Special Beekeepers Fund in Ontario Program

Special Beekeepers Fund in Ontario Program Application

All applicants will need to complete Section 2 "Applicant Contact Details" and Section 3 "Beekeepers Registration / Loss Information".

Please report the total number of colonies of bees lost from November 1, 2006 to April 30, 2007, as a direct result of the extraordinary winter conditions. Please do not deduct the 15 per cent provincial average industry standard loss. (Please see the Special Beekeepers Fund Guidebook for further details).

Section 1. Primary Applicant

Individual

First Name/Surname: _______________________________________________

Social Insurance Number: ___________________________________________

Corporation

Type of Corporation: (please check the form of corporation that applies to you)
Public
Non-Public
Incorporated under the Co-operative Corporations Act
Not-for-Profit - Incorporated under Part 3 of the Corporations Act

Corporation Name: ____________________________________________

Business Number: ____________________________________________

Section 2. Applicant Contact Details

Name of the Applicant (First/Last Name):_____________________________________
a) an Individual, use the same name as above
b) a Corporation, the Applicant contact must be a shareholder or appointed officer of the corporation

Full Mailing Address (Civic Address, including where applicable RR/PO Box/Number/Street):
___________________________________________________________________________

City/Town:___________________________________

Province: ____________________________________

Postal Code: _________________________________

Telephone: ___________________________________

Fax Number: _________________________________

E-mail Address: ______________________________

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Section 3. Applicant Contact Details

No. of colonies of honey bees registered with OMAFRA as per your most recent Honeybee Registration Form. _______________________

No. of colonies of bees in production in the 2006 season (March-October): ________________

No. of colonies of honey bees lost as a result of the extraordinary winter conditions: (from November 1, 2006 to April 30, 2007, inclusive) ___________________________________

Please read the declaration below and then sign and date that you understand and accept the conditions as hereby outlined:

I understand that the information provided by me in this application may be verified by the Ministry of Agriculture, Food and Rural Affairs through communication with other federal and or provincial bodies .

I understand that the information I have provided may be used by the Ministry of Agriculture, Food and Rural Affairs for the purpose of determining my eligibility to receive payment from any other programs funded directly or indirectly by the federal or provincial government (including but not limited to the Canadian Agricultural Income Stabilization [CAIS] Program), that might be developed and to which the beekeeper identified by the beekeeper registration number provided in this application may be eligible for compensation for the losses described in this application.

I consent to the release of the information I have provided in this application by the Ministry of Agriculture, Food and Rural Affairs to any other federal or provincial government agency or agents (including but not limited to the Canadian Agricultural Income Stabilization [CAIS] Program), that may be delegated to administer this or any other compensation program(s) for the losses described in this document (regardless of the form of the compensation).

I further understand that the compensation received from this Special Beekeepers Fund in Ontario Program will be included in income calculation by CAIS Program.

Applications submitted under the Special Beekeepers Fund in Ontario Program will be subject to the Freedom of Information and Protection of Privacy Act (Ontario). Inquiries about confidentiality should be directed to the Rural Community Development Branch (see contact information provided at the end of this application).

Signature: _________________________________

Date: _____________________________________

Eligible beekeepers in Ontario must submit the completed application for funding by the application deadline of 5pm Eastern Standard Time (EST) on August 8, 2007.

Please mail or deliver your completed application to the following address:
Special Beekeepers Fund
Rural Community Development Branch
Ministry of Agriculture, Food and Rural Affairs
4th Floor, 1 Stone Road West
Guelph, ON N1G 4Y2

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