GLAS – Green, Low-carbon, Agri-environment Scheme
Slurry Declaration Form
To be completed and returned not later than 15th November 2016
Participant Name
Participant Address
Herd/Partnership Number
Declaration – must be signed by all those named on the Herd/Partnership Number, please use an
additional sheet if required.
I/we hereby declare that I/we have fulfilled all the undertakings as set out in my/our Green, Lowcarbon, Agri-environment Scheme application for the year ending 31st December 2016 and that the
information outlined in this application is correct.
Signed
Date
Signed
Date
Signed
Date
Contact Number
Email
A false or misleading statement may lead to disqualification, liability to refund any payments
obtained and possible prosecution.
Notes:
Spread method e.g. trailing shoe, band spreading, injection system must be indicated overleaf.
A copy of the relevant record of movement of organic fertilisers form (Record 3) must be attached to
this application, where slurry is imported onto the holding.
Contractor Details (if applicable)
Receipts must be provided in respect of all contractors
Contractor Name
Contractor Address
Contractor Phone No.
GLAS – Green, Low-carbon, Agri-environment Scheme
Slurry Declaration Form
Give details of dates; spread method; volume of slurry produced on the holding; volume imported; total volume spread
using new technology and LPIS numbers where the slurry was applied.
Note: At least 50m3 of slurry must be applied annually on the holding to be eligible for this action. For calculation
purposes 1m3 equals 1,000 litres (220 gallons).
Date Spread
Spread Method
Volume
Produced (m3)
A
Volume
Imported (m3)
B
Total Volume
Spread using
New Technology
(m3)
A+B
LPIS number(s)