Creating Wealth through Farming

OUTGROWER PROGRAM
BENEFICIARY CONSENT FORM

I ________________________________ OF ________________LGA with phone

number ________________________ indicate interest to be part of Noman
Zamani Outgrower program 2023.

INPUT RECEIVED

1). UNITED FERTILIZER – NPK (15:15:15) 3BAGS SIGN/DATE_

2). INDOROMA (UREA) 2BAGS SIGN/DATE_

3). XTRAVEST (2 BOTTLES) SIGN/DATE_

4). MAIZE SEED (20KG) SIGN/DATE_

LOAN INPUT REFUND

The total value of input received worth ₦160,000, will be paid at harvest
(Nov/Dec 2023) with grains of maize of the equal value of input received. For if at
harvest, a bag of maize is sold at ₦16,000, it therefore means that a total of 10
bags will be recovered from the farmers to Noman Zamani.

I ______________________________ declare that I understand and agrees to

terms of the input loan

______________________________ ______________________________
Farmers sign/date Extension Agent sign/date

______________________________
LGA Coordinator sign/date