1 Give your personal information - Government of Nova Scotia · 2 Give loan information . ... Propulsion (engine to prop), Fuel System (see Note 3) $ 6. ... NOTES: 1) Quotes required

New Vessel Loan Application

Fisheries and Aquaculture

Checklist

Please submit the following with your application:

Full Personal Tax Returns for last 3 years

Notices of Assessment for last 3 years

Applicant confirmation of all fishing licenses currently held (print out) via National Online

Licensing System

Include “Bill of Materials” from this application signed and sealed by the boat builder and by the

Applicant plus the Quote(s) from builder or complete “Quote Details” section of this application

Quotes must include: 1) Engine Quote, and 2) Electronics Quote

Builder’s Risk Insurance

Life Insurance

Confirmation from Canada Revenue Agency that there are no outstanding taxes owed to

Canada Revenue Agency either corporate and/or personal

Photocopies of two (2) pieces of government ID (Birth Certificate, Driver’s License)

NOTE:

All applications are subject to an Administration Fee and a Mortgage Registration Fee.

RETURN ALL DOCUMENTS TO:

Nova Scotia Fisheries and Aquaculture Loan Board 74 Research Drive Bible Hill NS B6L 2R2 Phone: (902) 896-4800 Fax: (902) 896-4812

INDIVIDUAL



My loan will help me to (check all that apply):

Begin fishing

Create jobs for: full time or seasonal (½ year)

Expand my business

Apply new technology

Improve my business profitability

Maintain my vessel and equipment

Allow me to survive a low-price cycle or poor production year

INDIVIDUAL



1 Give your details (please print) Last name:

First name: Middle name:

Mailing address: Postal code:

Civic address: In the county of: __________

Telephone: Cell: Fax:

Email:

Date of birth (dd/mm/yyyy): Social Insurance Number: ________________________________________

Alternative Contact Person Name: _________________________________________________ Tel: __________________________

Your Spouse’s First and Last Name: _______________________________________________

Your Spouse’s Date of Birth (dd/mm/yyyy): __________________________ Your Spouse’s Social Insurance Number: ____________

Your Spouse’s Current Occupation: ________________________________ Your Spouse’s Email: ___________________________

Your Spouse’s Employer: ________________________________________ Your Spouse’s Gross Income: _____________________

Number of Dependents and Ages: ________________________________________________________________________________

2 Give loan information

A. Total amount required: $

B. Deposit (10% minimum): $

C. Net loan (A – B): $

State Source of Equity Deposit:

Upon loan approval, I/we prefer payments to begin the month of:

Continuing: Annually Semi-annually (please check one)

Do you have any existing or previous loans with the Loan Board? Yes No

Homeport: _________________________________ Port of Registry: __________________________________

Number of years of fishing: ____________ Fishing Master Certificate held: __________ Number of years as captain: _____________

Please list fishing licenses (include license #’s)

1. ________________________________________________________________________________________________________

2. ________________________________________________________________________________________________________

3. ________________________________________________________________________________________________________

Please provide copies of SVOP / Fishing Master Class and/or other certificates.

3 List references (fish buyer, bank, credit union, merchant, co-op, etc. — please provide 3 from the selection):

A reference letter from your financial institution (eg. bank / credit union) is preferred. This letter should provide all balances for loans, savings accounts, chequing accounts, stocks, bonds, RRSP, etc.

Name Address Business Telephone

INDIVIDUAL



4 Authorization

I/we hereby authorize the exchange of credit and production or landings information on the applicant(s) by the Nova Scotia Fisheries and Aquaculture Loan Board with any businesses providing credit, insurance coverage with whom the applicant(s) has/have or propose to have financial arrangements with during the period of time the applicant(s) has/have a loan with the Board.

By initialing this box, I/we hereby authorize the exchange of application information between the Nova Scotia Fisheries and Aquaculture Loan

Board and the Nova Scotia Provincial Coastal Resource Coordinator in my area.

All information on the loan will be subject to the disclosure and protection of privacy provisions of the Nova Scotia Freedom of Information and Protection of Privacy Act. The consent is irrevocable during the period of time the applicant(s) has/have financial arrangements with the Board. As well, the applicant authorizes the Department of Fisheries and Oceans to provide the Board with his/her statistical fish catch information.

Signature of applicant(s) Date

5 Return all pages to Nova Scotia Fisheries and Aquaculture Loan Board

74 Research Drive, Bible Hill NS B6L 2R2 Phone: (902) 896-4800 / Fax: (902) 896-4812

INDIVIDUAL



1 Provide Details of Fishing Experience

2 Employment History

Date Employer/Address/Contact Name/Phone Number Duties

Signature Date

ADDITIONAL INFORMATION



1 Give your details (please print)

Last name: First name: Middle name:

Social Insurance Number:

2 Financial History

Have you personally declared bankruptcy in the past 6 years?

Yes No

Are you involved in any lawsuits? Yes No

Have you ever had a judgment filed against you? Yes No

Are you financially obligated? (co-signor, guarantor, endorser) If yes, what is the total amount of the obligation?

Yes No

Do you currently have life insurance?

Life insurance face value:

Yes No

$_______________

$______________

3 List Assets

Item Estimated Value

House and land: $

Furniture: $

Boat – Name: Length: Age: $

Sell or keep:

Fishing licence(s) – state type of licence and estimated value of each:

1. $

2. $

3. $

Lobster traps – number: $

Other fishing gear – type: $

Car – year and make (no leased vehicles): $

Truck – year and make (no leased vehicles): $

Other – please describe $

Savings account, chequing account, RRSP, GIC or other investments (please detail below or on reverse if more space is required):

Item Financial Institution Account Number Current Balance

4 List Liabilities Mortgages/Loans/Credit Cards/Lines of Credit/Leased Vehicles (please detail below or on reverse if more space is required):

Financial Institution Purpose Original Amount Payment Current Balance

PERSONAL FINANCIAL STATEMENT



5 List Major Household Expenses

Item Monthly Cost Yearly Cost

Groceries

Utilities

Property Tax

Home Maintenance

Child Care

Insurance

Other – please describe

TOTAL

Amount owing to Revenue Canada: $ Repayment terms:

Signature Date

PERSONAL FINANCIAL STATEMENT



A) Income

Species Price Year 1

Total

Price Year 2 Total

Price Year 3 Total

Price Year 4 Total

Price Year 5 Total Lbs. Lbs. Lbs. Lbs. Lbs.

Other Income (EI, spouse, etc.) $

Total Income $

B) Direct Operating Expenses

Expense Item Year 1 Year 2 Year 3 Year 4 Year 5

Fuel

Gear

Food

Bait/Ice

Refit and Maintenance

Worker’s Compensation

Insurance

Loan Board Payment (Principal and Interest)

Crew Wages and Benefits

Captain’s Wage

Dockside Monitoring

Licence Fees/Dues

Berthage/Wharf Fees

General/Admin./Professional Fees

Vehicle

Telephone

Household Expenses (from Financials)

Other

Total Expenses $ $ $ $ $

C) Income before tax (Total A – Total B)

D) Income tax

E) Net income (Total C – Total D)

F) General Information

Areas to be fished:

Projected number of trips:

Last years’ gross stock for present vessel:

Fish Buyer:

Signature Date



1 Give contact information (please print)

Applicant: Email:

Mailing address: Postal code:

Civic address: County:


Builder: Email:

Address: Postal code:


Port of Registry (Transport Canada): ______________________________

2 List Contract Prices (do not include sales tax (HST or GST)

Description Builder *Owner* *Vendor*

1. Hull and Structures (frames, stiffeners, bulkheads) $

2. Decks and Superstructures $

3. Outfitting, Fire and Safety $

4. Electronics and Electrical Systems $

5. Propulsion (engine to prop), Fuel System (see Note 3) $

6. Mechanical and Hydraulic Systems $

7. Miscellaneous (additional items) $

Sub-Totals $ $ $

Total Contract Price

*OFFICE USE ONLY

LESS Payments made directly to supplier or builder.

Receipts required.

$ $

3 Other Information

Length Overall Length for Licence Breadth Depth

Vessel Dimensions

Type of Vessel

Hull Material Hull Maker

Construction Start Date Construction End Date

NOTES:

1) Quotes required for Board financed equipment supplied by owner/vendor/builder and must be attached to specification (Engine, Generator, Electronics & Hydraulics if applicable)

2) Builder must complete attached costed Bill of Materials or submit detailed, costed quote for build 3) Only new and rebuilt diesel engines that comply with emission provisions set forth by Transport

Canada, are eligible for Loan Board Financing. Please confirm compliance with engine supplier & provide documentation.

4) It is the responsibility of the Owner & Builder to ensure all equipment & materials are in compliance with the regulations and standards set forth by Transport Canada.

5) All extras intended for Board financing must be submitted and approved by Loan Board before construction; failure to do so may disqualify funding for extras.

4 Signatures and Notarizations (Hardcopy of this page, with company seals, must be sent via mail)

Applicant Builder

Date Date

5 Return the form Inspector Approval__________________

Nova Scotia Fisheries & Aquaculture Loan Board Loan Number______________________ 74 Research Drive, Bible Hill NS B6L 2R2

BILL OF MATERIALS



1) Hull & Structures (frames, stiffeners, bulkheads)

Item Component Type Material Size Qty. Cost

Aft (Lazz) Tank

Tanks

Insulation

Refrigeration

Grating

Gelcoat

AntiFouling Paint

Bulkheads

WT

Non-WT

Insulation

WT Bhd Gland

Curb Irons

Filled Keel

Fish Hold

Compartments

Pen Boards

Insulation

Refrigeration

Grating

Gelcoat

Frames

Hull Protect. IWO Hauler

Hull Ribbons

Live Wells

Compartments

Insulation

Refrigeration

Grating

Gelcoat

Name and Registry

Raised Stempost

Rope Locker

Rub Rail

Steering Gear Cmpt.

Stern Extension

Stiffeners

Vertical Floors

Total for Hull and Structures

QUOTE DETAILS – complete only if no builder quote is attached



2) Decks and Superstructures

Item Component Type Size Material Qty. Cost

A-Frame

Anchor Shoot

Boom

Bow Rail

Forward Deck

Gunnels

Hand Rail

Hatches

Engine Room

Deck

Foredeck

Cuddy

Fish Hold

Wheelhouse

Hawse Plates

Insulation

Engine Room

Deck

Cuddy

Wheelhouse

Interior Finish

Engine Room

Deck

Cuddy

Foredeck

Wheelhouse

Ladders

Engine Room

Deck

Cuddy

Fish Hold

Foredeck

Lobster Derrick/Block

Main Deck

Mast

Radar Arch

Radar Reflector

Scuppers / Freeing Ports

Slaughterhouse Doors

Staples / Cleats

Stern Extension / Tray

Stern Pipe

Tailgate

Toe Rail

Trap / Pot Rail

Vent Cowls

Washboard Rails




Wheelhouse Exterior

W/H Top

Total for Decks & Superstructures

3) Outfitting, Fire and Safety


Anchor

Anchor Windlass

Blowers / Fans

Bunks Cuddy

W/H

Cabinet Hardware Cuddy

W/H

Chart/Plate/Cup Rack

Chart Table

Clearview

Compass

Cupboards Cuddy

W/H

Doors Fixed

Sliding

EPIRB

ER Floor Plates

Exhaust Trunk

Fire Buckets

Flares / Rockets

Furnace

Heater Cuddy

W/H

Helm

Horn

Hyd. Cabinet

Liferaft

Life Jackets

Life Rings

Life Ring Lights

Mattress Cuddy

W/H

Microwave Cuddy

W/H

Mooring Lines

Pilot Chair

Propane Box

Propane Sensor

Propane Tanks




Refrigerator Cuddy

W/H

Seats Cuddy

W/H

Ship Bell

Shower Cuddy

W/H

Shutters

Sink / Faucet Cuddy

W/H

Stove Cuddy

W/H

Survival Suits

Toilet Cuddy

W/H

Table Cuddy

W/H

Vents

Visor

Windows Fixed

Sliding

Window Blower

Window Heater

Wet Locker

Wipers

Total for Outfit, Fire and Safety $




4) Electronics and Electrical Systems


Alternator

Anodes

Autopilot

Auxilliary Panel

Batteries

Battery Charger

Battery Isolation Switch

Converter

Electrical Panels

Wheelhouse AC

DC

Engine Room AC

DC

Cuddy AC

DC

Flood Lights

GPS

GPS WAAS

Hull Ground Plate

Inverter

Lights / Receptacles / Switches

Fish Hold

Lazarette

Deck

Slaughterhouse

Wheelhouse

Cuddy

Engine Room

Main Shutoff Switch

Monitor

Navigation Lights

Navigation Light Panel

Plotter

Radar

Radar Reflector

Satellite Tel.

Search Light

Shore Power

Sounder

Sound System

SSB

Transducer

VHF

Weather Fax

Total for Electronics and Electrical Systems $




5) Propulsion and Fuel Systems


Allen Bearing

Bow/Stern Thruster

Cutlass Bearing

Deck Fills

Emergency Tiller

Exhaust System wet ( ) dry ( )

Exhaust Insulation

Engine

Diesel

HP

RPM

Engine Bed

Engine Controls

Engine Mounts

Fuel Filters

Fuel Tanks

Fuel Lines

Generator

Jack Shaft

Propeller

Prop Cage

Prop Shaft

Reduction Gear Model

Ratio

Shaft Covers

Steady Bearing

Stuffing Box

Stern Tube

Surge Tank

SW Strainer

Skeg

Shaft Spurs

Vent Lines

Waterlock

WT Bulkhead Gland

Total for Propulsion and Fuel Systems $




6) Mechanical and Hydraulic Systems


Bait Cutter

Bilge Pumps & Float

Switch

Fish Hold

Lazzarette

Engine Room

Forward

Hanging Block

C02 System

Deck Washdown

Dump Table

Engine Cooling Pipes

Fairlead / Roller

Hauler

Capacity

Cooling Pipes

Clutch

200 ft-lb

400 ft-lb

1000 ft-lb

Tank

Hauler Pump

Direct Drive

Gear ( ) Vane ( )

Belt Driven

Demand

High Water Alarms

Hydraulic Tank

Hydraulic Filter

Hyd. Temp. Gauge

Hot Water Heater

Net Drum

Propane Tanks

Propane Tank Box

Pullmaster

Raw Water Strainer

Rudder

Rudder Stock

Rudder Packing Box

Steering System

Steering Cooling Pipes

Stabilizers

Vent / Fans

Engine Room

Wheelhouse

Cuddy

Water Pump

Winch

Washdown Pump

Total for Mechanical and Hydraulic Systems $




7) Miscellaneous


Total for Miscellaneous $


Documents

1 Give your personal information - Government of Nova Scotia · 2 Give loan information . ... Propulsion (engine to prop), Fuel System (see Note 3) $ 6. ... NOTES: 1) Quotes required