AgriValue OS
Input / Service Delivery Confirmation
Ref: DISBURSE-000001 • Printed: 10 Jun 2026 09:16
Status:
CONFIRMED
14 May 2026
Farmer Details
Farmer Name
Kofi Farmer 1
Farmer Code
FARM-DEMO-0001
Phone
+233240000001
Community
Demo Community
District
Techiman
Programme
2026 Maize-Soy Input Finance Programme
Input / Service Package
Package
Standard 2-Acre Maize Package
Total Supplied Value
GHS 1,250.00
Item
Category
Qty
Unit
Unit Cost
Total
Improved Maize Seed
seed
10.00
kg
35.00
350.00
NPK Fertilizer
fertilizer
2.00
bag
450.00
900.00
Delivery Details
Disbursed Date
14 May 2026
Confirmation Method
in_person
Confirmed Date
15 May 2026
Delivery Location
—
Confirmation Reference
—
Application
—
Notes
Demo disbursement — inputs delivered to farmer.
Signatures
Farmer Signature
Name: ______________________________ Date: ______________
Field Officer / Agent Signature
Name: ______________________________ Date: ______________