USTA TAMPERPROOF LABELS REQUEST FORM

Fill in required information Remarks

Date
18th May 2024

Name of the company

NASECO 1996 LTD
Crop MAIZE
Variety BAZOOKA

Lot number
NAS/032/24A
Lot Size
40MT
Pack Sizes
1Kgx 50
Seed treatment (chemicals
used) Show Proof Actellic Plus Thiram
Germination Test data (Attach
lab analysis results) 93%
Number of labels requested 800

Amount paid (Proof of

payment)

Requested by (MD of Seed Company or assigned official of Seed Company and stamp)

Name: ---Katwere Godfrey ---------

Signature: ----------------------------------------

USTA approval (Signature and stamp)

Name: ---------------------------------------------

Signature: -----------------------------------------

Note; This form to be filled in triplicate (One remains at USTA, 2nd copy to be retained by the company
and the 3rd copy to be submitted to MAAIF while requesting for labels
 USTA TAMPERPROOF LABELS REQUEST FORM

Fill in required information Remarks

Date
18th May 2024

Name of the company

NASECO 1996 LTD
Crop MAIZE
Variety BAZOOKA

Lot number
NAS/033/24A
Lot Size
40MT
Pack Sizes
1Kgx 50
Seed treatment (chemicals
used) Show Proof Actellic Plus Thiram
Germination Test data (Attach
lab analysis results) 94%
Number of labels requested 800

Amount paid (Proof of

payment)

Requested by (MD of Seed Company or assigned official of Seed Company and stamp)

Name: ---Katwere Godfrey ---------

Signature: ----------------------------------------

USTA approval (Signature and stamp)

Name: ---------------------------------------------

Signature: -----------------------------------------

Note; This form to be filled in triplicate (One remains at USTA, 2nd copy to be retained by the company
and the 3rd copy to be submitted to MAAIF while requesting for labels
 USTA TAMPERPROOF LABELS REQUEST FORM

Fill in required information Remarks

Date
18th May 2024

Name of the company

NASECO 1996 LTD
Crop MAIZE
Variety BAZOOKA

Lot number
NAS/034/24A
Lot Size
40MT
Pack Sizes
1Kgx 50
Seed treatment (chemicals
used) Show Proof Actellic Plus Thiram
Germination Test data (Attach
lab analysis results) 92%
Number of labels requested 800

Amount paid (Proof of

payment)

Requested by (MD of Seed Company or assigned official of Seed Company and stamp)

Name: ---Katwere Godfrey ---------

Signature: ----------------------------------------

USTA approval (Signature and stamp)

Name: ---------------------------------------------

Signature: -----------------------------------------

Note; This form to be filled in triplicate (One remains at USTA, 2nd copy to be retained by the company
and the 3rd copy to be submitted to MAAIF while requesting for labels
 USTA TAMPERPROOF LABELS REQUEST FORM

Fill in required information Remarks

Date
18th May 2024

Name of the company

NASECO 1996 LTD
Crop MAIZE
Variety BAZOOKA

Lot number
NAS/035/24A
Lot Size
40MT
Pack Sizes
1Kgx 50
Seed treatment (chemicals
used) Show Proof Actellic Plus Thiram
Germination Test data (Attach
lab analysis results) 94%
Number of labels requested 800

Amount paid (Proof of

payment)

Requested by (MD of Seed Company or assigned official of Seed Company and stamp)

Name: ---Katwere Godfrey ---------

Signature: ----------------------------------------

USTA approval (Signature and stamp)

Name: ---------------------------------------------

Signature: -----------------------------------------

Note; This form to be filled in triplicate (One remains at USTA, 2nd copy to be retained by the company
and the 3rd copy to be submitted to MAAIF while requesting for labels
 USTA TAMPERPROOF LABELS REQUEST FORM

Fill in required information Remarks

Date
18th May 2024

Name of the company

NASECO 1996 LTD
Crop MAIZE
Variety BAZOOKA

Lot number
NAS/036/24A
Lot Size
40MT
Pack Sizes
1Kgx 50
Seed treatment (chemicals
used) Show Proof Actellic Plus Thiram
Germination Test data (Attach
lab analysis results) 95%
Number of labels requested 800

Amount paid (Proof of

payment)

Requested by (MD of Seed Company or assigned official of Seed Company and stamp)

Name: ---Katwere Godfrey ---------

Signature: ----------------------------------------

USTA approval (Signature and stamp)

Name: ---------------------------------------------

Signature: -----------------------------------------

Note; This form to be filled in triplicate (One remains at USTA, 2nd copy to be retained by the company
and the 3rd copy to be submitted to MAAIF while requesting for labels
 USTA TAMPERPROOF LABELS REQUEST FORM

Fill in required information Remarks

Date
18th May 2024

Name of the company

NASECO 1996 LTD
Crop MAIZE
Variety BAZOOKA

Lot number
NAS/037/24A
Lot Size
40MT
Pack Sizes
1Kgx 50
Seed treatment (chemicals
used) Show Proof Actellic Plus Thiram
Germination Test data (Attach
lab analysis results) 95%
Number of labels requested 800

Amount paid (Proof of

payment)

Requested by (MD of Seed Company or assigned official of Seed Company and stamp)

Name: ---Katwere Godfrey ---------

Signature: ----------------------------------------

USTA approval (Signature and stamp)

Name: ---------------------------------------------

Signature: -----------------------------------------

Note; This form to be filled in triplicate (One remains at USTA, 2nd copy to be retained by the company
and the 3rd copy to be submitted to MAAIF while requesting for labels
 USTA TAMPERPROOF LABELS REQUEST FORM

Fill in required information Remarks

Date
18th May 2024

Name of the company

NASECO 1996 LTD
Crop MAIZE
Variety BAZOOKA

Lot number
NAS/038/24A
Lot Size
40MT
Pack Sizes
1Kgx 50
Seed treatment (chemicals
used) Show Proof Actellic Plus Thiram
Germination Test data (Attach
lab analysis results) 94%
Number of labels requested 800

Amount paid (Proof of

payment)

Requested by (MD of Seed Company or assigned official of Seed Company and stamp)

Name: ---Katwere Godfrey ---------

Signature: ----------------------------------------

USTA approval (Signature and stamp)

Name: ---------------------------------------------

Signature: -----------------------------------------

Note; This form to be filled in triplicate (One remains at USTA, 2nd copy to be retained by the company
and the 3rd copy to be submitted to MAAIF while requesting for labels
 USTA TAMPERPROOF LABELS REQUEST FORM

Fill in required information Remarks

Date
18th May 2024

Name of the company

NASECO 1996 LTD
Crop MAIZE
Variety BAZOOKA

Lot number
NAS/039/24A
Lot Size
40MT
Pack Sizes
1Kgx 50
Seed treatment (chemicals
used) Show Proof Actellic Plus Thiram
Germination Test data (Attach
lab analysis results) 93%
Number of labels requested 800

Amount paid (Proof of

payment)

Requested by (MD of Seed Company or assigned official of Seed Company and stamp)

Name: ---Katwere Godfrey ---------

Signature: ----------------------------------------

USTA approval (Signature and stamp)

Name: ---------------------------------------------

Signature: -----------------------------------------

Note; This form to be filled in triplicate (One remains at USTA, 2nd copy to be retained by the company
and the 3rd copy to be submitted to MAAIF while requesting for labels
 USTA TAMPERPROOF LABELS REQUEST FORM

Fill in required information Remarks

Date
18th May 2024

Name of the company

NASECO 1996 LTD
Crop MAIZE
Variety BAZOOKA

Lot number
NAS/040/24A
Lot Size
40MT
Pack Sizes
1Kgx 50
Seed treatment (chemicals
used) Show Proof Actellic Plus Thiram
Germination Test data (Attach
lab analysis results) 91%
Number of labels requested 800

Amount paid (Proof of

payment)

Requested by (MD of Seed Company or assigned official of Seed Company and stamp)

Name: ---Katwere Godfrey ---------

Signature: ----------------------------------------

USTA approval (Signature and stamp)

Name: ---------------------------------------------

Signature: -----------------------------------------

Note; This form to be filled in triplicate (One remains at USTA, 2nd copy to be retained by the company
and the 3rd copy to be submitted to MAAIF while requesting for labels
 USTA TAMPERPROOF LABELS REQUEST FORM

Fill in required information Remarks

Date
18th May 2024

Name of the company

NASECO 1996 LTD
Crop MAIZE
Variety BAZOOKA

Lot number
NAS/041/24A
Lot Size
40MT
Pack Sizes
1Kgx 50
Seed treatment (chemicals
used) Show Proof Actellic Plus Thiram
Germination Test data (Attach
lab analysis results) 93%
Number of labels requested 800

Amount paid (Proof of

payment)

Requested by (MD of Seed Company or assigned official of Seed Company and stamp)

Name: ---Katwere Godfrey ---------

Signature: ----------------------------------------

USTA approval (Signature and stamp)

Name: ---------------------------------------------

Signature: -----------------------------------------

Note; This form to be filled in triplicate (One remains at USTA, 2nd copy to be retained by the company
and the 3rd copy to be submitted to MAAIF while requesting for labels
 USTA TAMPERPROOF LABELS REQUEST FORM

Fill in required information Remarks

Date
18th May 2024

Name of the company

NASECO 1996 LTD
Crop MAIZE
Variety LONGE 10H

Lot number
NAS/023/24A
Lot Size
40MT
Pack Sizes
1Kgx 50
Seed treatment (chemicals
used) Show Proof Actellic Plus Thiram
Germination Test data (Attach
lab analysis results) 90%
Number of labels requested 800

Amount paid (Proof of

payment)

Requested by (MD of Seed Company or assigned official of Seed Company and stamp)

Name: ---Katwere Godfrey ---------

Signature: ----------------------------------------

USTA approval (Signature and stamp)

Name: ---------------------------------------------

Signature: -----------------------------------------

Note; This form to be filled in triplicate (One remains at USTA, 2nd copy to be retained by the company
and the 3rd copy to be submitted to MAAIF while requesting for labels
 USTA TAMPERPROOF LABELS REQUEST FORM

Fill in required information Remarks

Date
18th May 2024

Name of the company

NASECO 1996 LTD
Crop MAIZE
Variety LONGE 10H
Lot number
NAS/024/24A
Lot Size
40MT
Pack Sizes
1Kgx 50
Seed treatment (chemicals
used) Show Proof Actellic Plus Thiram
Germination Test data (Attach
lab analysis results) 90%
Number of labels requested 800

Amount paid (Proof of

payment)

Requested by (MD of Seed Company or assigned official of Seed Company and stamp)

Name: ---Katwere Godfrey ---------

Signature: ----------------------------------------

USTA approval (Signature and stamp)

Name: ---------------------------------------------

Signature: -----------------------------------------

Note; This form to be filled in triplicate (One remains at USTA, 2nd copy to be retained by the company
and the 3rd copy to be submitted to MAAIF while requesting for labels
 USTA TAMPERPROOF LABELS REQUEST FORM

Fill in required information Remarks

Date
18th May 2024

Name of the company

NASECO 1996 LTD
Crop MAIZE
Variety LONGE 10H
Lot number
NAS/025/24A
Lot Size
40MT
Pack Sizes
1Kgx 50
Seed treatment (chemicals
used) Show Proof Actellic Plus Thiram
Germination Test data (Attach
lab analysis results) 93%
Number of labels requested 800

Amount paid (Proof of

payment)

Requested by (MD of Seed Company or assigned official of Seed Company and stamp)

Name: ---Katwere Godfrey ---------

Signature: ----------------------------------------

USTA approval (Signature and stamp)

Name: ---------------------------------------------

Signature: -----------------------------------------

Note; This form to be filled in triplicate (One remains at USTA, 2nd copy to be retained by the company
and the 3rd copy to be submitted to MAAIF while requesting for labels
 USTA TAMPERPROOF LABELS REQUEST FORM

Fill in required information Remarks

Date
18th May 2024

Name of the company

NASECO 1996 LTD
Crop MAIZE
Variety LONGE 10H
Lot number
NAS/027/24A
Lot Size
40MT
Pack Sizes
1Kgx 50
Seed treatment (chemicals
used) Show Proof Actellic Plus Thiram
Germination Test data (Attach
lab analysis results) 93%
Number of labels requested 800

Amount paid (Proof of

payment)

Requested by (MD of Seed Company or assigned official of Seed Company and stamp)

Name: ---Katwere Godfrey ---------

Signature: ----------------------------------------

USTA approval (Signature and stamp)

Name: ---------------------------------------------

Signature: -----------------------------------------

Note; This form to be filled in triplicate (One remains at USTA, 2nd copy to be retained by the company
and the 3rd copy to be submitted to MAAIF while requesting for labels
 USTA TAMPERPROOF LABELS REQUEST FORM

Fill in required information Remarks

Date
18th May 2024

Name of the company

NASECO 1996 LTD
Crop MAIZE
Variety LONGE 10H
Lot number
NAS/028/24A
Lot Size
40MT
Pack Sizes
1Kgx 50
Seed treatment (chemicals
used) Show Proof Actellic Plus Thiram
Germination Test data (Attach
lab analysis results) 90%
Number of labels requested 800

Amount paid (Proof of

payment)

Requested by (MD of Seed Company or assigned official of Seed Company and stamp)

Name: ---Katwere Godfrey ---------

Signature: ----------------------------------------

USTA approval (Signature and stamp)

Name: ---------------------------------------------

Signature: -----------------------------------------

Note; This form to be filled in triplicate (One remains at USTA, 2nd copy to be retained by the company
and the 3rd copy to be submitted to MAAIF while requesting for labels
 USTA TAMPERPROOF LABELS REQUEST FORM

Fill in required information Remarks

Date
18th May 2024

Name of the company

NASECO 1996 LTD
Crop MAIZE
Variety LONGE 10H
Lot number
NAS/029/24A
Lot Size
40MT
Pack Sizes
1Kgx 50
Seed treatment (chemicals
used) Show Proof Actellic Plus Thiram
Germination Test data (Attach
lab analysis results) 91%
Number of labels requested 800

Amount paid (Proof of

payment)

Requested by (MD of Seed Company or assigned official of Seed Company and stamp)

Name: ---Katwere Godfrey ---------

Signature: ----------------------------------------

USTA approval (Signature and stamp)

Name: ---------------------------------------------

Signature: -----------------------------------------

Note; This form to be filled in triplicate (One remains at USTA, 2nd copy to be retained by the company
and the 3rd copy to be submitted to MAAIF while requesting for labels
 USTA TAMPERPROOF LABELS REQUEST FORM

Fill in required information Remarks

Date
18th May 2024

Name of the company

NASECO 1996 LTD
Crop MAIZE
Variety LONGE 10H
Lot number STACK G
Lot Size
40MT
Pack Sizes
1Kgx 50
Seed treatment (chemicals
used) Show Proof Actellic Plus Thiram
Germination Test data (Attach
lab analysis results) 91%
Number of labels requested 800

Amount paid (Proof of

payment)

Requested by (MD of Seed Company or assigned official of Seed Company and stamp)

Name: ---Katwere Godfrey ---------

Signature: ----------------------------------------

USTA approval (Signature and stamp)

Name: ---------------------------------------------

Signature: -----------------------------------------

Note; This form to be filled in triplicate (One remains at USTA, 2nd copy to be retained by the company
and the 3rd copy to be submitted to MAAIF while requesting for labels