FRIAA Dues/Reforestation Levies Remittance Form
Individual/Company Remitting Payment:__________________________________________
Disposition holder name: _______________________________________________________
Disposition number: ___________________________________________________________
FRIAA Dues Summary
Month or quarter to which FRIAA dues payment applies: _____________________________
Rate:		Coniferous:___________________	Deciduous: ___________________
Volume:	Coniferous:___________________	Deciduous: ___________________
Total FRIAA dues remitted: ______________________________________________
FRIAA dues rate applied:
		Under 107,296 m3: ______________________________________(rate)
		Over 107,296 m3: _______________________________________(rate)
		Community Reforestation disposition $0.50 (rate)
Reforestation Levy Summary
Do reforestation levies apply to this disposition:					Yes/No
Rate:		Coniferous:___________________	Deciduous: ___________________
Volume:	Coniferous:___________________	Deciduous: ___________________
Total Reforestation levy remitted: ______________________________________
Total reforestation remittance: ___________________________________
*	*	*	*	*	*	*	*	*	*	*
Contact Representative: ______________________	Phone Number: ______________
Date: ______________________________________
PLEASE REMEMBER TO INCLUDE A COPY OF YOUR TIMBER RETURN WITH ALL REMITTANCES

Forest Resource Improvement Association of Alberta (FRIAA)
Box 11094, Main Post Office
Edmonton, Alberta T5J 3K4
Telephone: (780) 429-5873
Fax: (780) 429-4026