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Initial Payment Request Form

Check Appropriate Box Commercial Building Incentive Program (CBIP) Industrial Building Incentive Program (IBIP)
Application #:
Date Sent:

INSTRUCTIONS

Once the Contribution Agreement has been signed by the Recipient, and by Natural Resources Canada, an Initial Payment Claim can be processed. Submit this Request Form to the address above to initiate payment.

PROJECT INFORMATION


Building Name:
Tentative Occupancy Date: (dd/mm/yy)
Building Address:
City:
Province:
Postal Code:
Building Permit or similar document acceptable to the Minister:	Attached Already provided to NRCan Will be provided before final payment
Owner: (legal name of registered company)
Contact:
Phone:
Company:
Fax:
Address:
City:
Province:
Postal Code:

PAYMENT INSTRUCTIONS


Total Amount of Approved Financial Incentive: (see Clause 4.1 of the Contribution Agreement)	$
Amount of this First Claim: 80% of Total Above	$
Make Cheque Payable to:
Send Cheque to:
Address:
City:
Province:
Postal Code:

APPLICANT'S DECLARATION


I, the undersigned, declare that I am the owner (or duly authorized representative of the owner) of the building described above, that it has met all the terms and conditions of the Commercial Building Incentive Program or the Industrial Buildings Incentive Program, and that Design Costs have been incurred up to the Total Approved Financial Incentive identified above and in Clause 4.1 of the Contribution Agreement.
Authorized Officier's Signature:
Name:
Phone:
Company:
Date:
Fax:
Address:
City:
Province:
Postal Code:

For NRCan Use Only


Date Payment Request Form Received:
Commitment Number:
Financial Coding:
Amount Payable:
Recommended by:
Approved by:
Account Manager:
Date:
RC Manager:
Date:
Chief, New Buildings Program:
Date:

Next: Download all IBIP forms