1. OLD
P.J. MARGO PVT. LTD.,
th
# 344/8, IV Main Sadashivnagar,
Bangalore – 560 080,
Ph No: 080 – 40061999 /23613051 /52
FARMER CARD
Agreement No.:0001
Farmer code: ………………………………….. Branch: ………………………………………
Father Name: …………………………………..S/o…………………………………………….
Village: ………………………………………….Taluk: …………………………………………
Cluster: ………………………………………………………………Acre: …………………….
AGRI INPUT ISUUE DETAILS
Issue
Date Particulars Unit Qty. Rs./Unit Signature
Slip No
Cluster In-charge Branch In-charge

2. PROCURMENT & PAYMENT DETAILS
DWS No. of Quantity PAYMENTS
Date Sign
Nos Bags (in Kgs) Deduction Amount Paid
Bags Details 1 2 3 4 5 6 7 8
Bags issued
Bags Collected
Cluster In-charge Branch In-charge

3. NEW
P.J. MARGO PVT. LTD.,
th
# 344/8, IV Main Sadashivnagar,
Bangalore – 560 080,
Ph No: 080 – 40061999 /23613051 /52
FARMER CARD
Farmer code: ………………………………….. Branch: ………………………………………
Farmer Name: ………………………………..S/o…………………………………………….
Village: ………………………………………….Taluk: …………………………………………
Cluster: ………………………………………………………………Acre: …………………….
AGRI INPUT ISUUE DETAILS
Issue
Date Particulars Packing Units Qty. Rs./Unit Signature
Slip No
Commercial Officer Production Executive

4. PROCURMENT & PAYMENT DETAILS
PAYMENTS
DWS No. of Quantity Amount /
Date Amount Sign
Nos Bags (in Kgs) Value Deduction
Paid
Bags Details 1 2 3 4 5 6 7 8
Bags issued
Bags Collected
Commercial Officer Production Executive

5. OLD
TIN No: 29960286507
1926/22 12
– 577 004
STOCK TRANSFER RECEIPT (STR)
STR SL No.:
:
: :
: :
: :
: :
:
:
:
____________________________________________________________________________
: . . :
:

6. NEW
TIN No: 29960286507
344/8, 4
– 560 080
080 – 40061999 /23613051 /52
STOCK TRANSFER RECEIPT (STR)
Region: DVG / TMK STR SL No.:00001
Branch ( :
Cluster : Date ( ):
Starting (KM) ( ): Reached (KM) ( ):
Marigold Fresh flowers are collected from farmers of the following villages is being
transferred to Hiriyuru / Tumakur for processing.
Vehicle No ): No. of Bags ):
Places ): Total weight As per DWS ):
Total weight As per STR ):
DWS Nos ( ):
Sender Sign ( ):
Time ( ):
____________________________________________________________________________
Accepter Sign ( ): No. of Bags Acptd ( . . ):

7. OLD
Time ( ):
P J MARGO PVT LTD
“ANUGRAHA” # 1926/22, Siddaveerappa Extension,
th
12 Cross, Davanagere – 577 004 Mob: 96826 51013
ISSUE/RECEPT
No. ……………… date…………………..
Branch/Cluster: FMR Code:
Issued the following input to Mr.……………………………….
S/o……………………………. Village…………………………………..
S Particulars Packing Qty
No.
1
2
3
4
5
Issued by: Farmer’s Signature:

8. NEW
P J MARGO PVT LTDth
# 344/8, IV Main Sadashivnagar,
Bangalore – 560 080,
Ph No: 080 – 40061999 /23613051 /52
INPUT ISSUE SLIP /
No ……………… Date …………..
Region : DVG / TMK FMR Code:
Issued the following input to
MR MRS .……………………………….
S/o ……………………………. Village ( ……………………………….
SL No. Input Packing UM Qty
1
2
3
4
5
Issued by: Farmer’s Signature:
: :
Date ( : Date ( :

9. OLD
TIN No: 29960286507
1926/22 12 – 577 004
DAILY WEIGHMENT Sl No.00001
: SLIP
: : :
: : :
Total/ Remarks /
Total Wt.
No. of Bags
Bags
Weight Ded
Net Weight
(Farmer’s Signature) (Weighted Staff Sign.)

10. NEW
TIN No: 29960286507
344/8, 4 – 560 080
080 – 40061999 /23613051 /52
P. J. Margo Private Limited
# 344/8, IVth Main Sadashivnagar, Bangalore – 560 080
DAILY WEIGHMENT Sl No.00001
SLIP
/ Farmer Code No :
/ Region: DVG / TMK :
:
1 2 3 4 5 6 7 8 9 10 Total/ Remarks /
Total Wt.
No. of Bags
Bags
Weight Deduction
Net Weight
(Farmer’s Signature) (Commercial Officer Sign.) (Commercial Assistant Sign)

11. Print on back side of First copy
Remarks /
Paid By/
V. No /
Amt Paid Rs./
Deduction/
1. Seed Rs. /
2. Input Rs. /
3. Others Rs. /
Total Ded. Rs./
Entered By/

12. OLD
Payout Complaints and Compliance Report
Cluster
Payout Date
Purchase Period From: To:
Disbursed By
Field Officer Field Assistant
Payment Taken Disbursed Balance
Current
Covers
Cash
Unpaid
Covers
Cash
COMPLAINTS noted Complaints Attended Signature
Officer in-charge Field Officer / Field Assistant

13. NEW
Payout Complaints and Compliance Report
Cluster
Payout Date
Purchase Period From: To:
Disbursed By
Production Production
Executive Assistant
Payment Taken Disbursed Balance
Current
Covers
Cash
Unpaid
Covers
Cash
COMPLAINTS noted Complaints Attended Signature
Commercial Assistant Commercial officer

14. OLD
P J MARGO PVT LTD
# 344/8, IVth MAIN, SADASHIVNAGAR
BANGALORE-560 080
MARIGOLD CULTIVATION SEED RECEIPT AND AGREEMENT COPY
DATE : AGREEMENT NO:
FARMER’S NAME : CLUSTER :
FATHER’S NAME : VILLAGE :
TALUK : DISTRICT :
SURVEY NO : ACRE :
I agree to pay an amount of Rs. …………………(Rupees. ………………..only) towards seed cost of
Marigold seed supplied by P J Margo Pvt Ltd. Bangalore on (date) ………. And I will grow the crop in
accordance to the terms and conditions below. I abide to the decisions taken by the Company in case
the above terms and conditions are violated.
Terms and Conditions:
1. I hereby agree to grow Marigold in my own Land under guidance of the company.
2. Procurement price during this season is Rs………………per MT of FF (Fresh Flower) I agree to this pre
fixed price.
3. I hereby authorize the Company to deduct all Agri input cost supplied by them in payment proceedings.
4. I agree to supply flowers at the designated CC (Collection Centre) fixed by the Company. The
Company has right to reject flowers immersed in water or adulterated with Stones, twigs, mud, other
foreign materials, etc.
5. The Company will make arrangements to transport FF from CC and bags for filling flowers.
6. Flowers produced from the seed provided by the Company should not be sold to any other person or
Company. If found so, I abide to the decision taken by the Company.
7. The Company is authorized to deduct half Kg per bag of flower after Weighment if flowers are
adulterated, the Company can take appropriate action.
8. The Company is authorized to engage labors to harvest FF in case farmer fails to do so in time and
cost of harvesting shall be deducted in FF payments.
9. I agree to collect payment in cash through Bank accounts at concerned regional office.
10. All disputes are subject to Bangalore jurisdiction.
11. The Company is not responsible for any situation arising out of natural calamities and improper
agricultural practice.
____________________ ____________________ ____________________
Farmer’s Signature Signature of Supervisor Signature of Area Manager

15. 344/8, 4 – 560 080
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16. NEW
P J MARGO PVT LTD
# 344/8, IVth MAIN, SADASHIVNAGAR
BANGALORE-560 080
MARIGOLD CULTIVATION SEED RECEIPT AND AGREEMENT COPY
DATE : AGREEMENT SL NO:
FARMER’S NAME : CLUSTER :
FARMER CODE :
FATHER’S NAME : VILLAGE :
TALUK : DISTRICT :
SURVEY NO : ACRE :
I agree to pay an amount of Rs. …………. (Rupees…only) towards seed cost of Marigold seed supplied by
P J Margo Pvt Ltd. Bangalore on (date) ………. And I will grow the crop in accordance to the terms and
conditions below. I abide to the decisions taken by the Company in case the above terms and conditions
are violated.
Terms and Conditions:
1. I hereby agree to grow Marigold in my own Land under guidance of the company.
2. Procurement price during this season is Rs………………per MT of FF (Fresh Flower) I agree to this pre
fixed price.
3. I hereby authorize the Company to deduct all agri input cost supplied by them in payment proceedings.
4. I agree to supply flowers at the designated CC (Collection Centre) fixed by the Company. The
Company has right to reject flowers immersed in water or adulterated with Stones, twigs, mud, other
foreign materials, etc.
5. The Company will make arrangements to transport FF from CC and bags for filling flowers.
6. Flowers produced from the seed provided by the Company should not be sold to any other person or
Company. If found so, I abide to the decision taken by the Company.
7. The Company is authorized to deduct half Kg of bag weight per bag of flower after Weighment if
flowers are adulterated, the Company can take appropriate action.
8. The Company is authorized to engage labors to harvest FF in case farmer fails to do so in time and
cost of harvesting shall be deducted in FF payments.
9. I agree to collect payment in cash through Bank accounts at concerned regional office. The Payment
will be disbursed once in 15 days.
10. All disputes are subject to Bangalore jurisdiction.
11. The Company is not responsible for any situation arising out of natural calamities and improper
agricultural practice by farmer.
____________________ ____________________ ____________________
Farmer’s Signature Production Executive Signature of Area Manager

17. 344/8, 4 – 560 080
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18. Payment Covers
Front Side Back Side
DATE:
FARMER CODE:
DWS No: Kgs
FARMER PAYOUT
AMOUNT (Rs.)
PAYABLE A
DEDUCTION :
Seed Cost :
Input Cost :
Others :
Total B
NET PAYABLE C
(C=A-B)
Approved by :
Denomination
1000 X
500 X
100 X
50 x
Total Amount: Rs.