Loan Registration and Fee Submission (Schedule 1)

You can use either the Web version or another version of the form from the Alternative Formats section.

Please complete, print and send the form by mail.

Please mail to:
Canadian Agricultural Loans Act (CALA)
Financial Guarantee Programs Division
Agriculture and Agri-Food Canada (AAFC)
1341 Baseline Road, Tower 7, 7th Floor
Ottawa, Ontario K1A 0C5
Fax: 613-773-2020

Protected "B" once completed

The information you provide on this document is collected under the authority of the Canadian Agricultural Loans Act for the purpose of obtaining a loan. Personal information will be stored in Personal Information Bank AAFC PPU 165, and will be protected under the provisions of the Privacy Act. The Collection Registration Number is AGR/POL-465-02960.

1. Lender Information (print)











2. Borrower Information (print)








Loan Details

3. Type of farmer:
      

4. Type of farm operation:





5. Date of disbursement (YYYY-MM-DD)

6. Term (in months)

7. Interest rate (%)
%

8. Interest type

9. Repayment frequency




10. Loan Purpose

See below for purpose codes.



$






(Sum of 3 above amounts)

11. Fees Details

The Registration Fee (B) of 0.85% indicated below must accompany this registration request.


Sub-Total (A) × 0.85% (Simple Calculation)



12. Total Amount of Loan (A + D)

Cheque payable to the "Receiver General for Canada".


13. Lender Acknowledgement

I hereby certify that I have scrutinized and checked the foregoing application and the statements contained therein with the care required of me by the Lender in the conduct of its ordinary business and that to the best of my knowledge the conditions and purposes of the loan made pursuant to the application are such as to qualify it for a guarantee under the Canadian Agricultural Loans Act and the Regulations made thereunder.


(by hand only)



14. Borrower Acknowledgement

I hereby apply for a loan under the Canadian Agricultural Loans Act and declare that I am the proprietor of the enterprise described above in respect of which the loan is to be granted and that to the best of my knowledge the information contained in the application is complete and correct.

I authorize you to furnish any person appointed by or on behalf of the Government of Canada in connection with the administration of the Canadian Agricultural Loans Act with all information in respect of the loan hereby applied for or in connection with any of my dealings with you.

I authorize you or the Government of Canada to make credit inquiries at any time in connection with the financing hereby applied for.




Loan Registration Number (AAFC):

Codes (for Loan Details)
  Type of Enterprise
Loan Purpose Beef Hog Dairy Grains and Oilseeds Poultry Pulse Crops Fruits Vegetables Exotic Birds Exotic Ruminants Other
Implements (Combine, hay baler, tractor, truck, bee-keeping equipment, others) 110 111 112 113 114 115 116 117 118 119 1110
Livestock (Livestock, bee-stock) 120 121 122 123 124 125 126 127 128 129 1210
Equipment (Purchase or installation fixed equipment, electrical system) 130 131 132 133 134 135 136 137 138 139 1310
Building (Construction, renovations, alterations, repairs, extension) 140 141 142 143 144 145 146 147 148 149 1410
Land 160 161 162 163 164 165 166 167 168 169 1610
Improvement or Development (Irrigation, drainage, fencing, clearing/breaking) 170 171 172 173 174 175 176 177 178 179 1710
Major Repair / Overhaul (Implements equipment, bee-keeping equipment, electrical systems) 180 181 182 183 184 185 186 187 188 189 1810
Other (specify) (for example insurance) 190 191 192 193 194 195 196 197 198 199 1910
Consolidation / Refinancing 210 211 212 213 214 215 216 217 218 219 2110
Intergenerational Loans (Purchases of assets/shares between generational family members) 220 221 222 223 224 225 226 227 228 229 2210

Instructions

  1. Prepare a separate report for each loan.
  2. The Schedule 1 is to be completed and signed by the borrower at the time the loan is negotiated and full or partial disbursement of funds is made. The Schedule 1 must be received at Agriculture and Agri-Food Canada, Ottawa, within 60 days from the date the funds are disbursed along with the lender's cheque in the amount of 0.85% (Registration fee) of the amount of the loan in order to obtain the Government guarantee.
  3. Upon receipt of the Schedule 1, Agriculture and Agri-Food Canada will register the loan. An Acknowledgement of Loan will be returned to the lender certifying the loan has been registered in the Minister's Register.
  4. The lender should take care to complete the form in full (areas 1 to 13)
  5. Retain on file the following current information to this schedule: application form, financial statements or tax return, plan of operation, any other pertinent information.

Alternative Formats

Help with Alternative Formats

Loan Registration and Fee Submission (Schedule 1) (On-Screen Fillable PDF Form, 598 KB)
Date modified: