Description for payment documentation
This is an image of the payment documentation for seed potato crop inspection CFIA/ACIA 5440 form used to collect information related to the application and hectarage fee for seed potato crop inspection by the CFIA. The form has space to collect the name and mailing address of the grower, the grower number, the number of hectares inspected, the province of inspection, the date of inspection, and space to calculate the costs for application and fee per hectare. Below the calculation, there is space to provide information on the method of payment by either marking a check box and indicating the cheque number or by marking a check box for either Visa, Mastercard or American Express depending on the credit card used. There is a box for the date payment was received by the CFIA, the receipt number, blotter number, sales office, contact name and phone number.