REPORT PREPARED BY A FOREST ENGINEER CONTAINING A STATEMENT OF DEVELOPMENT EXPENSES ELIGIBLE FOR REIMBURSEMENT OF PROPERTY TAXES OF CERTIFIED FOREST PRODUCERS
Part I - Forest producer (The information relating to the Permanent Code and the date of expiry of the forest producer’s certificate appears in the forest producer’s certificate). Forest producer’s name and address: Permanent Code: Date of expiry of forest producer’s certificate:
Year of the last statement of development expenses: Year during which the eligible development expenses entered in this report were incurred:
Part 2 - Eligible development expenses (The development expenses must have been incurred during the calendar year or the fiscal year, as the case may be, indicated in this report and for a registered forest area for which a forest management plan was in force. This latter information appears in the forest producer’s certificate).
Unit of assessment for which the development expense was incurred Value of exigible development expense Name of municipality Number (registration) Identification of eligible development expense Quantity realized and unit of measurement (B) Without financial assistance
(C) With financial assistance
(D) = (B) x (C) $ + $ + $ + $ + $ + $ + $ + $ TOTAL OF ELIGIBLE DEVELOPMENT EXPENSES (A) = $
Part 3 - Forest engineer’s statement Part 4 - Forest producer’s statement I hereby certify that: I hereby certify that: — each of the development expenses declared in this report was incurred in such a way as to have an impact on the establishment, maintenance or improvement of a forest stand and to fulfil the objective fixed in the Regulation respecting the reimbursement of real estate taxes of certified forest producers; — I have not observed any departure from municipal by-laws; — I am a member in good standing of the Ordre des ingénieurs forestiers du Québec. — to date all the information in my forest producer’s certificate is valid; — the development expenses declared in this report were incurred on a registered forest area for which a forest management plan is in force; — the municipal by-laws have been complied with; — those expenses have never been declared for the purposes of a reimbursement of real estate taxes; — the work carried out with the financial assistance of a regional agency for private forest development has been declared to the forest engineer; — none of the work was financed under section 73.1 of the Forest Act. Name: Signature: Permit No. Date: In addition, I agree to provide any vouchers that the Ministère du Revenu or the Ministère des Ressources naturelles et de la Faune may require. Date: ___________________________________________ Signature: _______________________________________ Applicant or authorized representative