APPENDIX 2: CULTIVATION AND/OR PLANT BREEDING OF INDUSTRIAL HEMP Indicate each proposed site for cultivation and/or plant breed of industrial hemp. Each proposed site must be assigned a site number (e.g. 1,2,3,4, etc.). Please submit additional pages for additional sites, if needed. Site Number Proposed Legal Location Approved Cultivar Name(s) Industrial Hemp form Name of Activity Landowner Pedigreed Seed Legal Land Location Cultivar #1 Owned by Applicant Viable Fibre Cultivation Owned by another Pedigreed Seed Rural Municipality Cultivar #2 Plant Breeding Viable Grain Appendix 3 (Complete Fibre attached Appendix 1) Pedigreed Seed City/Town Prov Postal Code Cultivar #3 Viable Grain Fibre Pedigreed Seed Legal Land Location Cultivar #1 Owned by Applicant Viable Grain Fibre Cultivation Pedigreed Seed by another Rural Municipality Cultivar #2 Viable Plant Breeding Fibre Appendix 3 (Complete attached Pedigreed Seed Appendix 1) City/Town Prov Postal Code Cultivar #3 Viable Grain Fibre Pedigreed Seed Legal Land Location Cultivar #1 Owned by Applicant Viable Grain Fibre Cultivation Owned by another Pedigreed Seed Rural Municipality Cultivar #2 Viable Grain Plant Breeding Fibre Appendix 3 (Complete attached Pedigreed Seed Appendix 1) City/Town Prov Postal Code Cultivar #3 Viable Grain Fibre SECTION 2.1 DECLARATION that my production site(s) is/are not within one kilometre of any school grounds or any public place usually frequented by persons under the age of 18 years. I hereby declare Signature: Date:
APPENDIX 2: CULTIVATION AND/OR PLANT BREEDING OF INDUSTRIAL HEMP Indicate each proposed site for cultivation and/or plant breed of industrial hemp. Each proposed site must be assigned a site number (e.g. 1,2,3,4, etc.). Please submit additional pages for additional sites, if needed. Site Number Activity Proposed Legal Location Approved Cultivar Name(s) Industrial Hemp form Name of Landowner Cultivation Plant Breeding (Complete Appendix 1) Legal Land Location Cultivar #1 Pedigreed Seed Viable Fibre Owned by Applicant Owned by another Appendix 3 attached Rural Municipality Cultivar #2 Pedigreed Seed Viable Grain Fibre City/Town Prov Postal Code Cultivar #3 Pedigreed Seed Viable Grain Fibre Cultivation Plant Breeding (Complete Appendix 1) Legal Land Location Cultivar #1 Pedigreed Seed Viable Grain Fibre Owned by Applicant by another Appendix 3 attached Rural Municipality Cultivar #2 Pedigreed Seed Viable Fibre City/Town Prov Postal Code Cultivar #3 Pedigreed Seed Viable Grain Fibre Cultivation Plant Breeding (Complete Appendix 1) Legal Land Location Cultivar #1 Pedigreed Seed Viable Grain Fibre Owned by Applicant Owned by another Appendix 3 attached Rural Municipality Cultivar #2 Pedigreed Seed Viable Grain Fibre City/Town Prov Postal Code Cultivar #3 Pedigreed Seed Viable Grain Fibre SECTION 2.1 DECLARATION I hereby declare that my production site(s) is/are not within one kilometre of any school grounds or any public place usually frequented by persons under the age of 18 years. Signature: Date:
Application%20IH%202016-17%20.docx