Envita™ 2021 Performance Guarantee Claim Form

Thank you for using Envita in 2021. We are sorry Envita didn’t provide a typical yield response. We hope you will try Envita again.

Before continuing to make a claim, please ensure ALL of the criteria below were met:

Program details:

Used at least 160 ac of Envita (4 gallons)
Purchased and applied Envita prior to June 15, 2021 for use on corn or July 30, 2021 for use on soybeans or canola
Applied on applications registered in Canada.
Fertilized your field at recommended rates of nitrogen fertilizer (i.e. 100% of recommended N)
Applied Envita on Corn or Soybeans in-furrow or foliar application at labelled rates and per use guidelines
Left an appropriate check within the same field (i.e. minimum of 5 ac, side by side treated area, similar soil type and topography).
Used a harvest monitor to measure the yield of the Envita treated area and the check area
Corn: If the harvest monitor does not show at least a 2.5 bu/ac increase on the Envita treated area vs. the check area, we will replace your Envita product on the field that did not perform for the 2022 season (separate check strips are required on each distinct field Envita is applied).
Soybeans: f the harvest monitor does not show at least a 1.5 bu/ac increase on the Envita treated area vs. the check area, we will replace your Envita product on the field that did not perform for the 2022 season (separate check strips are required on each distinct field Envita is applied).
Canola: If the harvest monitor does not show at least a 1 bu/ac increase on the Envita treated area vs. the check area, we will replace your Envita product on the field that did not perform for the 2022 season (separate check strips are required on each distinct field Envita is applied).

To assist in the fulfillment of your claim, please fill in the following information no later than December 15, 2021.

Personal Information

Name*
First Name Last Name
Farm Name*
Phone*
Email*
Address*
Mailing Address Mailing Address 2 City Province Postal Code
Claim Details
Land location of fields under claim (If you need to make a claim for an additional field, please submit a separate claim for each field.)*
Acres under claim (treated Envita acres that did not provide minimum yield guarantee)*
Yield of treated acres (bu/ac)*
Acres of check area*
Yield of untreated check acres (bu/ac)*
Other than Envita, was the management of the fields the same?*
Planting date*
MM slash DD slash YYYY
Harvest date*
MM slash DD slash YYYY
Field Soil Type - Best Description*
Method used to collect data*
Type of year*
Estimate of rainfail (inches)*
Method of Envita application*
If Foliar application, what growth stage applied (i.e. V2, V3, V4, V5, V6)
Applied water volume (gal/ac)
What was tank mixed with Envita?

Please list all that apply
Was Envita mixed with water before added to the tank mix?
Amount of actual nitrogen (lbs/ac) applied?
Proof of Purchase*
Accepted file types: jpg, gif, png, pdf, doc, Max. file size: 32 MB.
Please provide proof of purchase.
Yield Monitor Data & Crop Pictures
Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, Max. file size: 32 MB.
Please provide crop/field pictures, and yield monitor data.
Email
This field is for validation purposes and should be left unchanged.

Fulfillment:

All claims must be submitted no later than December 15, 2021.

Azotic North America will let you know the status of your claim within one month of receiving your application. We may follow up with you by phone to collect further details.

With approval, we will be applying a credit for the equivalent product replaced in time for the 2022 season to a maximum value of product purchased.

Thank you again for trying Envita in 2021. We are sorry Envita didn’t provide a typical yield response. We hope you will try Envita again.

Envita™ 2021 Performance Guarantee Claim Form

Thank you for using Envita in 2021. We are sorry Envita didn’t provide a typical yield response. We hope you will try Envita again.

Personal Information

Claim Details

Fulfillment: