2014 Year-end application

Transcription

1 2014 Year-end application AgriStability 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 tes section at the end of this form or contact Agricorp at 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? (complete Section E) Agricorp ID Business Number (BN) Preferred language of correspondence English French A Production Insurance customer number AgriStability PIN Name of corporation Name of sole proprietor or individual in a partnership First name Middle name Last name Mailing address (civic number and road name) Business address (optional) City/Town Province Postal code Primary business telephone number Alternate business telephone number Business fax number (optional) Section B: Main farm location County/District/Region Municipality Geographical township Lot Concession Year-end application AgriStability Page 1 of 13

2 AgriStability PIN Section C: For corporations Record your shareholder information below. Complete section E if the shareholders of your business have interest in any other farm business other than the business completing this application. Name of shareholder Percentage of common shares Percentage of voting shares Agricorp ID AgriStability PIN Production Insurance number Is this shareholder involved in any other farming business? (if yes complete section E) Y N Individual Corporation Ontario resident % % % % % % % % % % Attach additional pages as required. Section D: For partnerships Record your partnership information (including your own name) below. Complete section E if any partners have interest in any other farming business other than the business completing this application. Name of partner (include yourself in the list of partners) Partnership percentage Agricorp ID AgriStability PIN Production Insurance number Is this partner involved in any other farming business? (if yes complete section E) Y N % % % Attach additional pages as required Year-end application AgriStability Page 2 of 13

3 AgriStability PIN Section E: Involvement in other farming business Record the information below for the business completing this application, any shareholders and/or partners who have interest in any other farming business other than the business completing this application. Name of individual, shareholder or partner involved in other farming business Name of other business Type of other business Agricorp ID AgriStability PIN Production Insurance Individual Corporation Attach additional pages as required Year-end application AgriStability Page 3 of 13

4 AgriStability PIN Section F: Farming activity For 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: 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: 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: 4. Are you involved in any sharecrop arrangements? If yes, provide name of other party, share percentage, crop and acreage: 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. 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: b. Expansion or downsizing of farm activity. If yes, explain the change in your farming activity and the reason for the change below: c. Change of ownership or legal status. If yes, explain the change in your business structure (e.g., change in shareholders) below: 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: 2014 Year-end application AgriStability Page 4 of 13

5 AgriStability PIN 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: 8. Do you have any farming activities outside Ontario? If yes, provide the location and farming activity below: 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: 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? 2014 Year-end application AgriStability Page 5 of 13

6 Farm name AgriStability PIN Financial reporting summary Complete a separate financial reporting summary for each farm operation. Record the data for 2014 in the column indicated below. Attach additional pages as required. Fiscal period From YYYY/MM/DD YYYY/MM/DD YYYY/MM/DD YYYY/MM/DD YYYY/MM/DD YYYY/MM/DD To YYYY/MM/DD YYYY/MM/DD YYYY/MM/DD YYYY/MM/DD YYYY/MM/DD YYYY/MM/DD Method of accounting Income tax filed to the Canada Revenue Agency (indicate cash or accrual) Financial statements (indicate cash or accrual) Production summary (Schedule 1) Complete a separate production summary for each farm operation. Partners record 100 per cent of your partnerships production. Record the data for 2014 in the column indicated below. Attach additional pages as required. Crops produced for sale Unit Acreage (square feet for greenhouses) Total Crops produced for feed Unit Acreage Total 2014 Year-end application AgriStability Page 6 of 13

7 Farm name AgriStability PIN Production summary continued (Schedule 1) New and non-bearing plantings (e.g., orchard, vineyard, wheat, etc.) Unit Acreage Breeding livestock Unit Average number Marketed livestock (list by weight category) Unit Total number marketed Total 2014 Year-end application AgriStability Page 7 of 13

8 Farm name AgriStability PIN Homegrown crop production and inventory (Schedule 2) Do you have homegrown crop production and inventory to report? To report homegrown crop production and inventory, complete a separate homegrown crop production and inventory for each farm operation. Complete this inventory even if there are no opening and ending inventory totals. Partners record 100 per cent of your partnerships production. Record the data for 2014 in the column indicated below. Attach additional pages as required. Type of homegrown crop Units Opening inventory. of acres Production Purchases Usage Ending inventory** Yield per acre Total* Feed and/or spoilage Seed Crop share Sales *Total production = number of acres x yield per acre **Ending inventory = opening inventory + total production + purchases feed seed crop share sales 2014 Year-end application AgriStability Page 8 of 13

9 Farm name AgriStability PIN Livestock production inventory (Schedule 2) Do you have livestock production inventory to report? To report livestock production inventory, complete a separate livestock production inventory for each farm operation. Complete this inventory even if there are no opening and ending inventory totals. Partners record 100 per cent of your partnerships production. Record the data for 2014 in the column indicated below. Livestock producers who use the accrual method of accounting, please provide the fair market value of your breeding livestock. Attach additional pages as required. Type of breeding livestock (list by weight category) Units Opening price Opening inventory Transferred in Purchased Deaths, home use Transferred out** Sold Ending inventory* Ending price Total Type of marketed livestock (list by weight category) Units Opening inventory Born Transferred in Purchased Deaths, home use Transferred out** Sold Ending inventory* Total *Ending inventory = opening inventory + number born + number transferred in + number purchased number of deaths number transferred out number sold. **The total in the transfer in and transferred out columns should be equal. If you transfer livestock out of a weight category, you must indicate which category it is being transferred into Year-end application AgriStability Page 9 of 13

10 Farm name AgriStability PIN Purchased inputs and crop-in-ground inventory (Schedule 2) Do you have purchased inputs or crop-in-ground inventory to report? Report the value of your purchased input inventory at the end of your fiscal year (e.g., seed, fertilizer, feed, fuel, prepaid expenses). Report the value of your crop inputs for crops in-ground that were not mature at the end of your fiscal year. Complete a separate purchased input and crop-in-ground inventory for each farm operation. Partners record 100 per cent of the partnership s production. Record the data for 2014 in the column indicated below. Attach additional pages as required. Type of purchased input or crop-in-ground Opening Inventory Purchases Resold and used Ending inventory* Inventory change *Ending inventory = opening inventory + purchases resold and used Accounts receivable for allowable income (Schedule 2) Do you have accounts receivable to report? Report accounts receivable (e.g., for commodity sales) that were not received by the end of your fiscal year. Include any Production Insurance claims that were not received. Complete a separate accounts receivable report for each additional farm operation. Include only allowable income under the program. For a complete list of allowable income, refer to the RC4060 Farming Income and the AgriStability and AgriInvest Programs Guide (available on agricorp.com). Attach additional pages as required. Accounts receivable for allowable income Opening total Ending total Change in accounts receivable* *Change in accounts receivable = opening total ending total 2014 Year-end application AgriStability Page 10 of 13

11 Farm name AgriStability PIN Accounts payable for allowable expenses (Schedule 2) Do you have accounts payable to report? Report accounts payable that were not paid by the end of your fiscal year. Complete a separate accounts payable report for each additional farm operation. Include only allowable expenses under the program. For a complete list of allowable expenses, refer to the RC4060 Farming Income and the AgriStability and AgriInvest Programs Guide (available on agricorp.com). Attach additional pages as required. Accounts payable for allowable expense Opening total Ending total Change in accounts payable* *Change in accounts payable = opening total ending total tes 2014 Year-end application AgriStability Page 11 of 13

12 AgriStability PIN Section G: Agreement and signature I 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 Year-end application AgriStability Page 12 of 13

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 Attach additional pages as required. Section H: Submit completed form Signature X Date YYYY/MM/DD Submit online To submit this form online, click Submit. You will immediately receive a confirmation number. Mail or fax Agricorp 1 Stone Road West Box 3660 Stn. Central Guelph, ON N1H 8M4 Fax: Questions? Mon. to Fri., 7 to 5 agricorp.com contact@agricorp.com TTY: tice: 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 and Food 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, Errors and omissions excepted Version française disponible 2014 Year-end application AgriStability Page 13 of 13