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Buyer Registration Form
Buyer Registration Form
SECTION 1: As a purchaser of Saskatchewan-grown pulses, “a regulated product under Saskatchewan’s Agri-Food Act 2004”, we hereby file for registration as required under the Act. We state that we will comply with the Act, the Pulse Crop Development Plan Regulations, and the Saskatchewan Pulse Crop Development Board Orders.
IF YOU DO NOT PURCHASE SASKATCHEWAN PULSES DIRECTLY FROM THE PRODUCER, PLEASE SKIP SECTION 1 AND PROCEED TO SECTION 2
Company Name
(Required)
Mailing Address
(Required)
City/Town/Village
(Required)
Province/State
(Required)
Postal/ZIP Code
(Required)
Phone Number
(Required)
Fax Number
Email Address
(Required)
Website
Additional Information
PRIMARY – Contact Person Name and Title (to be used for SPG invitations, special events, etc.)
(Required)
Phone Number
(Required)
Fax Number
Email Address
(Required)
Additional Information/Comments
LEVY COLLECTION – Contact Person Name and Title
(Required)
Phone Number
(Required)
Fax Number
Email Address
(Required)
Additional Information/Comments
PURCHASES – Contact Person Name and Title (this contact telephone number and email will be published on the SPG website)
(Required)
Phone Number
(Required)
Fax Number
Email Address
(Required)
Additional Information/Comments
TYPE OF COMPANY: PLEASE CHECK ALL THAT APPLY
(Required)
PROCESSOR
PROCESSOR (organic)
BUYER
BUYER (organic)
BROKER
BROKER (organic)
EXPORTER
EXPORTER (organic)
PLEASE CHECK ALL THE PULSE CROPS YOUR COMPANY PURCHASES:
(Required)
Edible Yellow Peas
Edible Green Peas
Feed Peas
Desi Chickpeas
Kabuli Chickpeas
B90 Chickpeas
Green Lentils
Red Lentils
French Green Lentils
Black Lentils
Other Lentils
Beans
Faba Beans
Soybeans
Fenugreek
Other Pulses
SECTION 2
IF YOUR COMPANY DOES NOT PURCHASE SASKATCHEWAN GROWN PULSE CROPS DIRECTLY FROM THE PRODUCER, PLEASE COMPLETE THE BOX BELOW
I CERTIFY THAT (Company Name)
DOES NOT PURCHASE SASKATCHEWAN GROWN PULSE CROPS DIRECTLY FROM PRODUCERS. (Name and Title of Authorized Individual)
Date
MM slash DD slash YYYY
SECTION 3: I warrant that the information provided in this form is correct and I am authorized to bind the purchaser identified in this form.
Name and Title
(Required)
Date
(Required)
MM slash DD slash YYYY
If you have questions, please contact our Levy Manager at 306-668-0590.
Phone
This field is for validation purposes and should be left unchanged.