REPUBLIC OF THE PHILIPPINES

DEPARTMENT OF AGRICULTURE
PHILIPPINE COCONUT AUTHORITY
[REGIONAL OFFICE]

CERTIFICATE OF REGISTRATION

This is to certify that, Mr./ Ms. __________________________________________________________________________,

Complete Name (First, Middle, Last)

a resident of ____________________________________________________________________________________________,
Complete Address (Sitio/ Street, Barangay, City/ Municipality, Province, Region)

was duly registered in National Coconut Farmers Registry System (NCFRS) on

_____________________________.
Date of Registration (mm-dd-yyyy)

This certifies further that per records in the system, Mr./ Ms. ____________________________________ is
a Last Name

__________________________________________________________________, with coconut farm information

below:Status: Owner, Owner-Tiller, Grower, Tenant, Tenant-Worker, Worker-Laborer
Tenurial

NCFRS Farmer’s ID No.

Total Land Area (in hectares)

1x1 Photo Farm Location

Complete Address (Sitio/ Street, Barangay, City/ Municipality, Province, Region)

Issued this ______ day of __________________, __________ in _____________________________________,

Philippines.

Issued by: Certified by:

_______________________________________ ___________________________________________________
Officer-of-the-Day Regional Manager
Certificate No.: ________________________
Note: This certification was issued with an official stamp of this office and does not bear any alteration.