60 Research Drive, Bible Hill, Nova Scotia B6L 2R2 Phone: 902-893-7455 Fax: 902-893-7063 NSCP 2015 Registration Form and 2014 Verification of Levies Paid Farm Name: Contact: NSCP #: Civic Address: Town: Postal Code: Phone: Fax: Email: I marketed the following beef animals between January 1, 2014 and December 31, 2014 and need to remit levy to the Nova Scotia Cattle Producers Date Sold To No. Of Beef Total Levy ( # x$3.00) NOTE: Make cheques payable to Nova Scotia Cattle Producers; use and attach an additional piece of paper if required to complete your list.

(a) Subtotal (b) HST (A x 15%) (c) Total (a + b) I marketed the following beef animals between January 1, 2014 and December 31, 2014 for which the levy has already been remitted. Date Sold To No. Of Beef I, ____________________, hereby consent to the Nova Scotia Cattle Producers collecting information, in accordance to Section 4 of the Nova Scotia Cattle Producers Regulations from the Canadian Cattle Identification Agency. Furthermore, I hereby consent to the Canadian Cattle Identification Agency disclosing information, in accordance with Section 4 of the Nova Scotia Cattle Producers Regulations to the Nova Scotia Cattle Producers and such consent shall apply to disclosure of the information and information relating to my use of cattle tags under the Radio Frequency Tag system (RFID) and information from the Canadian Livestock Tracking System (CLTS). (Print name) (Signature) (Date).

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