Instructions: Please supply the required information below by filling-in the blanks and ticking appropriate information in the

selections. Date of Submission: _________________

FARM MACHINERY UTILIZATION REPORT AND FEEDBACK FORM
Name of FCA : _____________________________________________________________________________ Address: ____________________________________________________________________
Contact Person: __________________________________________________________________________ Contact Number: __________________________________________________________
Cropping Period: 1st cropping 2nd cropping 3rd cropping Inclusive Months: _______________ to ________________ Year: ___________
Type of Farm Operation: Land Preparation and Plant Establishment Harvesting and Threshing
Present Buying Price of Palay in Your Area (Php): Fresh (Sariwa) ___________ Dry (Tuyo) _____________
Status of Machine Machinery Utilization Information Financial Information
Total no. of Total Area
Operational = (being used Farmers Availed Serviced
Date of for its intended purpose) Rate of
the Service (Kabuuang Available Funds
Delivery Non-Operational = (not Service Fee Operating
Farm Machinery (Bilang ng hektaryang (including
of being used due to technical (Php) Gross Income Expenses
kliyenteng naserbisyuhan) collectibles)
Machine
problems/ for repair) (Gastos)
Functional = (ready for use naserbisyuhan) (ha) (a-b)
(a) (b)
but presently idle due to
Non- Non- Non-
organizational problems or Member Member Member Collected Collectibles
Member Member Member Total
other issues) (Nagbayad) (Utang)
1.
2.
3.
4.
5.

Suggested Solutions/ Other Comments/

Problems Encountered (if there’s any)
Recommendations Suggestions
Organization and Management Issues
Low acceptability of The management Others (pls specify)
machine/ lack of awareness
Conflict among officers/ members
team lacks training _________________________
Technical Issues Non-compatibility of Others (pls specify)
Frequent breakdown of High maintenance cost
of machine machine in the area _________________________
machine
Financial Issues Others (pls specify)
Lack of operating Poor management
Unpaid collectibles _________________________
capital of funds
Other Problems Encountered
_ __________________________________________________________________________________________________________________________________________

Prepared by: ________________________________ / _________________________ Reviewed/ Approved by: _____________________________________

Name and Signature Position or Designation Name and Signature of Chairman/ President

Disclaimer: The contents of this form will be used solely for monitoring purposes of PHilMech and will be treated with utmost confidentiality.
This form is for enrollment to PHilMech-IMS.
Instructions: Please supply the required information below by filling-in the blanks and ticking appropriate information in the selections. Date of Submission: _________________

LIST OF FARMER CLIENTS

Farm Machinery: ________________________________

Address/ Location of Category Date of farm machinery Area Serviced Operating hours of farm
Client’s Farm service provided (ha) operation Amount Paid
Name of Farmer Client
(Lokasyon ng bukid ng Non- (petsa ng pagseserbisyo (bilang ng oras ng pagseserbisyo) (Php)
kliyente) Member * If Applicable
member ng makinarya) *If applicable
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
Prepared by: ________________________________ / _________________________ Reviewed/ Approved by: _____________________________________
Name and Signature Position or Designation Name and Signature of Chairman/ President

Disclaimer: The contents of this form will be used solely for monitoring purposes of PHilMech and will be treated with utmost confidentiality.
This form is for enrollment to PHilMech-IMS.
Instructions: Please supply the required information below by filling-in the blanks and ticking appropriate information in the selections. Date of Submission: _________________

CASH FLOW STATEMENT OF FARM MACHINERY OPERATION PER CROPPING

Name of FCA : _____________________________________________________________________________ Address: _____________________________________________________________________
Contact Person: __________________________________________________________________________ Contact Number: __________________________________________________________

Cropping Period: 1st cropping 2nd cropping 3rd cropping Inclusive Months: _____________ to _____________ Year: ___________

Machinery 1: Machinery 2: Machinery 3: Machinery 4: Machinery 5:

________________________ _________________________ ______________________ _____________________ ____________________

Operating Cash-Beginning (a) Php___________________ Php___________________ Php__________________ Php________________ Php_______________

Cash Inflows (INCOME)

Total Service Fee Collected ________________ ________________ ________________ ________________ _______________

Other income ________________ ________________ ________________ ________________ _______________

Total Cash Inflows (b) ________________ ________________ ________________ ________________ _______________

Total Source of Cash (c) = a+b _____________________ _____________________ ____________________ ____________________ ___________________

Cash Outflows (EXPENSES)

Fuel expense (diesel, etc.) _______________ _______________ _______________ _______________ _______________

Labor Cost/ Honorarium _______________ _______________ _______________ _______________ _______________

Repair and Maintenance _______________ _______________ _______________ _______________ _______________

Other expenses _______________ _______________ _______________ _______________ _______________

Total Cash Outflows (d) _______________ _______________ _______________ _______________ _______________

Net Cash Flow per machinery (e) = c-d Php___________________ Php___________________ Php__________________ Php_________________ Php________________

Prepared by: ________________________________ / _________________________ Reviewed/ Approved by: _____________________________________

Name and Signature Position or Designation Name and Signature of Chairman/ President

Disclaimer: The contents of this form will be used solely for monitoring purposes of PHilMech and will be treated with utmost confidentiality.
This form is for enrollment to PHilMech-IMS.