The Saskatchewan Farm Security Act 2016 Farm Land Ownership Declaration Corporation

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3 Farm Land Security Board The Saskatchewan Farm Security Act 2016 Farm Land Ownership Declaration Corporation I/We, being a Corporate officer of (clearly print all names making declaration (Corporation Address(s: (Include additional sheet for additional names and addresses DO HEREBY DECLARE BY SIGNING THIS DECLARATION THAT: 1. I am/we are the authorized officer(s of the Corporation named in this document, and have made the necessary inquiries to confirm the information contained in this document is true and accurate. 2. All shareholders of the above named company are Canadian Citizens; Yes No; And/or, All shareholders of the above company are permanent residents of Canada and received their permanent residency on:, (Date for (name, (Date for (name, (Date for (name (Include additional sheet for additional names 3. No non-canadian persons or entities hold a registered or non-registered interest in the farm land that above named corporation owns. Interest includes any agreement that provides a right of possession or any right of control ordinarily accruing solely to the owner of the farm land, including capital appreciation. Interest does not include mortgage security agreements held by Canadians or financial institutions supervised by a Canadian government authority. 4. The Saskatchewan farm land parcel(s being purchased are: (Include additional sheet for additional parcels

4 5. I/We hereby acknowledge that we have received advice from a lawyer and understand the restrictions and requirements of the farm ownership provisions of Part VI of The Saskatchewan Farm Security Act. I/We confirm that I/We understand the consequences of failing to complete the declaration, including an administrative penalty of up to $10,000 under The Saskatchewan Farm Security Act. 6. Funds to purchase the above described Saskatchewan farm land were obtained from: (check each that apply personal resources, private borrowing, a Canadian financial institution, other (Explain. I/We make this solemn declaration conscientiously believing it to be true, and knowing that it is of the same force and effect as if made under oath, and by virtue of the Canada Evidence Act. I/We acknowledge that the Criminal Code, R.S.C. 1985, Chapter C-46, makes it a criminal offense punishable on summary conviction to make a statement by solemn declaration knowing that the statement is false. DECLARED BEFORE ME at the (signature + printed name of individual making declaration of, in the Province of, this day (signature + printed name of individual making declaration of, 2. (signature + printed name of individual making declaration A COMMISSIONER FOR OATHS in and for the Province of My Commission expires: This declaration is to be submitted to the Farm Land Security Board within 60 days of the registration of the farmland transfer, by one of the following options. Mail: Farm Land Security Board, Albert Street, Regina SK S4S 0B1 inquiries@farmland.gov.sk.ca Fax:

5 The Saskatchewan Farm Security Act 2016 Farm Land Ownership Declaration Individual(s Farm Land Security Board I/We: ; (clearly print all names making declaration Address(s: (Include additional sheet for additional names and addresses DO HEREBY DECLARE BY SIGNING THIS DECLARATION THAT: 1. I am/we are a Canadian Citizen; Yes No; or, I am/we are a permanent resident of Canada and received permanent residency on:, (Date for (name, (Date for (name, (Date for (name (Include additional sheet for additional names 2. No non-canadian persons or entities hold a registered or non-registered interest in the farm land that above named individual(s owns. Interest includes any agreement that provides a right of possession or any right of control ordinarily accruing solely to the owner of the farm land, including capital appreciation. Interest does not include mortgage security agreements held by Canadians or financial institutions supervised by a Canadian government authority. 3. The Saskatchewan farm land parcel(s being purchased are: (Include additional sheet for additional parcels

6 4. I/We hereby acknowledge that we have received advice from a lawyer and understand the restrictions and requirements of the farm ownership provisions of Part VI of The Saskatchewan Farm Security Act. I/We confirm that I/We understand the consequences of failing to complete the declaration, including an administrative penalty of up to $10,000 under The Saskatchewan Farm Security Act. 5. Funds to purchase the above described Saskatchewan farm land were obtained from: (check each that apply personal resources, private borrowing, a Canadian financial institution, other (Explain. I/We make this solemn declaration conscientiously believing it to be true, and knowing that it is of the same force and effect as if made under oath, and by virtue of the Canada Evidence Act. I/We acknowledge that the Criminal Code, R.S.C. 1985, Chapter C-46, makes it a criminal offense punishable on summary conviction to make a statement by solemn declaration knowing that the statement is false. DECLARED BEFORE ME at the (signature + printed name of individual making declaration of, in the Province of, this day (signature + printed name of individual making declaration of, 2. (signature + printed name of individual making declaration A COMMISSIONER FOR OATHS in and for the Province of My Commission expires: This declaration is to be submitted to the Farm Land Security Board within 60 days of the registration of the farm land transfer, by one of the following options: Mail: Farm Land Security Board, Albert Street, Regina SK S4S 0B1 inquiries@farmland.gov.sk.ca Fax: