Canadian Chicken Licensing Regulations

Province:

• 1 As the holder of specialty chicken Licence No. issued by Chicken Farmers of Canada, (Name of Primary Processor or Producer) requests the production of the following classes and the amounts (in kilograms live weight) of specialty chicken during the allocation period A-, for planned marketing in accordance with the Canadian Chicken Licensing Regulations:

  Class of Specialty Chicken	Amount

• 2 (Name of Primary Processor or Producer) commits to market the requested classes and the amounts (in kilograms live weight) of specialty chicken during the allocation period A-.

• 3 The applicant confirms that (select one of the following options):

  The applicant is a primary processor and arrangements are in place with producers to produce the requested product volume.

  The applicant is a producer and arrangements are in place with primary processors to process the requested product volume.

(Signature of Primary Processor or Producer)(Signature of CFC or CFC Designate)

Date Date

Date of receipt of this form by CFC or CFC Designate: