Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 1
Registration form for the agricultural operations with the Ministère de l’Agriculture, des Pêcheries et de l’Alimentation For the registration slip provided for in the Act respecting the Ministère de l’Agriculture, des Pêcheries et de Alimtation (CQLR, chapter M-14)
Translation
General Guideline
This document contains four (4) parts: 1. Information about the business; 2. Characteristics of the business; 3. Summary of information about the operation; and 4. Registration of an assessment unit that is part of your agricultural operation.
To help you update the information in your registration file and to be sure you enter the proper information when completing the form, please refer to the attached Companion Guide.
If you have questions that the guide does not answer, please contact the ministry at the Agricultural Operation Registration Department at this number: 1 844 544-DEEA (3332).
Instructions for Parts 1 and 2
Parts 1 and 2 of the form apply to your entire agricultural operation, regardless of the number of assessment units you operate.
If your operation has an email address, please enter it in section 1.2.1., Correspondence address, in Part 1 of the form. The ministry will increasingly use email for correspondence in the years to come.
Once the form has been filled out and section 1.6, Signature and declaration, has been signed and dated, please return it to your farm operation registration agent. To find out the contact information for this agent, please contact the ministry at the Agricultural Operation Registration Department at 1 844 544-DEEA (3332).
l’
Part 1. Information about the Business
Remember to read section 1.5 and to sign section 1.6.
Legal business name
Legal name
Legal status (the legal status can be a natural person, a general or limited partnership, a corporation, a company, a cooperative, etc.
Quebec enterprise number (NEQ) Date of constitution of the operation (yyyy-mm-dd)
Other business names (Enter a maximum of three names):
1.
2.
3.
Correspondence email for the agricultural operation: Out of concern for the environment, the ministry wishes to collect the email addresses of agricultural operations to use them for communication with its clientele from time to time.
1.1. Information on the Operation
1.1.1. Correspondence Email for the Agricultural Operation
1.2.1. Correspondence Email for the Agricultural Operation
Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 2
Number, street, apartment
Municipality, Province Province
Postal Code
If one of the members of the operation is a business, enter its ten digit (no hyphens) Quebec enterprise number (NEQ) and write “not applicable” (N/A) in the “gender” column.
Surname Given name SIN or NEQ (1)
Gender (M, F
or N/A)
Percentage of shares
(%)
Date of birth (yyyy-mm-dd)
(1)
Year of acquisition of
first shares (yyyy)
1.
2.
3.
4.
5.
6.
(1) If you do not wish to register a "SIN" or "Date of Birth" in writing, please contact MAPAQ by telephone using the contact information provided on the letter attached to this form.
1.2. Correspondence Address
1.3. Information on Members of the Operation
Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 3
Main respondent
Surname Given name Gender (M or F) Position
Main telephone number Extension Secondary telephone number Extension
Cell Fax Proxy (yes or no)
Email address
Secondary respondent
Surname Given name Gender (M or F) Position
Main telephone number Extension Secondary telephone number Extension
Cell Fax Proxy (yes or no)
Email address
Other secondary respondent
Surname Given name Gender (M or F) Position
Main telephone number Extension Secondary telephone number Extension
Cell Fax Proxy (yes or no)
Email address
1.4. Information on Respondents of the Operation
Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 4
Consent Notice
As in previous years, three times a year the headquarters of the Union des producteurs agricoles (UPA) is able to collect information concerning your agricultural operation: general information on the business, contact information, legal status, region in which the primary site of the operation is located, type of production, primary shareholders or members, primary sources of income, etc. The information provided is disclosed under the Farm Producers Act and in accordance with an agreement authorized by the Commission d’accès à l’information du Québec.
To facilitate the information concerning your business, we will use the information in the enterprise register of the Inspecteur général des institutions financières for operations that are registered and have a registration number.
Important Message
The information requested in the registration form is necessary for the issuance of the registration card from the Ministère de l’Agriculture, des Pêcheries et de l’Alimentation. This card gives access to professional and technical consulting services and to all the ministry’s assistance programs.
In addition, you are responsible for updating the information provided to the ministry, in accordance with section 7 of the Regulation respecting the registration of agricultural operations and the payment of property taxes and compensations.
Note that the Minister may require you to provide any information or documents deemed necessary when filing an application for registration of an agricultural operation, or necessary to demonstrate that the agricultural operation meets the conditions to remain registered with the ministry.
Please note that a false declaration may result in the revocation of your registration.
Act respecting access to documents held by public bodies and the protection of personal information
The Ministère de l’Agriculture, des Pêcheries et de l’Alimentation wishes to inform you that the identifying information in this document is treated as confidential, in accordance with the provisions of the Act respecting access to documents held by public bodies and the protection of personal information (CQLR, c. A-2.1), particularly the provisions of Chapter III on the protection of personal information. Furthermore, this information will be disclosed only to persons or organizations according to the terms and conditions provided for in the Act in sections 53, 59, 67, 67.2, 68 and 68.1, among others.
The personal information collected in this document may eventually be used for the purposes of research, evaluation, management and the administration of programs, and for the planning of agricultural development. It may also be used for preparing surveys, in accordance with the provisions of the Act.
You can also exercise your rights of access and correction under the Act by contacting the ministry.
I certify that the information in this application is, to my knowledge, accurate and complete. I recognize that any false declaration may result in revocation of the registration. I understand that my eligibility for the Ministère’s financial assistance programs will be based on information in the registration form.
Signature Date (yyyy-mm-dd)
Surname and given name (printed)
Ministerial identification number (NIM)
Signature Date (yyyy-mm-dd)
1.5. Notice and Important Message
1.6. Signature and Declaration
1.7. Reserved for the Ministère de l’Agriculture, des Pêcheries et de l’Alimentation
Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 5
Gross agricultural revenue = agricultural revenue + crop and stabilization insurance compensations and other income support programs of “la Financière agricole du Québec” (FADQ) + revenue generated by agrotourism activities authorized by the Commission de protection du territoire agricole du Québec (CPTAQ).
Exclude all revenue from the rental of land, snow removal and contract work.
The “Others” source of revenue includes agricultural production carried out at the farm that is not specified in the boxes above. It excludes revenue from insurance, from processing and from the sale of breeding stock, which should already be included in the details of revenue sources.
Percentages (%) must not contain a decimal point.
What was the gross agricultural revenue of your business in the last fiscal year?
$
Specify for what year:
Specify the percentage of agricultural revenue for the following sources of revenue:
% %
Maple syrup production Beekeeping
% %
Blueberries (lowbush) Aquaculture (fresh and salt water)
% %
Cranberries Beef cattle
% %
Apples Dairy cattle and milk production
% %
Other fruits Goats
% %
Wood Horses
% %
Grains, oilseed crops, legumes and other seeds
Eggs
% %
Mushrooms Chickens and turkeys
% %
Sheltered crops Other poultry
% %
Forage Sheep
% %
Ornamental horticulture Swine
% %
Potatoes Heavy calves
% %
Other vegetables for processing Others
%
Other fresh vegetables If others, specify: (e.g., farm tourism)
Be sure that the total equals 100%. %
Which of the sources of revenue mentioned above corresponds to your primary activity? (The primary activity of the operation is the production that most fully defines the business’s activities.)
Part 2. Business Characteristics
2.1. Revenue from your Agricultural Operation
2.1.1. Gross Agricultural Revenue and Source of Agricultural Revenue in the Last Fiscal Year
Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 6
What is the source of labour for the business? (You may check multiple boxes)
Family
Non-family from Quebec
Non-family from outside Quebec
Are you planning to sell or transfer the business in the next five years?
Yes
No
I don’t know
Do you plan to have a successor (family or otherwise) for your operation? (The successor must be 14 years or older.)
Yes
No
I don’t know
If so, does the successor currently have shares in the business?
Yes
No
The percentages below should include only processed products containing agricultural products raised or grown on your farm and processed by your farm.
Do you process your agricultural products on the farm?
Yes
No; go to the next section (2.3.2)
If so, what percentage of gross agricultural revenue that you declared above in Section 2.1.1 comes from processed products containing agricultural products raised or grown on your farm and processed by your farm?
(%)
What sectors do processed products containing agricultural products raised or grown on your farm and processed by your farm belong to?
Cutting or processing of meat, poultry or fish (¨pâté¨, cold meats etc.)
Manufacturing of alcoholic beverages
Manufacturing of baked goods and pastries
Manufacturing of maple products (other than syrup)
Manufacturing of dairy products (cow, goat or sheep)
Processing of fruits and vegetables (preserves, juice, etc.)
Other (specify):
2.2. Business Labour and Transfer
2.2.1. Labourers
2.2.2. Transfer
2.3. Processing, Marketing and Agrotourism
2.3.1. Processing
Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 7
The sum of percentages of agricultural revenue must be indicated at the end of Section 2.3.2.
What are your marketing methods? (You may check multiple boxes.)
Short supply chain – Direct sale to consumers
Pick your own
Stand on the farm
Stand off the farm
Public market
Community supported agriculture (vegetable or meat basket, etc.)
Transactional website
Other (specify):
What percentage of the gross agricultural revenue that you declared in Section 2.1.1 comes from direct sale to consumers? (A)
(%)
Short supply chain – Direct sale to an intermediary
Hotel
Restaurant
Institution (schools, hospitals, children day care centre, etc.)
Virtual market
Retailers (grocery stores, independent markets, fruit stores, bakeries, butcher’s shops, etc.)
Processor or packager of food or agricultural products for direct sale to the consumer without an intermediary
Other (please specify):
What percentage of the gross agricultural revenue that you declared in Section 2.1.1 comes from direct sale to an intermediary? (B)
(%)
Long supply chain – More than one intermediary between the operator and consumer
Retail and HRI (hotel, restaurant and institutional sector) distributors
Wholesalers or food chains
Food brokers
Collective marketing agency or organization under a joint plan (Producers Federation)
Processor or packager of food or agricultural products that mainly sells wholesale (slaughter plant, grain centre, mill, etc.)
Other (please specify):
What percentage of the gross agricultural revenue that you declared in section 2.1.1 comes from long-supply chain sale, with more than one intermediary between the operator and consumer? (C)
(%)
The total of percentages in Section 2.3.2., Marketing, must equal 100% of the revenue from the last available fiscal year. Add the amounts in boxes A, B and C (A+B+C).
(%)
2.3.2. Marketing
Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 8
Do you offer Agrotourism activities at the farm (reception, visits, entertainment, meals and lodging)? (Agrotourism is a tourist activity that is complementary to agriculture and that takes place in an agricultural operation. It puts agricultural producers in contact with tourists or excursionists, allowing tourists or excursionists to discover the agricultural operation, agriculture and the agri-environment, thanks to the information provided by the host.)
Yes
No; go to the next section (2.4)
If so, what types of agrotourism activities do you offer? (You may check multiple boxes.)
Farm visits, interpretation and programming
A meal at the farm, highlighting products from the farm and local agri-food products
Lodging at the farm
Do you do organic production?
Yes
No
If you do organic production, what organizations certify your production? (You may check multiple boxes.)
Ecocert
Letis S.A.
OCIA
Pro-Cert Organic Systems Ltd.
Quality Assurance International
Québec Vrai
Other organizations (specify):
If you have organic production, which of the following are certified as organic in your production?
Maple syrup production
Fruit trees (apples, pears, cherries, etc.)
Grains, oilseed crops, legumes and other seeds
Sheltered crops
Forage
Field berries
Fresh vegetables
Processing vegetables
Other crops production (specify):
Beekeeping
Beef cattle
Dairy cattle and milk production
Goats
Eggs
Chickens and turkeys
Other poultry (ducks, emus, etc.)
Sheep
Swine
Heavy calves
Other animal production (specify):
Do you practice direct seeding or ridge tillage for your annual crops? (Direct seeding is seeding carried out without practicing tillage since the last harvest, and ridge tillage entails a permanent ridge that is not destroyed each year.)
Yes
No
Not applicable
If so, what is the area of the farmland on which you practiced direct seeding or ridge tillage during the current year?
Hectares
2.3.3. Agrotourism
2.4. Production Characteristics
Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 9
Do you practice reduced tillage for your annual crops? (Reduced tillage entails the use of a chisel, a harrow or any other tool other than a plow or rotary cultivator.)
Yes
No
Not applicable
If so, what is the area of the farmland on which you practiced reduced tillage during the current year?
Hectares
Do you plant green manure (as catch crops or intercropping) in your fields?
Yes
No
Not applicable
How much did you spend on mineral fertilizers last year (excluding lime)?
$
What type of treatment do you use for your manure or slurry?
Full
Partial
None / not applicable
Instruction for Part 3
Part 3 must be filled out for each assessment unit that your agricultural business operates, whether it is owned or rented.
Do not fill out Part 3 for assessment units rented to another operator.
Answer all questions for each assessment unit you own or lease and which is part of your farm (one page per assessment unit).
You may enter a usage name for each assessment unit in your file to facilitate communication with the ministry. For example, you can give an assessment unit the name of the owner, the previous or new lot number, or any other name or description you choose (e.g., Trait-Carré plot).
It is very important to verify the numbers of the assessment units using your municipal tax bill, for example so that they can be eligible for a tax credit under the ministry’s Programme de crédit de taxes foncières agricoles (Farm Property Tax Credit Program).
You will need to make a detailed statement of the crop and livestock productions produced on this assessment unit in the section entitled "Detailed Statement of Farm Production"
If you need to register crop or livestock production in one of the boxes "Other (specify)", please refer to the attached list (Annex 1).
Ensure that the total area associated with each crop production corresponds to the area currently harvested (E) for each assessment unit.
Answer only in the boxes provided (white boxes).
Each additional page can contain details of production (animal and crops) for two assessment units.
Convert the area into hectares for each assessment unit using the following table:
2.5. Environmental Characteristics
Acres: 1 acre = 0.404 hectare Square feet: 107,640 sq. ft. = 1 hectare
Arpents: 1 arpent = 0.341 hectare Square metres: 10,000 m² = 1 hectare
Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 10
Parts 3. Registration of an Assessment Unit on your Farm (Completed French version for part 3)
To help you complete section 3 of the French registration form, you can consult the list of all productions (animals and crops) at the end of the guide.
Name of Municipality
Assessment unit (An assessment unit consists of a series of 15 digits in this format: 12345 6789 12 3456. However, the first 5 digits may be missing.)
Lot Numbers attached to this assessment unit
Name of owner of this land
Usage name for this land (if desired)
/
If it is a new purchase, what is the date of this transaction (yyyy-mm-dd) and the date of taking possession if different (yyyy-mm-dd)?
Is the purchase of the assessment unit a total area or a partial area?
Total
Partial
If the land is rented, what is the starting date of the lease (yyyy-mm-dd)?
When does the rental end (yyyy-mm-dd)?
Is the rental renewable? A revolving agreement has the advantage of being automatically renewed at MAPAQ without having to re-submit this signed form. It may be revoked at any time as agreed by the parties. You must then notify the MAPAQ of the ending date of the agreement.
Yes
No
Are livestock buildings parts of the rental?
Yes
No
Are agricultural buildings parts of the rental?
Yes
No
Total assessment unit area (hectares)
Exploited area used (E) (hectares)
Does the landowner want to participate in the Farm Property Tax Credit Program for this assessment unit?
Yes, for a leased assessment unit, complete a joint payment request form (available at www.mapaq.gouv.qc.ca/taxes) and send it to the contact information displayed on the form.
No, please specify the reason for the refusal (optional):
Assessment Unit
Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 11
Agri-Environmental Practices
Are there any animals on this assessment unit?
No, please go directly to the sections on crops.
Yes, please complete the following table and go to the sections on crops or livestock.
What form of storage do you use on this assessment unit?
Manure storage (type) Number of structures Number of roof systems
Floor with run-off to holding basin (low walls and holding basin)
Floor without run-off(low walls but no holding basin)
Reservoir (concrete, pit, underbarn, etc.)
Earthen lagoon
Inside the building, with direct spreading or immediate export
Inside the building, with field storage (including stockpiling in field )
In a pile (on the ground or on a slab without walls), outside the livestock building
In a planned pen (high or low density) with direct spreading
In a planned pen (high or low density) with field storage
Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 12
Name of Municipality
Assessment unit (An assessment unit consists of a series of 15 digits in this format: 12345 6789 12 3456. However, the first 5 digits may be missing.)
Lot Numbers attached to this assessment unit
Name of owner of this land
Usage name for this land (if desired)
/
If it is a new purchase, what is the date of this transaction (yyyy-mm-dd) and the date of taking possession if different (yyyy-mm-dd)?
Is the purchase of the assessment unit a total area or a partial area?
Total
Partial
If the land is rented, what is the starting date of the lease (yyyy-mm-dd)?
When does the rental end (yyyy-mm-dd)?
Is the rental renewable? A revolving agreement has the advantage of being automatically renewed at MAPAQ without having to re-submit this signed form. It may be revoked at any time as agreed by the parties. You must then notify the MAPAQ of the ending date of the agreement.
Yes
No
Are livestock buildings parts of the rental?
Yes
No
Are agricultural buildings parts of the rental?
Yes
No
Total assessment unit area (hectares)
Exploited area used (E) (hectares)
Does the landowner want to participate in the Farm Property Tax Credit Program for this assessment unit?
Yes, for a leased assessment unit, complete a joint payment request form (available at www.mapaq.gouv.qc.ca/taxes) and send it to the contact information displayed on the form.
No, please specify the reason for the refusal (optional):
Assessment Unit…
Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 13
Agri-Environmental Practices
Are there any animals on this assessment unit?
No, please go directly to the sections on crops.
Yes, please complete the following table and go to the sections on crops or livestock.
What form of storage do you use on this assessment unit?
Manure storage (type) Number of structures Number of roof systems
Floor with run-off to holding basin (low walls and holding basin)
Floor without run-off(low walls but no holding basin)
Reservoir (concrete, pit, underbarn, etc.)
Earthen lagoon
Inside the building, with direct spreading or immediate export
Inside the building, with field storage (including stockpiling in field )
In a pile (on the ground or on a slab without walls), outside the livestock building
In a planned pen (high or low density) with direct spreading
In a planned pen (high or low density) with field storage
Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 14
Detailed Declaration of Agricultural Production
Translation and French Version
Conversion table for Sections 3 and 4:
107,640 sq. ft. = 1 ha 10,000 m² = 1 ha 1 sq. ft. = 0.093 m²
Assessment Unit / Unité d’évaluation
1. Maple Syrup Production 1-Acériculture
Area / Superficie (hectares)
Taps / Entailles
Area /
Superficie (hectares)
Taps / Entailles
Area of sugar bush (tapped or not) Superficie totale de l'érablière (entaillée ou non)
Number of taps used Nombre d'entailles exploitées
Actual and potential taps Potentiel d'entailles de l'érablière (entaillées + non entaillées actuellement)
2. Grains, Oilseed Crops, Legumes and Other Seeds 2-Céréales, oléagineux, légumineuses et autres grains
Area / Superficie (hectares)
Area with GMOs /
Superficie avec OGM
Area / Superficie (hectares)
Superficie avec OGM
Oats / Avoine
Wheat (animal feed) / Blé (alimentation animale)
Wheat (human consumption) / Blé (alimentation humaine)
Canola (total) / Canola (total)
Mixed grains / Céréales mélangées
Grain corn (total) / Maïs-grain (total)
Barley / Orge
Buckwheat / Sarrasin
Rye / Seigle
Soy (total) / Soya (total)
Other (specify): / Autre, spécifiez :
Other (specify): / Autre, spécifiez :
Other (specify): / Autres, spécifiez :
3. Mushrooms 3-Champignons
Area / Superficie (hectares)
Area / Superficie
(m2)
Number / Nombre
Area / Superficie (hectares)
Area / Superficie
(m
2)
Number / Nombre
Area of buildings used for production (ha) /
Superficie des bâtiments servant à la production (ha)
Area seeded per cycle / Superficie ensemencée par cycle (en mètres carrés)
Number of cycles per year / Nombre de cycles par année
Number of harvests per cycle / Nombre de récoltes par cycle
Total Area (1 to 3) Total des superficies (1 à 3)
Total Area Superficie
totale (hectares)
Total Area Superficie
totale (hectares)
Total area declared for each assessment unit (A) Total des superficies déclarées pour chaque unité d’évaluation (A)
Vegetables Production (Sections 1 to 12) /
Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 15
Assessment Unit / Unité d’évaluation
4. Sheltered Crops (Greenhouse) 4. Cultures abritées (en serres)
Area / Superficie (hectares)
Area / Superficie
(m2)
Number of harvests / Nombre
de récoltes
Area / Superficie (hectares)
Area / Superficie
(m2)
Number of harvests / Nombre
de récoltes
Write the total physical area of greenhouses (ha) / Inscrivez la superficie physique (totale) des serres (ha)
Cucumbers / Concombres
Annuals in boxes and planters / Fleurs annuelles en caissettes et jardinières
Lettuce / Laitues
House plants / Plantes vertes
Perennials / Plantes vivaces
Vegetables in boxes / Plants de légumes en caissettes
Potted flowering plants / Potées fleuries
Cut roses / Roses coupées
Tomatoes / Tomates
Other cut flowers / Autres fleurs coupées
Other (specify): / Autre (spécifiez) :
Other (specify): / Autres (spécifiez) :
5. Forage Crops 5. Fourrages
Area / Superficie (hectares)
Area /
Superficie (hectares)
Corn for silage or forage / Maïs d’ensilage ou fourrager
Improved and cultivated pastures / Pâturages améliorés et cultivés
Natural pastures / Pâturages naturels
Grassland (dry hay and silage) / Prairie (foin sec et ensilage)
Other (specify): / Autres (spécifiez) :
6. Fruits (Field) 6. Fruits (champ)
Area / Superficie (hectares)
Area /
Superficie (hectares)
Blueberries (highbush or cultivated) / Bleuets en corymbe ou géants
Blueberries (lowbush) / Bleuets nains
Cranberries / Canneberges
Strawberries (conventional and high density) / Fraises conventionnelles et à haute densité
Strawberries (fall varieties, day-neutral) / Fraises d’automne (à jours neutres)
Raspberries (conventional) / Framboises conventionnelles
Raspberries (fall varieties, day-neutral) / Framboises d’automne (à jours neutres)
Melons and cantaloupes / Melons et cantaloups
Grape vines / Vignes
Other (specify): / Autre (spécifiez) :
Other (specify): / Autre (spécifiez) :
Other (specify): / Autres (spécifiez) :
Total Area (4 to 6) Total des superficies (4 à 6)
Total Area Superficie
Totale (hectares)
Total Area Superficie
Totale (hectares)
Total area declared for each assessment unit(B) Total des superficies déclarées pour chaque unité d’évaluation (B)
Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 16
Assessment Unit / Unité d’évaluation
7. Fruits (Orchard) 7. Fruits (vergers)
Area / Superficie (hectares)
Number of trees /
Nombre d’arbres
Area /
Superficie (hectares)
Number of trees /
Nombre d’arbres
Pear trees / Poiriers
Dwarf apple trees / Pommiers nains
Semi-dwarf apples trees / Pommiers semi-nains
Standard apple trees / Pommiers standards
Plum trees / Pruniers
Other (specify): / Autres (spécifiez) :
8. Ornamental Horticulture in Open Field 8. Horticulture ornementale en plein champ
Area / Superficie (hectares)
Area /
Superficie (hectares)
Christmas trees / Arbres de Noël
Hardwood trees / Arbres feuillus
Shrubs / Arbustes
Softwood trees / Conifères
Turf / Gazon
Perennials and rosebushes / Plantes vivaces et rosiers
Other (specify): / Autres (spécifiez) :
9. Ornamental Horticulture in Containers 9. Horticulture ornementale en conteneurs
Area / Superficie (hectares))
Number of units /
Nombre d’unités
Area /
Superficie (hectares)
Number of units /
Nombre d’unités
Hardwood trees / Arbres feuillus
Shrubs / Arbustes
Softwood trees / Conifères
Perennials and rosebushes / Plantes vivaces et rosiers
Other (specify): / Autres (spécifiez) :
Total Area (7 to 9) Total des superficies (7 à 9)
Total Area Superficie
Totale (hectares)
Total Area Superficie
Totale (hectares)
Total area declared for each assessment unit (C) Total des superficies déclarées pour chaque unité d’évaluation (C)
Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 17
Assessment Unit / Unité d’évaluation
10. Fresh Vegetables 10. Légumes pour le marché frais
Area / Superficie (hectares)
Area /
Superficie (hectares)
Asparagus / Asperges
Garden beets / Betteraves potagères
Broccoli / Brocolis
Carrots / Carottes
Cabbage / Choux
Cauliflower / Choux fleurs
Pumpkins, winter squash, summer squash and zucchinis / Citrouilles, courges d’hiver, courgettes d’été et zucchinis
Cucumbers / Concombres
French shallots (different from green onions) / Échalotes françaises (différentes de l’oignon vert)
Spinach / Épinards
Fine Herbs / Fines herbes
Lettuce / Laitues
Sweet corn / Maïs sucré
Turnips and rutabagas / Navets et rutabagas
Dry onions / Oignons secs
Green onions (different from shallots) / Oignons verts (différents de l’échalote)
Peppers / Poivrons
Potatoes (fresh market) / Pommes de terre (marché frais)
Seed potatoes / Pommes de terre de semence
Radishes / Radis
Tomatoes / Tomates
Other (specify): / Autre (spécifiez) :
Other (specify): / Autre (spécifiez) :
Other (specify): / Autres(spécifiez) :
11. Vegetables for Processing 11. Légumes de transformation
Area / Superficie (hectares)
Area /
Superficie (hectares)
Carrots / Carottes
Beans / Haricots
Lettuce / Laitues
Sweet corn / Maïs sucré
Onions / Oignons
Peas / Pois
Potatoes (chips) / Pommes de terre (croustilles)
Potatoes (pre-peeling) / Pommes de terre (pré pelage)
Other (specify): Autre (spécifiez) :
Other (specify): Autres (spécifiez) :
Total Area (10 to 11) Total des superficies (10 à 11)
Total Area Superficie
Totale (hectares)
Total Area Superficie
Totale (hectares)
Total area declared for each assessment unit (C) Total des superficies déclarées pour chaque unité d’évaluation (C)
Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 18
Assessment Unit / Unité d’évaluation
12. Other Area 12. Autres superficies
Area / Superficie (hectares)
Area /
Superficie (hectares)
Woodlots and tree plantations / Boisés et plantations forestières
Fallow land / Jachères
Abandoned land / Terres en friche (terres abandonnées)
Other cultivated area (specify): / Autre superficie cultivée (spécifiez) :
Other cultivated area (specify): / Autres superficies cultivées (spécifiez) :
Other uncultivated area (specify): / Autres superficies non cultivées (spécifiez) :
Total Area ( 12) Total des superficies (12)
Total Area Superficie
Totale (hectares)
Total Area Superficie
Totale (hectares)
Total area declared for each assessment unit (D) Total des superficies déclarées pour chaque unité d’évaluation (D)
Total Area (1 to 12) Total des superficies (1 à 12)
Total Area Superficie
Totale (hectares)
Total Area Superficie
Totale (hectares)
Total area declared for each assessment unit(A) Total des superficies déclarées pour chaque unité d’évaluation (A)
Total area declared for each assessment unit (B) Total des superficies déclarées pour chaque unité d’évaluation (B)
Total area declared for each assessment unit (C) Total des superficies déclarées pour chaque unité d’évaluation (C)
Total area declared for each assessment unit(D) Total des superficies déclarées pour chaque unité d’évaluation (D)
Current operating area declared (E) for each assessment unit(A+B+C+D=E) Superficie exploitée actuellement (E) pour chaque unité d’évaluation (A+B+C+D=E)
Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 19
Detail the number of head and the estimated annual production for your operation, among the different types of productions. Détaillez, parmi les types de productions, le nombre de têtes et les productions annuelles estimées de votre exploitation.
* EAPS = Estimated annual production for sale *PAEV = production annuelle estimée pour la vente.
Assessment Unit / Unité d’évaluation
13. Apiculture 13. Apiculture The hives must be declared once, by their owner.
Number of Hives (1) / Nombre de ruches (1)
Honey (kg) / Miel (kg)
Number of Hives (1) / Nombre de ruches (1)
Honey (kg) / Miel (kg)
Hives / Ruches
Hives renting to others (commercial pollination) / Ruches louées à d’autres (pollinisation commerciale)
Estimated annual production for sale (kg of honey) / Production annuelle estimée pour la vente (kilogrammes de miel)
(1) Hives must be declared by their owner, and this only once. / Les ruches doivent être déclarées par leur propriétaire, et ce, une seule fois;
14. Aquaculture (Freshwater and Saltwater) 14. Aquaculture en eau douce et en eau marine Declare the number of tonnes of live weight sold last year.
Number of Tons (2) /
Nombre de tonnes
(2)Nombre de tonnes
(2)
Number of Tons (2) /
Nombre de tonnes
(2)Nombre
Mussels / Moules
Scallops / Pétoncles
Trout (for cooking) / Truites de table
Trout (stockeers) / Truites d’ensemencement
Trout (fishing pond) / Truites en étang de pêche
Other (specify): / Autres (spécifiez) :
(2) Report the number of tons sold in live weight in the previous year; / Déclarez le nombre de tonnes vendues en poids vif, durant l’année précédente;
15. Beef Cattle 15. Bovins de boucherie
Number of Head
(average inventory) Nombre de
têtes (inventaire
moyen)
EAPS* (number of
head) / PAEV*
(nombre de têtes)
Number of Head
(average inventory) Nombre de
têtes (inventaire
moyen)
EAPS* (number of
head) / PAEV*
(nombre de têtes)
Finishing cattle / Bovins de finition
Backgrounding (maximum 425 kg when sold ) / Bovins de semi-finition (maximum 425 kg à la vente)
Open beef heifers (less than 12 months) / Génisses de boucherie (moins de 12 mois)
Beef bulls / Taureaux de boucherie
Beef heifers (12 months or older) / Taures de boucherie (12 mois et plus)
Beef cows (one calving or more) / Vaches de boucherie (une mise bas et plus)
* EAPS - Feeder calves / PAEV* – Veaux d’embouche
Are you the owner of these animals? Êtes-vous propriétaire de ces animaux?
Yes No Partially
Oui Non En partie
Yes No Partially
Oui Non En partie
If you answered “partially,” write the number of head you own Si vous avez indiqué « en partie », indiquez le nombre de têtes possédées ::
Animal Production (Sections 13 to 24) / Productions animales (sections 13 à 24)
Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 20
Assessment Unit / Unité d’évaluation
16. Dairy Cattle 16. Bovins laitiers
Number of Head
(average inventory) Nombre de
têtes (inventaire
moyen)
Number of Head
(average inventory) Nombre de
têtes (inventaire
moyen)
Open Dairy heifers (less than 12 months) / Génisses laitières (moins de 12 mois)
Dairy slaughter veal calves / Petits veaux laitiers d’abattage
Dairy bulls / Taureaux laitiers
Dairy bred heifers (12 months or more) / Taures laitières (12 mois et plus)
Dairy cows (one birthing or more) / Vaches laitières (une mise bas et plus)
Are you the owner of these animals? Êtes-vous propriétaire de ces animaux?
Yes No Partially
Oui Non En partie
Yes No Partially
Oui Non En partie
If you answered “partially,” write the number of head you own: Si vous avez indiqué « en partie », indiquez le nombre de têtes possédées :
17. Goats 17. Caprins
Number of Head
(average inventory) Nombre de
têtes (inventaire
moyen)
EAPS* (3,4,5) / PAEV* (3,4,5)
Number of Head
(average inventory) Nombre de
têtes (inventaire
moyen)
EAPS* (3,4,5) / PAEV* (3,4,5)
Grower-finisher kids / Chevreaux laitiers à l’engraissement
Meat goats (one birthing or more) / Chèvres de boucherie (une mise bas et plus)
Dairy goats (one birthing or more) / Chèvres laitière (une mise bas et plus)
Are you the owner of these animals? Êtes-vous propriétaire de ces animaux?
Yes No Partially
Oui Non En partie
Yes No Partially
Oui Non En partie
If you answered “partially,” write the number of head you own: Si vous avez indiqué « en partie », indiquez le nombre de têtes possédées :
(3) EAPS for the number of grower-finisher kids / PAEV: pour le nombre de chevreaux laitiers à l’engraissement; (4) EAPS for the number of kids for meat goats / PAEV: pour le nombre de chevreaux pour les chèvres de boucherie; (5) EAPS for the number of hectolitres for dairy goats / PAEV: pour le nombre d’hectolitres pour les chèvres laitières;
18. Horses 18. Chevaux
Number of Head
(average inventory) Nombre de
têtes (inventaire
moyen)
Number of Head
(average inventory) Nombre de
têtes (inventaire
moyen)
Racing horses(female) / Chevaux de course femelles
Racing horses (male) / Chevaux de course mâles
Riding ou Saddle horses (female) / Chevaux de selles femelles
Riding ou Saddle horses (male) / Chevaux de selles mâles
Draft horses (female) / Chevaux de trait femelles
Draft horses (male) / Chevaux de trait mâles
Geldings / Hongres
Colts and fillies (less than 2 years)
Are you the owner of these animals? Êtes-vous propriétaire de ces animaux?
Yes No Partially
Oui Non En partie
Yes No Partially
Oui Non En partie
If you answered “partially,” write the number of head you own: Si vous avez indiqué « en partie », indiquez le nombre de têtes possédées :
Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 21
Assessment Unit / Unité d’évaluation
19. Sheep 19. Ovins
Number of Head
(average inventory) Nombre de
têtes (inventaire
moyen)
EAPS* (6,7) / PAEV* (6,7)
Number of Head
(average inventory) Nombre de
têtes (inventaire
moyen)
EAPS* (6,7) / PAEV* (6,7)
Lambs / Agneaux
EAPS*-Milk lambs / PAEV* - Agneaux de lait
EAPS*-Light lambs / PAEV* - Agneaux légers
EAPS*-Heavy lambs / PAEV* - Agneaux lourds
Replacement ewe lambs / Agnelles de remplacement
Breeding rams / Béliers (reproducteur)
Meat ewes (one birthing or more) / Brebis de boucherie (une mise bas et plus)
Dairy ewes (one birth or more) / Brebis laitières (une mise bas et plus)
Are you the owner of these animals? Êtes-vous propriétaire de ces animaux?
Yes No Partially
Oui Non En partie
Yes No Partially
Oui Non En partie
If you answered “partially,” write the number of head you own: Si vous avez indiqué « en partie », indiquez le nombre de têtes possédées :
(6) EAPS for the number of milk lambs, light lambs and heavy lambs / PAEV: pour le nombre de d’agneaux de lait, d’agneaux légers et d’agneaux lourds; (7) EAPS for the number of hectolitres for dairy ewes (one birth or more) / PAEV: pour le nombre d’hectolitres pour les brebis laitières (une mise bas et plus);
20. Swine 20. Porcs
Number of Head
(average inventory) Nombre de
têtes (inventaire
moyen)
EAPS* (number of
head) / PAEV*
(nombre de têtes)
Number of Head
(average inventory) Nombre de
têtes (inventaire
moyen)
EAPS* (number of
head) / PAEV*
(nombre de têtes)
Gilts (replacement gilts) / Cochettes (truies de remplacement)
Nursing pigs (suckling piglets) / Porcelets non sevrés (à la mamelle)
Weaned piglets / Porcelets sevrés
Grower-finisher pigs / Porcs à l’engraissement
Sows (one birthing or more) / Truies (une mise bas et plus)
Boars / Verrats
Are you the owner of these animals? Êtes-vous propriétaire de ces animaux?
Yes No Partially
Oui Non En partie
Yes No Partially
Oui Non En partie
If you answered “partially,” write the number of head you own: Si vous avez indiqué « en partie », indiquez le nombre de têtes possédées :
21. Heavy Calves 21. Veaux lourds
Number of Head
(average inventory) Nombre de
têtes (inventaire
moyen)
EAPS* (number of
head) / PAEV*
(nombre de têtes)
Number of Head
(average inventory) Nombre de
têtes (inventaire
moyen)
EAPS* (number of
head) / PAEV*
(nombre de têtes)
Grain-fed veal calves (starter) / Veaux de grain (démarrage)
Grain-fed veal calves (finisher) / Veaux de grain (finition)
Milk-fed veal calves / Veaux de lait
Are you the owner of these animals? Êtes-vous propriétaire de ces animaux?
Yes No Partially
Oui Non En partie
Yes No Partially
Oui Non En partie
If you answered “partially,” write the number of head you own: Si vous avez indiqué « en partie », indiquez le nombre de têtes possédées :
Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 22
Assessment Unit / Unité d’évaluation
22. Poultry (Chickens and Turkeys) 22. Volailles (poulets et dindons)
Number of Head
(average inventory) Nombre de
têtes (inventaire
moyen)
EAPS* (8,9) / PAEV*
(nombre de têtes)
(8,9)
Number of Head
(average inventory) Nombre de
têtes (inventaire
moyen)
EAPS* (8,9) / PAEV*
(nombre de têtes)
(8,9)
Broiler turkeys / Dindons à griller
Turkey breeders / Dindons de reproduction
Heavy toms / Dindons lourds
Large chickens / Gros poulets
Broiler chickens / Poulets à griller
Table-eggs-laying hens / Poules pour œufs de consommation
Hatching-eggs-laying hens / Poules pour œufs d’incubation
Table-eggs-laying pullets (less than 20 weeks) / Poulettes pour œufs de consommation (moins de 20 semaines)
Hatching-eggs-laying pullets (less than 20 weeks) / Poulettes pour œufs d’incubation (moins de 20 semaines)
Are you the owner of these animals? Êtes-vous propriétaire de ces animaux?
Yes No Partially
Oui Non En partie
Yes No Partially
Oui Non En partie
If you answered “partially,” write the number of head you own:
Si vous avez indiqué « en partie », indiquez le nombre de têtes possédées :
(8) EAPS for the number of broiler turkeys, heavy toms, large chickens and broiler chickens / PAEV: pour le nombre de dindons à griller, de dindons lourds, de
gros poulets et de poulets à griller; (9) EAPS for the number of dozens of eggs for table-eggs laying hens and hatching-eggs laying hens / PAEV: pour le nombre de douzaine d’œufs pour les
poules de consommation ou les poules pour œufs d’incubation.
23. Other Poultry (ducks, emus, etc.) 23. Autres volailles (canard, émeus, etc.)
Number of Head
(average inventory) Nombre de
têtes (inventaire
moyen)
EAPS* (number of
head) / PAEV*
(nombre de têtes)
Number of Head
(average inventory) Nombre de
têtes (inventaire
moyen)
EAPS* (number of
head) / PAEV*
(nombre de têtes)
Ostriches / Autruches :
Quails / Cailles
Ducks / Canards
Emus / Émeus
Pheasants / Faisans
Geese / Oies
Guinea fowls / Pintades
Other poultry (specify): / Autre volaille (spécifiez) :
Other poultry (specify): / Autres volailles (spécifiez) :
Are you the owner of these animals? Êtes-vous propriétaire de ces animaux?
Yes No Partially
Oui Non En partie
Yes No Partially
Oui Non En partie
If you answered “partially,” write the number of head you own:
Si vous avez indiqué « en partie », indiquez le nombre de têtes possédées :
Ministerial identification number (NIM) Legal business name
Ministère de l’Agriculture des Pêcheries et de l’Alimentation du Québec DEEA_Formulaire Enregistrement VA : 20170706 23
Assessment Unit / Unité d’évaluation
24. Other Animal Productions 24. Autres productions animales
Number of Head
(average inventory) Nombre de
têtes (inventaire
moyen)
EAPS* (number of
head) / PAEV*
(nombre de têtes)
Number of Head
(average inventory) Nombre de
têtes (inventaire
moyen)
EAPS* (number of
head) / PAEV*
(nombre de têtes)
Bison (female) / Bisons (femelles) :
Red deer (female) / Cerfs rouges (femelles)
Breeding rabbits (mated) / Lapines de reproduction (accouplées)
Rabbits sold for meat per year (9 to 12 weeks) / Lapins vendus par an pour la chair (de 9 à 12 semaines)
Wild boars (females) / Sangliers (femelles)
Mink (female) / Visons (femelles)
Elk (female) / Wapitis (femelles)
Other female cervids (specify): / Autres cervidés femelles (spécifiez) :
Other species (specify): / Autre espèce (spécifiez) :
Other species (specify): / Autres espèces (spécifiez) :
Are you the owner of these animals? Êtes-vous propriétaire de ces animaux?
Yes No Partially
Oui Non En partie
Yes No Partially
Oui Non En partie
If you answered “partially,” write the number of head you own: Si vous avez indiqué « en partie », indiquez le nombre de têtes possédées :