ALBERTA BEEF PRODUCERS (ABP) SERVICE CHARGE REFUND REQUEST FORM

Refund requests for the period January 1 until June 30 of a calendar year are due in the ABP office by July 31 for processing in August and will be paid by October 31. Refund requests for the period July 1 until December 31 of the calendar year are due in the ABP office by January 31, for processing in February and will be paid by April 30. The refund request form must be completed by the producer requesting the refund. The name on this form must be the same as the name of the producer who has paid the service charge to ABP or has had the service charge deducted by a purchaser or livestock dealer. As of April 1, 2018, the $4.50 deduction includes a $2.50 non-refundable national levy and a $2.00 Alberta Service Charge. Only Alberta residents are eligible to apply for a refund of the $2.00 Alberta Service Charge (or a portion of it) on cattle marketed and collected in Alberta and remitted to ABP. The $2.50 national levy is non-refundable. Marketings outside of Alberta are collected under the Federal Levy Order and are not refundable.

Completed refund forms and all supporting documentation can be sent to the ABP office to the Attention ABP Controller by Canada Post or courier addressed to Alberta Beef Producers 165, 6815 8th Street NE Calgary, AB T2E 7H7; by Fax at (403) 451-1188 (backup fax number 403-274-0007); or by E-mail to Laurap@albertabeef.org.

Name of Producer: _____________________________________________________________________

Address: _____________________________________________________________________________

Town, City: ______________________________ Province: __________ Postal Code: _____________

Telephone Number: _______________________ Fax Number (optional): _______________________

E-mail address (optional): _______________________________________________________________

I am predominately a: Cow Calf Producer ____ Backgrounder ______ Feedlot ____Custom Feedlot _____ Licensed Dealer ____ Auction Market ____ Other ____

If the producer is a corporation or partnership, the contact person is:

On the back page, please complete the Calculation of Refund Request section and list each invoice/settlement statement or other documentation that reflects the amount of service charge paid by the producer or deducted by a purchaser or livestock dealer and attach a photocopy of your supporting documentation on the attached schedule. ABP will retain this documentation for audit purposes. If you complete your submission on an excel worksheet, please email the excel worksheet to laurap@albertabeef.org and submit the supporting documentation via fax or Canada Post. For those who complete this form in an excel spreadsheet or a word document you are asked to submit your spreadsheet electronically. Documents and supporting documents sent by Canada Post ____; courier _____; Fax ____ Fax number used___________. Spreadsheet sent electronically __________ to _________________________.

Refund period: January1 until June 30 ____ OR July 1 until December 31 _____.

Total number of head on which a refund is requested ____________(from Calculation of Refund Request)Total amount of refund request, before GST $____________(from Calculation of Refund Request)

I hereby certify that the service charge was paid by the producer requesting the refund and was not passed on to another person for payment and that the copies of the documentation supporting this request for a refund are true copies of the original documents.

__________________________________________ ___________________Signature of the Producer Date

Calculation of Refund Request

Even though you are requesting a refund on the service charge that you paid, there may be specific activities undertaken with service charge funds that you wish to support. When you consider your refund request, you are encouraged to leave a portion of our service charge with ABP to fund these activities. This is not a directional check-off, but is an opportunity for you to adjust your refund request to support valuable industry investments.

Total service charge refund available $2.00/head

Possible reductions in refunds

less Dealer Rebate $0.05/head -- _________(ABP pays this rebate on all marketings)

less Canadian Cattlemen’s Association (CCA) assessment $0.53/head -- _________(CCA leads national trade advocacy and policy work, ABP paysthe $0.53 assessment on all marketings)

less contribution to ABP advocacy, communications, promotion, -- __________and research projects and activities

Total service charge refund request per head = __________

Total number of head on which a refund is requested x __________

Total refund request before GST = __________

Please list each invoice/settlement statement or other documentation that reflects the amount of service charge paid by the producer or deducted by a purchaser or livestock dealer. Further instructions are found on the first page of this form. If you need additional space, you can add separate pages.

Name of Purchaser or Livestock Dealer who deducted the service

charge OR name of Producer Who has remitted the service

charge to ABP

Invoice Number from

Supporting Documentation

that reflects the AB check off being

withheld

Date onSupporting

Documentation(Month, Day,

Year)

Number of Head

Sold, Fed or Slaughtered

Amount of service charge

and non-refundable levy deducted or paid

Office Use

Continued Page ____ of _____

Name of Purchaser or Livestock Dealer who deducted the service

charge OR name of Producer Who has remitted the service charge to ABP

Invoice Number from

Supporting Documentation

that reflects the AB check off being withheld

Date onSupporting

Documentation(Month, Day, Year)

Number of Head

Sold, Fed or Slaughtered

Amount of service charge and non-refundable levy deducted or paid

Office Use