Report of Claim for Loss (Schedule 4)

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 send 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.

Loan Registration Number (AAFC)

The following documents are attached:
  
  
  
  
  
  
  
  
  
Claim Items

$ (1)

$ (2)



$ (3)

$ (4)

$ (5)

$  (1+2+3+4+5)

$ (Amount of Claim (6) * 0.95)



Instructions
  1. A Schedule 4 must be completed whenever a Claim for Loss is to be made under the CALA guarantee.
  2. A Claim for Loss must be submitted within 18 months from the date of default. CALA defines the date of default as the day after the day on which a payment under a loan was scheduled to be made, but was not made.
  3. Documents listed on the Claim for Loss form must accompany the Schedule 4 unless previously submitted with the Schedule 3.
  4. The lender should take care to provide the loan registration number (Agriculture and Agri-Food Canada No.) when submitting a Claim for Loss.
  5. Any cost claimed for Legal Services will be forwarded to Justice Canada by CALA for approval and taxing prior to payment.
  6. It is the lender's responsibility to inform itself of the non-refundable nature of taxes (HST, GST, PST) or custom duties that apply to assets financed.

For additional information please refer to Section C of the Lender's Guidelines or Section 20 of the CALA Regulations.


Alternative Formats

Help with Alternative Formats

Report of Claim for Loss (Schedule 4) (On-Screen Fillable PDF Form, 580 KB)
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