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 product categories and the amounts (in kilograms live weight) of specialty chicken during the following allocation periods, for planned marketing in accordance with the provisions of the Canadian Chicken Licensing Regulations:

  Allocation Period
  Product Category	A-	A-	A-	A-	A-	A-	A-

• 2 (Name of Primary Processor or Producer) commits to market the requested product categories and the amounts (in kilograms live weight) of specialty chicken for each allocation period as indicated in the table above.

• 3 If the applicant requesting production is a primary processor:

  (Name of Primary Processor) confirms that arrangements are in place with the following producers(s) to produce the requested product volume.

  Producer	Amount of requested product volume

• 4 If the applicant requesting production is a producer:

  (Name of Producer) confirms that arrangements are in place with the following primary processor(s) to process the requested product volume.

  Primary Processor	Amount of 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: