STATEMENT OF FARMING INCOME AND EXPENSES

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1 STATEMENT OF FARMING INCOME AND EXPENSES NAME: Business #: AgriStability #: Commodity Sales and Program Payments Code Amount Other Farming Income Line Amount GRAINS & FORAGES: Program payouts - Other 9540 Wheat 056 Program payouts - Business Risk Canadian wheat board payments 002 Management, AgriStability & Other 9544 Barley 003 Disaster Assistance Canola 010 Fertilizer and chemical rebates 9574 Field peas 013 Agricutural contract work 9601 Oats 045 Patronage dividends 9605 Alfalfa - forage 264 Gravel 9610 Hay 264 Trucking (farm-related only) 9611 Straw 267 Resales of commodities purchased 9612 Forage seed (list by variety): 015 Leases (gas, oil well, surface lease) Machine rental Other (list): Crop insurance Alberta Spring Price Endorsement (SPE) Canada-Alberta Excess Moisture Initiative (CAEMI) Please list all farm program payments: LIVESTOCK : Cattle or Bison(Circle one-if both, put one under other) # of animals Bulls Cows - Bred - Culls Calves Replacement calves Swine 341 Other (list): Total B Summary of Income Total A 9950 Gross farming income Total A Total B

2 STATEMENT OF FARMING INCOME AND EXPENSES NAME:. SIN:. Commodity purchases and Program Payments SEED & GRAIN: Code Amount Non-allowable Expenses Line Amount Machinery: Bushels/lbs bought Repairs and maintenance 9760 Wheat 056 Insurance and licences 9760 Barley 003 Machinery lease/rental 9765 Canola 010 Advertising and promotion: Field peas 013 Meals $ x 50% 9792 Oats 045 Advertising, marketing costs 9792 Hay 264 Travel 9792 Straw 267 Building and fence repairs 9795 Alfalfa 264 Land clearing and draining 9796 Forage seed (list by variety): 015 Custom work(combining/spraying) Other insurance premiums 9804 Prepared feed supplements 046 Interest (real estate, mortgage,other) 9805 Custom feeding 577 Memberships/subscriptions 9807 Office expenses 9808 Legal and accounting fees 9809 LIVESTOCK: Property taxes 9810 Cattle or Bison(Circle one-if both, put one under other) Rent (land, building, pasture) 9811 # of animals Salaries (family) Bulls Paid to dependants 9816 Cows - Bred Paid to spouse 9816 Calves Motor vehicle expenses (car) 9819 Replacement calves Small tools 9820 Feeders Soil testing 9821 Swine 341 Licences/permits 9823 Other (list): Telephone: Home $ x % 9824 Cell $ x % 9824 Total C 9960 Gravel 9826 Purchases of commodities resold 9827 Allowable Expenses Line Amount Motor vehicle interest/leasing cost 9829 Others (specify): 9896 Containers and twine 9661 Spring Price Endorsement Premium 9896 Fertilizers and lime Pesticides & chemicals Insurance premiums (crop) Veterinary fees, medicine, A.I. fees 9713 Minerals and salts 9714 Machinery (diesel, fuel, oil) 9764 Electricity $ x % 9799 Freight and shipping 9801 Heating fuel $ x % 9802 Salaries (non-family) 9815 Storage/drying 9822 cleaning 9822 Commissions and levies 9836 Total E Summary of Expenses Total D Total Expenses Total C Total D Total E

3 INVENTORY AT DECEMBER 31, 2015 "Completion is mandatory" CROPS GRADE TYPE QUANTITY ON HAND PRICE TOTAL VALUE BUSHELS PER BUSHEL DEC 31, 2015 Wheat #1 CWRS 13 H.P #2 CWRS 6.56 #3 CWRS 6.21 Feed #1 CWES #1 CPSR 11.5 P #1 CPSW Canola # # # Sample Barley Malt - Two row Malt - Six row Feed 1 CW 3.07 Peas Edible Green Edible Yellow Feed Oats Feed 2.20 Forage seed & Other crops (list by variety) OTHER -FALL APPLIED AND PRE-BOUGHT SEED, FERTILIZER, CHEMICALS AND FUEL Fertilizer (list) Chemicals Fuel & Oil (Gas & Diesel) LIVESTOCK PURCHASED OR # OF HEAD PRICE TOTAL VALUE HOME RAISED PER ANIMAL DEC 31, 2015 CATTLE Bulls Cows - bred - culls Bred heifers Replacement calves Calves-indicate Dec 31 BISON Bulls Cows - bred - culls Bred heifers Replacement calves Calves OTHER Swine FEED Weight per bale # of bales $ / bale Hay Straw

4 DEFERRED GRAIN TICKETS "Completion is mandatory" CHEQUES DEFERRED TO EARLY JANUARY 2016 Deposited to Bank Account Grade Tonnes $ WHEAT CANOLA BARLEY CROP INSURANCE (Specify Crop Year) OTHER TOTAL DEFERRED GRAIN TICKETS ACCOUNTS PAYABLE AT DECEMBER 31, 2015 Expense (fuel, fertilizer, chemicals, utilities..) Amount $ Purchases: TOTAL ACCOUNTS PAYABLE CAPITAL PURCHASES AND SALES FOR 2015 Including computers, new buildings, farm machinery and land (including lawyer fees) Date of Description Serial # Total cost Trade-in Net cost purchase Sales: Date sold Descripton Serial # Sale price Original Trade ( Y / N ) cost price PLEASE PROVIDE A PHOTOCOPY OF THE MAJOR PURCHASES AND SALES INVOICES FOR OUR RECORDS.

5 2015 Crop Production Name: Please provide information on grain, forage, forage seed and pasture for 2015 Field name or land description # of acres Fall Harvest (Fall 2015) ed Summer - Type of crop # of acres Grade & (Spring 2015 & fallow & pasture seeded (Spring harvested approximate yield Forage crops) (2015) 2015) per acre

6 GRAIN INVENTORY WORKSHEET Name: Description Commodity Type Grade/ Weight Check Box if CWB grain For the program year January 1, 2015 to December 31, 2015 Schedule 2 CHECK HERE IF NOTHING TO REPORT Home Raised Production Program Year Program Year Starting Inventory Number Yield Ending Inventory of per Quantity Purchases Sales Amount (SPECIFY UNITS) Acres Acres Produced Fed Used (SPECIFY UNITS) TOTAL Summerfallow acres Unseedable acres Pasture/uncultivated acres Total acres farmed Ending Inventory Balance Check Crop share acres (landlord share) acres included in total above

7 Name: Do you have share cattle? Yes No LIVESTOCK INVENTORY WORKSHEET For the program year January 1, 2015 to December 31, 2015 If yes, include only your share on this worksheet. CHECK HERE IF NOTHING TO REPORT Program Year Starting Transfers Inventory Average Average Description (a) Average Births Purchases Purchase Sales Sale Deaths (b) # of Head Weight # of Head # of Head Weight # of Head Weight # of Head In Out # of Head Enter livestock type below: e.g. Elk, Beef Cattle, Bison Schedule 3 Program Year Ending Inventory Average Weight Breeding bulls Bred cows/heifers Open cows/culls Replacement heifers Home-raised calves Purchased calves TOTAL: COMPLETE IF YOU CUSTOM FEED FOR INCOME: Ending inventory balance check Type of animals custom fed (e.g. Beef feeders): Number of animals custom fed: Average custom feed days per animal:

STATEMENT OF FARMING INCOME AND EXPENSES

STATEMENT OF FARMING INCOME AND EXPENSES STATEMENT OF FARMING INCOME AND EXPENSES - 2012 NAME: Business #: AgriStability #: Commodity Sales and Program Payments Code Amount Other Farming Income Line Amount GRAINS & FORAGES: Program payouts -

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