
sine
ss c
ompl
etin
g th
is a
pplic
atio
n.
Nam
e of
indi
vidu
al, s
hare
hold
er o
r pa
rtne
r inv
olve
d in
oth
er fa
rmin
g bu
sine
ss
Nam
e of
oth
er b
usin
ess
(if a
pplic
able
)Ty
pe o
f ot
her
busi
ness
Agr
icor
p ID
(if a
pplic
able
)A
griS
tabi
lity
PIN
(if
app
licab
le)
Prod
uctio
n In
sura
nce
(if a
pplic
able
)
Individual
Corporation
Atta
ch a
dditi
onal
pag
es a
s re
quire
d.
2013 Year-end application – AgriStability Page 4 of 13
Section F: Farming activityFor accurate and timely processing, provide all relevant details. Attach additional pages and information as required.
1. Did you start farming within the last six years? If yes, provide the year that you first reported farming income/expenses to the Canada Revenue Agency below:
Yes No
2. Are you involved in transactions with related or non-arms length parties (including but not limited to, joint ventures, income splitting, group purchasing, payment in kind)? If yes, provide details of all other transactions below:
Yes No
3. Are you involved in contract or custom livestock feeding arrangements? If yes, provide name of owner, type of livestock, number of head and basis of payment below:
Yes No
4. Are you involved in any sharecrop arrangements? If yes, provide name of other party, share percentage, crop and acreage:
Yes No
5. Do you have any futures market transactions? If yes, attach a written summary of your futures market strategy, a written summary of your losses and gains and copies your brokerage statements. Yes No
6. Have you had any of the following significant changes on your farm during the previous six years?
a. Change in main farming commodity. If yes, explain the change in your commodity and the reason for the change below: Yes No
b. Expansion or downsizing of farm activity. If yes, explain the change in your farming activity and the reason for the change below: Yes No
c. Change of ownership or legal status. If yes, explain the change in your business structure (e.g., change in shareholders) below: Yes No
d. Any change in circumstance affecting your operation. If yes, explain what the circumstance was, how it affected your operation and the business impact below: Yes No
AgriStability PIN
2013 Year-end application – AgriStability Page 5 of 13
7. Are you involved in a business with farm-related activities, including processing agricultural products (e.g., contract work, seed cleaning), producing or marketing agricultural inputs (e.g., feed, fertilizer, seed)?If yes, list all of your farm-related activities below:
Yes No
8. Do you have any farming activities outside Ontario? If yes, provide the location and farming activity below: Yes No
9. Did you receive government transition or compensation program payments (e.g., CFIA, SRED)? If yes, provide the program name, payment amount and line code (on T1163 for individuals and Statement A for corporations) below:
Yes No
Option to receive farm analysis report
Your AgriStability data provides sufficient information to conduct a simplified farm analysis. Would you like to receive a Towards Increased Profits (TIP) report, which is a financial analysis of your farm business based on the information submitted?
Yes No
AgriStability PIN
2013
Yea
r-en
d ap
plic
atio
n –
Agr
iSta
bilit
y
Pag
e 6
of 1
3
Farm
nam
eA
griS
tabi
lity
PIN
Fina
ncia
l rep
ortin
g su
mm
ary
Com
plet
e a
sepa
rate
fina
ncia
l rep
ortin
g su
mm
ary
for e
ach
farm
ope
ratio
n. R
ecor
d th
e da
ta fo
r 201
3 in
the
colu
mn
indi
cate
d be
low
. Atta
ch a
dditi
onal
pag
es a
s re
quire
d.
Fisc
al p
erio
d20
0820
0920
1020
1120
1220
13
From
YY
YY
/MM
/DD
YY
YY
/MM
/DD
YY
YY
/MM
/DD
YY
YY
/MM
/DD
YY
YY
/MM
/DD
YY
YY
/MM
/DD
ToY
YY
Y/M
M/D
DY
YY
Y/M
M/D
DY
YY
Y/M
M/D
DY
YY
Y/M
M/D
DY
YY
Y/M
M/D
DY
YY
Y/M
M/D
D
Met
hod
of a
ccou
ntin
g20
0820
0920
1020
1120
1220
13
Inco
me
tax
filed
to th
e C
anad
a R
even
ue A
genc
y (in
dica
te c
ash
or a
ccru
al)
Fina
ncia
l sta
tem
ents
(ind
icat
e ca
sh o
r acc
rual
)
Prod
uctio
n su
mm
ary
(Sch
edul
e 1)
Com
plet
e a
sepa
rate
pro
duct
ion
sum
mar
y fo
r eac
h fa
rm o
pera
tion.
Par
tner
s re
cord
100
per
cen
t of y
our p
artn
ersh
ips
prod
uctio
n. R
ecor
d th
e da
ta fo
r 201
3 in
the
colu
mn
indi
cate
d be
low
. Atta
ch a
dditi
onal
pag
es a
s re
quire
d.
Cro
ps p
rodu
ced
for s
ale
Uni
tA
crea
ge
(squ
are
feet
for g
reen
hous
es)
2008
2009
2010
2011
2012
2013
Cro
ps p
rodu
ced
for f
eed
Uni
tA
crea
ge
2008
2009
2010
2011
2012
2013
2013
Yea
r-en
d ap
plic
atio
n –
Agr
iSta
bilit
y
Pag
e 7
of 1
3
Farm
nam
eA
griS
tabi
lity
PIN
Prod
uctio
n su
mm
ary
cont
inue
d (S
ched
ule
1)
New
and
non
-bea
ring
plan
tings
(e
.g.,
orch
ard,
vin
eyar
d, w
heat
, etc
.)U
nit
Acr
eage
2008
2009
2010
2011
2012
2013
Bre
edin
g liv
esto
ckU
nit
Aver
age
num
ber
2008
2009
2010
2011
2012
2013
Mar
kete
d liv
esto
ck
(list
by
wei
ght c
ateg
ory)
Uni
tTo
tal n
umbe
r mar
kete
d
2008
2009
2010
2011
2012
2013
2013
Yea
r-en
d ap
plic
atio
n –
Agr
iSta
bilit
y
Pag
e 8
of 1
3
Farm
nam
eA
griS
tabi
lity
PIN
Hom
egro
wn
crop
pro
duct
ion
and
inve
ntor
y (S
ched
ule
2)
Do
you
have
hom
egro
wn
crop
pro
duct
ion
and
inve
ntor
y to
repo
rt?
Y
es
N
o
To re
port
hom
egro
wn
crop
pro
duct
ion
and
inve
ntor
y, c
ompl
ete
a se
para
te h
omeg
row
n cr
op p
rodu
ctio
n an
d in
vent
ory
for e
ach
farm
ope
ratio
n. C
ompl
ete
this
inve
ntor
y ev
en if
th
ere
are
no o
peni
ng a
nd e
ndin
g in
vent
ory
tota
ls. P
artn
ers
reco
rd 1
00 p
er c
ent o
f you
r par
tner
ship
s pr
oduc
tion.
Rec
ord
the
data
for 2
013
in th
e co
lum
n in
dica
ted
belo
w. A
ttach
ad
ditio
nal p
ages
as
requ
ired.
Type
of h
omeg
row
n cr
opU
nits
Ope
ning
in
vent
ory
Prod
uctio
nPu
rcha
ses
Usa
geEn
ding
in
vent
ory*
*N
o. o
f ac
res
Yiel
d pe
r ac
reTo
tal*
Feed
an
d/or
sp
oila
ge
Seed
Cro
p sh
are
Sale
s
*Tot
al p
rodu
ctio
n =
num
ber o
f acr
es x
yie
ld p
er a
cre
**E
ndin
g in
vent
ory
= op
enin
g in
vent
ory
+ to
tal p
rodu
ctio
n +
purc
hase
s –
feed
– s
eed
– cr
op s
hare
– s
ales
2013
Yea
r-en
d ap
plic
atio
n –
Agr
iSta
bilit
y
Pag
e 9
of 1
3
Farm
nam
eA
griS
tabi
lity
PIN
Live
stoc
k pr
oduc
tion
inve
ntor
y (S
ched
ule
2)
Do
you
have
live
stoc
k pr
oduc
tion
inve
ntor
y to
repo
rt?
Y
es
N
o
To re
port
lives
tock
pro
duct
ion
inve
ntor
y, c
ompl
ete
a se
para
te li
vest
ock
prod
uctio
n in
vent
ory
for e
ach
farm
ope
ratio
n. C
ompl
ete
this
inve
ntor
y ev
en if
ther
e ar
e no
ope
ning
and
en
ding
inve
ntor
y to
tals
. Par
tner
s re
cord
100
per
cen
t of y
our p
artn
ersh
ips
prod
uctio
n. R
ecor
d th
e da
ta fo
r 201
3 in
the
colu
mn
indi
cate
d be
low
. Liv
esto
ck p
rodu
cers
who
use
the
accr
ual m
etho
d of
acc
ount
ing,
ple
ase
prov
ide
the
fair
mar
ket v
alue
of y
our b
reed
ing
lives
tock
. Atta
ch a
dditi
onal
pag
es a
s re
quire
d.
Type
of b
reed
ing
lives
tock
(li
st b
y w
eigh
t cat
egor
y)U
nits
Ope
ning
pr
ice
Ope
ning
in
vent
ory
Tran
sfer
red
inPu
rcha
sed
Dea
ths,
ho
me
use
Tran
sfer
red
out
Sold
Endi
ng
inve
ntor
yEn
ding
pr
ice
Type
of m
arke
ted
lives
tock
(li
st b
y w
eigh
t cat
egor
y)U
nits
Ope
ning
in
vent
ory
Bor
nTr
ansf
erre
d in
Purc
hase
dD
eath
s,
hom
e us
eTr
ansf
erre
d ou
t**
Sold
Endi
ng
inve
ntor
y*
*End
ing
inve
ntor
y =
open
ing
inve
ntor
y +
num
ber b
orn
+ nu
mbe
r tra
nsfe
rred
in +
num
ber p
urch
ased
– n
umbe
r of d
eath
s –
num
ber t
rans
ferr
ed o
ut –
num
ber s
old.
**Th
e to
tal i
n th
e ‘tr
ansf
er in
’ and
‘tra
nsfe
rred
out
’ col
umns
sho
uld
be e
qual
. If y
ou tr
ansf
er li
vest
ock
out o
f a w
eigh
t cat
egor
y, y
ou m
ust i
ndic
ate
whi
ch c
ateg
ory
it is
bei
ng tr
ansf
erre
d in
to.
2013
Yea
r-en
d ap
plic
atio
n –
Agr
iSta
bilit
y
Pag
e 10
of 1
3
Farm
nam
eA
griS
tabi
lity
PIN
Purc
hase
d in
puts
and
cro
p-in
-gro
und
inve
ntor
y (S
ched
ule
2)
Do
you
have
pur
chas
ed in
puts
or c
rop-
in-g
roun
d in
vent
ory
to re
port
?
Yes
No
Rep
ort t
he v
alue
of y
our p
urch
ased
inpu
t inv
ento
ry a
t the
end
of y
our fi
scal
yea
r (e.
g., s
eed,
ferti
lizer
, fee
d, fu
el, p
repa
id e
xpen
ses)
. Rep
ort t
he v
alue
of y
our c
rop
inpu
ts fo
r cro
ps
in-g
roun
d th
at w
ere
not m
atur
e at
the
end
of y
our fi
scal
yea
r. C
ompl
ete
a se
para
te p
urch
ased
inpu
t and
cro
p-in
-gro
und
inve
ntor
y fo
r eac
h fa
rm o
pera
tion.
Par
tner
s re
cord
100
pe
r cen
t of y
our p
artn
ersh
ips
prod
uctio
n. R
ecor
d th
e da
ta fo
r 201
3 in
the
colu
mn
indi
cate
d be
low
. Atta
ch a
dditi
onal
pag
es a
s re
quire
d.
Type
of p
urch
ased
inpu
t or c
rop-
in-g
roun
dO
peni
ng
Inve
ntor
y (d
olla
r val
ue)
Purc
hase
s (d
olla
r val
ue)
Res
old
and
used
(d
olla
r val
ue)
Endi
ng
inve
ntor
y*
(dol
lar v
alue
)
Inve
ntor
y ch
ange
(d
olla
r val
ue)
*End
ing
inve
ntor
y =
open
ing
inve
ntor
y +
purc
hase
s –
reso
ld a
nd u
sed
Acc
ount
s re
ceiv
able
for a
llow
able
inco
me
(Sch
edul
e 2)
Do
you
have
acc
ount
s re
ceiv
able
to re
port
?
Yes
No
Rep
ort a
ccou
nts
rece
ivab
le (e
.g.,
for c
omm
odity
sal
es) t
hat w
ere
not r
ecei
ved
by th
e en
d of
you
r fisc
al y
ear.
Incl
ude
any
Pro
duct
ion
Insu
ranc
e cl
aim
s th
at w
ere
not r
ecei
ved.
C
ompl
ete
a se
para
te a
ccou
nts
rece
ivab
le re
port
for e
ach
addi
tiona
l far
m o
pera
tion.
Incl
ude
only
allo
wab
le in
com
e un
der t
he p
rogr
am. F
or a
com
plet
e lis
t of a
llow
able
inco
me,
re
fer t
o th
e R
C40
60 F
arm
ing
Inco
me
and
the
Agr
iSta
bilit
y an
d A
griIn
vest
Pro
gram
s G
uide
(ava
ilabl
e on
agr
icor
p.co
m).
Atta
ch a
dditi
onal
pag
es a
s re
quire
d.
Acc
ount
s re
ceiv
able
for a
llow
able
inco
me
Ope
ning
tota
lEn
ding
tota
lC
hang
e in
ac
coun
ts
rece
ivab
le*
*Cha
nge
in a
ccou
nts
rece
ivab
le =
ope
ning
tota
l – e
ndin
g to
tal
2013
Yea
r-en
d ap
plic
atio
n –
Agr
iSta
bilit
y
Pag
e 11
of 1
3
Farm
nam
eA
griS
tabi
lity
PIN
Acc
ount
s pa
yabl
e fo
r allo
wab
le e
xpen
ses
(Sch
edul
e 2)
Do
you
have
acc
ount
s pa
yabl
e to
repo
rt?
Y
es
N
o
Rep
ort a
ccou
nts
paya
ble
that
wer
e no
t pai
d by
the
end
of y
our fi
scal
yea
r. C
ompl
ete
a se
para
te a
ccou
nts
paya
ble
repo
rt fo
r eac
h ad
ditio
nal f
arm
ope
ratio
n. In
clud
e on
ly
allo
wab
le e
xpen
ses
unde
r the
pro
gram
. For
a c
ompl
ete
list o
f allo
wab
le e
xpen
ses,
refe
r to
the
RC
4060
Far
min
g In
com
e an
d th
e A
griS
tabi
lity
and
Agr
iInve
st P
rogr
ams
Gui
de
(ava
ilabl
e on
agr
icor
p.co
m).
Atta
ch a
dditi
onal
pag
es a
s re
quire
d.
Acc
ount
s pa
yabl
e fo
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2013 Year-end application – AgriStability Page 12 of 13
Section G: Agreement and signatureI agree to:• Abide by all terms, conditions and procedures of the AgriStability program
as set out in the AgriStability Program Guidelines (available on agricorp.com).
• Allow Agricorp and its representatives access to the farm, and to farm financial and production records, for verification or audit purposes.
• Provide accurate, timely and full information to Agricorp when requested, and notify Agricorp in the event that there are any changes to information I have provided on this form or to the Canada Revenue Agency.
I certify that:• All information submitted on this application is accurate and true.• I have not purposely altered my farm’s ownership, business structure,
size of operation, farming practices, type of farming activity, accounting methods or any other activity or practice, in order to be eligible for, or to increase an AgriStability benefit.
• I have included details on all farming activities that I am involved in (e.g., sole proprietorships, partnerships, corporations). The information provided is complete and correct and may be confirmed with the Canada Revenue Agency.
• My main farmstead is in Ontario. Any farming activities conducted by me outside of Ontario have been disclosed on this form.
• I am actively involved in carrying out the physical work needed to produce and market agricultural commodities, or actively participating in a wide variety of day to day management decisions required for the ongoing operation of the farm enterprise.
• I have or will be reporting farming income to the Canada Revenue Agency for the program year.
• I have conducted a minimum of six consecutive months of farming activity and completed a production cycle in the program year.
• I have provided information on any non- arm’s length farming relationship in which I am involved, including any involving business transactions that fall below or exceed what would be considered fair market value or barter.
• I have followed the AgriStability Program Guidelines when completing these forms and have provided full and accurate information.
I consent to:• Agricorp’s access to the Canada Revenue Agency, Net Income
Stabilization Account (NISA), and/or previous Ontario Whole Farm Relief Program (OWFRP), Ontario Farm Income Disaster Program (OFIDP), Canadian Agricultural Income Stabilization (CAIS) Program, Production Insurance (PI), Risk Management Program (RMP), Market Revenue program information and information from other federal/provincial programs related to my farming activities. This information may be used specifically to verify the information provided in this AgriStability application or during any audit.
• Agricorp’s access to, and the use of, NISA and/or previous OWFRP, CAIS, PI and OFIDP information to determine my reference margin and program year margin. Other NISA information may be used specifically to verify the
information provided in this AgriStability application or during any audit.I understand and acknowledge that:• Separate AgriStability information may be required for all activities in which
all individuals, partners and shareholders are involved in order for this application to be considered for AgriStability benefits.
• Any funds payable to me under this program may be subject to recovery or offset against any pre-existing debts I may have to the Crown in right of Ontario or Canada.
• I will incur an administrative cost share (ACS) of $55 per program year to cover part of the program’s administrative costs.
• I may be required to provide Agricorp access to information held directly by third parties including, but not limited to, insurance companies, banks, trust companies, other financial institutions, and marketing boards, and I will execute any consent or similar forms any third party may require before providing Agricorp such access.
• In addition to its use in AgriStability, agricultural production and contact information collected in this application may also be used by provincial, federal, or municipal government authorities for the purpose of emergency management. Emergency management includes planning, activities and programs for preventing, preparing for, responding to, and recovering from emergencies.
• Further farm income tax records relating to the reference or program years may be required as part of an audit for further verification. AgriStability and income tax records must be consistent in order for the participant to be eligible for AgriStability. I will retain farm financial and production records relating to this application for 10 (ten) years.
• Information on the AgriStability forms and in supporting documents is collected by Agricorp to administer AgriStability under the Federal/Provincial Growing Forward Agreement as amended, or any subsequent Federal/Provincial Agreement.
• If I provide any information that is false or misleading in this application or supporting documents, I may be required to repay any AgriStability benefits I have received for this program year, and may be deemed ineligible to participate in the AgriStability program for up to two additional program years.
• If it is determined that I have received benefits beyond the amount I am entitled to in the program year, or in contravention of any program requirements, the obligations set out in this application, or the laws of Ontario or Canada, such amounts (overpayments) will be debts due and payable to the Crown in right of Ontario or Canada, and I will be required to return all or part of the funds received, as determined by Agricorp. Overpayments may be offset from payments I may be eligible to under this or any other program administered or delivered by Agricorp, other federal or provincial programs, or federal or provincial tax programs. Information collected in this application may be used by Agricorp or shared with provincial or federal ministries or agencies for the purpose of recovering overpayments.
AgriStability PIN
2013 Year-end application – AgriStability Page 13 of 13
Signature of (select one) Sole proprietor or individual in partnership Signing officer Other signing authority Authorized third-party contact* *Participants must authorize third parties using Agricorp’s Authorized customer contacts form or by calling Agricorp, before third parties can sign this application on behalf a participant.
Print name Signature X
Date YYYY/MM/DD
Attach additional pages as required.
Section H: Submit completed form
Submit onlineTo submit this form online, click Submit. You will immediately receive a confirmation number.
Mail or faxAgricorp1 Stone Road West Box 3660 Stn. Central Guelph, ON N1H 8M4Fax: 519-826-4334
Questions?1-888-247-4999 Mon. to Fri., 7 to 5 agricorp.com [email protected] TTY: 1-877-275-1380
Notice: For specific legal obligations under the AgriStability program, please refer to the AgriStability Program Guidelines (available on agricorp.com). Information collected is used by Agricorp to administer the AgriStability program. This information may also be used and disclosed for the purpose of administering, auditing and evaluating the program, or your participation in the program, as well as other programs administered by Agricorp and other farm income and special assistance programs. This may include sharing information with the Ontario Ministry of Agriculture, Food and Rural Affairs or Agriculture and Agri-Food Canada. Agricorp collects social insurance numbers for the purpose of making payments under this program and for the purposes of tax, auditing and collection of overpayments. This information will be shared with the Canada Revenue Agency for the purpose of issuing tax receipts for payments. Questions about the collection of this information can be directed to Agricorp’s FOI-Privacy Advisor, Box 3660, Stn. Central, Guelph, ON N1H 8M4, 1-888-247-4999.
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