Name of the Producer :
Commercial Name or Institution :
Address :
The genus and variety of the seed :
The first Seed Sample
1. Name and address taken
2.Name of the experts taking
3. The institution of the experts taking
4. The institution issuing certification or report
5. Date and number of the certificate or report
6. Class and chronological age of the seed
The second Seed Sample
1.Name and address to be taken
2.The amount of the sample (kg)
3. The number of seed package
4.The lot number of the seed
5.The date to be selected
6.The duration of the selection (day)
Producer Name
Signature, Seal and Date