Manitoba Premises Identification Application For Livestock and Poultry

Premises Information

A premises is a parcel of land, on which or on any part of which livestock or poultry are grown, kept, assembled or disposed of at any point during the year. When applying for multiple premises complete an additional form for each premises or contact your local Manitoba Agriculture Office for assistance.

Land Description
Premises Type (select all that apply)
Species Type

Select all species that may be present at any time during the year at this location. For each species indicate the maximum capacity (i.e the maximum number of animals this premises is expected to accommodate). For the other birds and other categories list all applicable species and indicate the maximum capacity for each. Please see the guidelines for a list of the other species to be included.

Contact Information
Emergency Contact Information: (individual responsible for day-to-day operations at premises)
Notice of Collection of Personal Information

The personal information on this form is being collected for the Premises Identification Program of Manitoba Agriculture under the authority of section 3(1) of the Animal Premises Identification Regulation 104/2010 under The Animal Diseases Act, and will be used for one or more of the following purposes, described in section 2(2) of the Regulation:

(a) detecting, preventing, controlling, managing and eliminating disease;
(b) analyzing the geographical distribution of disease and the epidemiology of disease outbreaks;
(c) conducting assessments and models to prevent disease risk;
(d) tracking the movement of animals from premises to premises;
(e) protecting animal health and human health;
(f) emergency planning;
(g) eliminating disease barriers to market access;
(h) checking the accuracy of information collected or provided under this regulation.

And may be disclosed to the following persons or entities, under section 6(2) of the Regulation:

(a) a department, branch, office or agency of the Government of Manitoba;
(b) the Government of Canada or a municipal, provincial or foreign government, or an agency of such a government, or a person or body whose duties and interests include

(i) protecting the public health
(ii) monitoring or reporting on the safety of agricultural inputs, food, livestock or livestock products, or
(iii) monitoring or reporting on the biological, chemical and physical integrity of agricultural inputs, food, livestock or livestock products;

(c) a producer board.

The personal information is protected by the privacy provisions of The Freedom of Information and Protection of Privacy Act. Other than in circumstances referenced in this notice the personal information will only be disclosed where authorized by law. If you have any questions concerning the collection, use or disclosure of the personal information, please contact the FIPPA Access and Privacy Coordinator, Manitoba Agriculture at 204-945-4823.

Additional Information

For more information, contact your local Manitoba Agriculture Office, call Manitoba Government Inquiry at
1-866-626-4862 to help locate your nearest office or email

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