Hay Authorization Application



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Hay Authorization Application

Operations Division




Temporary Field Authorization No:      

LSAS Client ID No:      

Grazing Disposition No. (if applicable):     






Applicants Name: (please print)      

Address:      

City:      

Province:      

Postal Code:      

Telephone: (     )      

Fax: (     )      

Are you an employee of the Alberta Government?  Yes  No If yes, name of dept:     

Associations

Are any members of your association an employee of the Alberta Government?  Yes  No  N/A

Corporations

Are any of the shareholders of the corporation employees of the Alberta Government?  Yes  No  N/A

Please identify any such members of a grazing association or shareholders of a corporation on a separate page.

Are you a Canadian Citizen?  Yes  No

Have you attained the age of 18 years?  Yes  No

Provincial Government Employee(s) (If yes, attach approval pursuant to Public Service Act) ?  Yes  No

The total number of tons of:

 native hay estimated to be cut:       x (rate) $      = $     

 tame hay estimated to be cut:       x (rate) $      = $     


I hereby apply for a TFA to cut hay on public land covering the land listed below, pursuant to the Public Lands Act.
Department Use Only

LSD

Qtr

Sec

Twp

Rge

Mer

Tons




Receipt No:      

Dues Received: $      

GST Amount: $      

Total: $      



     

     

     

     

     

     

     




     

     

     

     

     

     

     




     

     

     

     

     

     

     




     

     

     

     

     

     

     




Haying dues (plus GST) must accompany this application

Witness:       Signature:       Date:      


No hay shall be cut until written approval has been granted under Temporary Field Authorization
The TFA for haying expires on October 31st.
Any significant shortfall in the hay permitted herein may be reported to the issuing office on a statutory declaration for consideration prior to December 1st for the year of the TFA issuance. Any overcut above and beyond the estimate must be reported to the issuing office on a statutory declaration along with payment prior to December 1st. for the year of the TFA.
Comments:

     

     

     

     


The personal information contained on this form is collected under the authorization of Section 33(c) of the Freedom of Information and Protection of Privacy (FOIP) Act and is managed in accordance with Part 2 of the FOIP Act. It will be used for the purpose of monitoring public land utilization in accordance with the Public Lands Act. Alberta Environment & Parks will disclose all information contained on this form, including personal information, to anyone requesting a copy in accordance with Section 166(2) of the Public Lands Administration Regulation. For further information, please contact Land Policy Branch, Policy and Planning Division, Alberta Environment and Parks, 4th Floor, Great West Life Building, 9920-108 Street, Edmonton, Alberta, T5K 2M4, telephone (780) 427-3595.

Jun 2016


Hay Authorization Application

© 2016 Government of Alberta



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