Farm Business Registration Form

PLEASE NOTE:

Please note: Farmer Purchaser’s Permit Annual Report information is now mandatory and must be provided to complete this application for the Farm Business Registration. A registration package consists of a completed registration form (sections 1, 3, 5 and 6 of the form are mandatory), the associated registration fee and a completed Farmer Purchaser’s Permit Annual Report.
Please have your Farm Business Registration number available as it is a mandatory requirement in renewing your registration
FAQs : http://www2.gnb.ca/content/dam/gnb/Departments/10/pdf/Services/Agriculture/FarmBusinessRegistryFAQ.pdf
If you have any questions or would like assistance in completing the form, please call the Registrar of Farms at (506) 444-2848 or [email protected]
Registrations are valid from February 1 of each year until January 31 of the following year

* Required fields

SECTION 1 - FARM BUSINESS INFORMATION
*	Application Type:	New Application Renewal Application
		Registration Number: NB
*	Ownership Type:	Sole Proprietorship
		Partnership
		Corporation
*	Business Name:
*	Legal / Owner's Name:
*	Business Number:
*	Street / POBox :
*	City, Town or Village:
*	Province:
*	Postal Code:
*	Telephone Number:
	Fax Number:
*	Email:

SECTION 2 - CONTACT PERSON


*	Name:
*	Relationship to Farm Business:
*	Language Preference:	English French
	Street/PO Box:
	City, Town or Village:
	Province:
	Postal Code:
	Telephone Number:
	Fax Number:
	Email:

SECTION 3 – REGISTRATION ELIGIBILITY

*	To ensure your farm business is eligible to register, please select one or more of the appropriate activities that apply to your farm business under the federal Income Tax Act:

Tillage of soil (crops) Potato Vegetable Hay Grain Other	Raising or exhibiting of livestock Beef Sheep Pork Goat Other	Dairy farming
Raising of poultry	Fruit growing	Fur farming
Keeping of bees	Maintenance of horses (racing/exhibiting)	Mechanical hatching operation
Nursery/greenhouse	Tree farming (Christmas trees/maple syrup)	Start-up operation

SECTION 4 - PAYMENT

Please select the appropriate box corresponding to the annual gross farm income of your farm business for the most recent taxation year (check one):

(Check one)	Annual Gross Farm Income	Registration Fee
	$1 - $49,999	$165
	$50,000 - $149,999	$250
	$150,000 - $249,999	$360
	$250,000 - $499,999	$440
	$500,000 - $749,999	$550
	$750,000 or more	$675

SECTION 5 – MEMBERSHIP INFORMATION

* Please indicate your preference by checking one of the boxes below:

I wish to register/renew as a member of the Agricultural Alliance of New Brunswick

I wish to register/renew as a member of the National Farmers Union in New Brunswick

I wish to be a member of both accredited general farm organizations. (Please note: if you choose to be a member of both the Alliance and the NFU, a separate registration fee must be paid to each organization).

General Farm Organization	Web address	Toll free number
Agricultural Alliance of New Brunswick	www.fermenbfarm.ca	1-888-826-4522 506-452-8101


National Farmers Union in New Brunswick	www.nfunb.org and www.nfu.ca	506-260-0087


*Please note: if you choose to be a member of both the Alliance and the NFU, a separate registration fee must be paid to each organization.

SECTION 6 – FARMER PURCHASER’S PERMIT
* *I wish to apply for a Farmer Purchaser’s Permit under the Gasoline and Motive Fuel Tax Act.*
Yes
No

For further information you can call 1-888-622-4742.

SECTION 7 – DECLARATION

With submission of payment, I agree that the information provided in this form is complete and accurate, and I understand that it is an offence under the Agricultural Producers Registration and Farm Organizations Funding Act to make a false statement on this form. I agree that the information contained in this application for registration can be used by other departments of the Province of New Brunswick to verify farm business eligibility for government programs and for the development of government policy. I further agree the information contained in Sections 1 – 6 will be shared with the accredited general farm organization (G.F.O.) as I have indicated in Section 5.


* Name		* Date (yyyy/mm/dd)

TO COMPLETE YOUR REGISTRATION PACKAGE CLICK ON “CONTINUE TO ANNUAL REPORT” TO COMPLETE THE FARMER PURCHASER’S PERMIT ANNUAL REPORT