Grant Application and Program for Use

FINANCIAL SUPPORT FOR ASPIRING FARMERS
Grant Application and Program for Use
(Please use block letters and print in ink)
Reserved FADQ
(Client No.)
(Measure No.)
Québec Business No. (NEQ)
1 Client
Name or business name
Ministry Identification No. (NIM)
Operation’s address (No. street or rang)
Municipality
Postal code
Phone No. (home)
Mailing address (No. street or rang), if different from above
Municipality
Postal code
Fax No.
2 Financial Support for Aspiring Farmers
Establishment grant or
Start-up grant
Name of the person that makes the operation eligible
Amount of the grant
$
$
$
Interim financing requested:
Yes
No
3 Program for use
Description of uses *
Amount applied for**
Reserved for FADQ
TOTAL:
* Description of uses: Specify the purpose(s) for which you wish to use the grant, e.g.: underground drain.
** Amount applied for: For every purpose, enter the amount applied for. The amount must not include taxes and any other grant
associated with the purpose.
Additional information
The grant must be used for:





Permanent improvements to farmland, farm buildings and farm equipment;
Purchase of additional farm land and farm equipment, construction of a farm building;
Purchase of animals for breeding and productive plants;
Support for training recognized as having been acquired after establishment;
Support for business management.
If the operation has none of the above-mentioned needs, the grant could be used for:
 Acquisition of quotas and farm machinery;
 Payment of net interest on loans from La Financière agricole du Québec.
4 Declaration and commitment
- I am submitting this grant application in accordance with the programs of La Financière agricole du Québec.
- I authorize any financial institution, any department or agency, including the boards that administer joint plans, any individual or group to provide
La Financière agricole with the documents and information deemed necessary concerning my file.
- I authorize La Financière agricole to transmit to the financial institution and to the Ministère de l’Agriculture, des Pêcheries et de l’Alimentation, any
document and information deemed necessary concerning my file.
- I declare that all the information, of a financial nature or otherwise, that was provided in the framework of this application, is true and complete.
- The personal information gathered by La Financière agricole will be treated in a confidential manner and will be transmitted only to authorized
persons or agencies, in accordance with the terms provided for in the Act respecting Access to documents held by public bodies and the Protection
of personal information.
Signature of the client or authorized person
Date
5 Reserved for FADQ
Pour confirmer le programme d’utilisation et effectuer la gestion du rabais ASRA lors d’une subvention à l’établissement
Rabais de contribution à l'ASRA : Le client est-il adhérent à l'ASRA?
Rappel :
Non
Oui : si oui, années du rabais : __________ et __________
- La 1re année retenue ne doit pas précéder l'année de confirmation de la subvention.
- La 1re année retenue ne devrait pas inclure un produit ASRA dont l’adhésion s’est effectuée au cours de cette année (année de production incomplète).
Conseiller en financement de La Financière agricole du Québec
This form is available on our web site www.fadq.qc.ca
1003-A (2014-03)
La Financière agricole du Québec
Date