ARCHIVED - First Nations Land Management Report

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PDF Version - Fill & Print (95 Kb, 1 Page)

Form Instructions

DCI# 41740 (2014-2015)

Privacy Act Statement

The information you provide in this document is collected under the authority of the Lands and Economic Development Program. Information on individuals is used by Aboriginal Affairs and Northern Development Canada employees. We do not share the personal information with other government departments. The personal information will be kept for a period of 30 years. Individuals have the right to the protection of and access to their personal information under the Privacy Act. The information collected is described under the Personal Information Bank INA PPU 608, which is detailed at InfoSource.

Note: This reporting template must be used to properly identify and file attachments in meeting the reporting requirement in FNITP.


Recipient Name

Recipient Number

Recipient Contact - Given Name

Family Name


Telephone Number

Email Address

Project Name

Project Number/ID

Report Period (Quarter)

Date (From) (YYYYMMDD)


Project Activities
Attach a copy of your Quarterly Milestone Report as outlined in Schedule C of your Community Approval Process Plan (CAPP).

The report should indicate which quarter you are reporting on by ticking off the appropriate box in the top right of the report you attach.

Indicate the name(s) of supporting document(s) being submitted and the method of submission.

Name of Supporting Document Method Method of Submission

The information provided is accurate to the best of my knowledge.

Given Name

Family Name



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