Herd Number:
DEPARTMENT OF AGRICULTURE,
FOOD AND THE MARINE,
BASIC PAYMENT UNIT,
APPLICATION FOR PAYMENT UNDER THE 2017 EU BASIC
PAYMENT SCHEME (BPS) AND OTHER AREA BASED
SCHEMES
Please Use Block Caps For Name & Address
Name
OLD ABBEYLEIX ROAD,
PORTLAOISE, CO. LAOIS.
[email protected]
THE CLOSING DATE FOR BOTH WRITTEN AND ONLINE
APPLICATIONS IS 15 MAY 2017
Address
Penalties will apply to late applications, leading to the
complete loss of payments where an application is more
than 25 days late.
Telephone:
Mobile No:
ENTITLEMENTS DETAILS
Entitlement Type
Entitlement
Identifier
YOUNG FARMER'S SCHEME (YFS)*
Number of
Entitlement
Net Unit
Value
Lease End date
where applicable
Entitlements that will be lost
to the National Reserve if all
Entitlements not 100% used
in 2017 (please see relevant
section of BPS Terms and
Conditions)
Payment
Order
Alternative Payment Order.
Insert your choice of Payment
Order
Please tick to confirm that you wish to apply for continued participation in the Young Farmer's
Scheme. New applicants are required to complete a separate online application.
ACTIVE FARMER - NEGATIVE LIST
Please refer to the relevant section of the Terms and Conditions and tick to confirm if you are engaging in any of the activities listed below.
Airports
Real Estate
Permanent Sport/Recreational Grounds
Railway Service
Waterworks
AREAS OF NATURAL CONSTRAINTS SCHEME (formely DAS)
Please tick to confirm that you wish to apply for payment under the AREAS OF NATURAL CONSTRAINTS SCHEME confirming that you are pursuing a
farming activity on land designated under that Scheme.
PLEASE NOTE: YOU MUST APPLY ONLINE IN 2017 IF YOU HAVE A REQUIREMENT UNDER GREENING AND/OR IF YOU ARE
FORMING A PARTNERSHIP AND/OR IF YOU ARE A BENEFICIARY UNDER THE ORGANIC FARMING SCHEME/GLAS.
DECLARATION: I also apply for payment under the 2017 Basic Payment Scheme in respect of the entitlements that I hold under the Basic Payment
Scheme and/or any Basic Payment Scheme entitlements transferred to me.
Where applicable, I also apply for payment in respect of the Greening Scheme, 2017 Beef Data Genomics Programme, Green Low Carbon Agri-Environment
Scheme, Protein Aid Scheme, Burren Programme, Knowledge Transfer Programme, Agri-Environment Options Scheme, Natura 2000 Scheme and the Organic
Farming Scheme.* I hereby declare that all the details contained in this application are true and complete. I confirm that I am aware of the conditions attaching
to the Schemes for which application is made, as set out in the 2017 Helpsheet/Terms and Conditions, and agree to comply fully with those requirements. I
confirm that all the land declared on this application will be at my disposal for a period including 31 May 2017 and I accept that I will be responsible for any
breach in cross compliance with regard to that land up to 31 December 2017. I accept that lands I declare as being available for a period including 31 May 2017
must be maintained as agricultural land (or afforestation newly planted in 2017) for the 2017 calendar year and undertake to inform the Department of
Agriculture, Food and Marine (DAFM) of any change in the status of that land. I further agree that the details supplied on this application, whether written or
submitted online, along with any supporting documentation, may be made available to any other Department, Agency or Body for the purposes of crosscompliance controls or for evaluation purposes. I understand that the DAFM is subject to the provisions of the Freedom of Information Act (FOI).
*Separate application forms may be required in respect of some/all of these individual schemes.
Publication of payment details: I understand that in accordance with Regulation 1306/2013 under EAGF and EAFRD that details will be published and may
be processed by auditing and investigating bodies of the European Union and of Member States for the purpose of safeguarding the European Union's financial
interests. I also understand that all personal data will be processed in accordance with the Data Protection Act 1988 and 2003.
SIGNATURE(S). Please note that this application cannot be accepted if it is not signed by the applicant or, where there are joint applicants, by all the parties
concerned. Where this application is made on behalf of a company or other legal entity, the application must be signed by an authorised officer of that
company and the official status of the signatory (Director, Secretary etc.) must be stated.
SIGNATURE: ________________________________________
Joint applicant's signature: _____________________________
DATE :/
Joint applicant's signature: _____________________________
/ 2017
Status of Signatory (Company): ________________________
For official use only
DATE :/
/ 2017
NC
M
C
ANC
YF
NEG
1
2
3
Herd Number
Please delete any parcels that are not part of your holding on 31 May 2017 by drawing a line through the pre-printed detail all the way across the page. This includes rented land that is
no longer available to you.
The claimed area in column 7 should not exceed the MEA in column 5. If it does you must place an X in column 6 and supply a map or other evidence to verify the new claim.
1
Townland
You are legally required to declare all the land in your holding on
31 May 2017 excluding any parcels that you may have leased
out or rented out.
Penalties may apply for non-declaration of any parcel/plot in
your holding on 31 May 2017.
Add any new parcels/plots by writing in the parcel/plot details on
a new line. Where you wish to sub-divide a parcel draw a line
through the pre-printed details all the way across the page and
write in all the parcel details with an indicator of A, B, etc and the
revised claimed area in Column 7 for each sub-division.
PLEASE NOTE
A MAP MUST BE ENCLOSED FOR ANY NEW PLOT OR
AMENDED PARCEL
2
Land Parcel Number
PLEASE NOTE
3
Commonage
Fraction
4
Digitised
Area
5
Maximum
Eligible Area
(MEA)
6
Request
change to
MEA
7
Claimed Area
of each parcel
in hectares
State if the
This is the
parcel is
area of each This area is fixed If you wish
This is the area
parcel before for each parcel to request an of the parcel that you
Owned = O
the deduction
based on
amendment
are claiming
Rented-in = R
of any
previous claims
to the
for payment.
Leased in = L
ineligible area
made on that
MEA
If you are changing
PLEASE
such as
parcel and on
of a parcel,
your claimed area
NOTE
roadways,
inspections..
you must
for any parcel in 2017,
inaccessible
place an 'X'
please amend
Any claim on areas, rivers,
in this
and update
Commonage dense scrub,
Column
the pre-printed
land must be
etc.
against
details.
supported by
the
documentary
parcel
evidence of
you wish
entitlement (if
to change.
not previously
submitted).
An asterisk * beside State the share
claimed as a
the parcel number
fraction of the
indicates that all or
total
part of the parcel is
Natura land as
Commonage
designated by NPWS.
A hashtag # indicates
an Environmentally
Sensitive Permanent
Grassland parcel.
Please refer to
Terms & Conditions
(T&C) for
requirements on
these parcels.
8
ORL
HECTARES
HECTARES
HECTARES
9
PARCEL USE
IN 2017
State the actual crop or other use of each
parcel in 2017. Please see the list of
Parcel Uses in the enclosed Terms and
Conditions.
Only a Parcel Use stated on that list
should be entered here.
REPS participants need to adhere to
Sections applicable to REPS in the
Helpsheet/T&C
10
ANC
Parcel
Please
place an X
in the
appropriate
box to
indicate
that the
parcel is
not
available
for a full 12
months.
Please
refer to
T&C for
requiremen
ts on ANC
parcels.