Philippine Government Forms All in One Location
Waiver/Certificate of First Refusal
NTA first refusal certificate/waiver for local trading
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WAIVER/CERTIFICATE OF FIRST REFUSAL
TO WHOM IT MAY CONCERN:
I, ____________________________, Operator/Authorized Representative of
__________________________ Trading Center/Buyer Firm (TC/BF), hereby certify under
oath that our company has refused to accept the following leaf tobacco production of Mr./Ms.
________________________, an NTA/TC/BF financed tobacco farmer-producer, with whom
this company has entered into a Marketing Agreement, to wit:
That our refusal to accept the above described leaf tobacco was due to
That said Mr./Ms. ____________ is hereby authorized to sell/deliver his/her leaf
tobacco produce to any licensed/authorized buyer/s, subject to the condition that the said
sale shall be attested/witnessed by an NTA Assisting TPRO/Agriculturist, and provided,
further, that the amount of loan he/she availed from NTA/TC/BF is deducted/collected and
remitted to the _____________ by the NTA Assisting TPRO/Agriculturist within 24 hours after
That I forever waive any right or claim as against the said farmer-producer and/or the
second buyer with respect to the above-described leaf tobacco produce, except his/her
obligations as mentioned in paragraph 2, hereof are fully settled.
Issued this __day of ___________, 20__ at ________________, ________________.
Signature Over Printed Name
of TC/BF Operator/Authorized
(Signature Over Printed Name
of Tobacco Farmer Seller)
( Signature Over Printed Name
of Assisting TPRO/Agriculturist)
SUBSCRIBED AND SWORN to before me this ___________________ at
Page No. ________;
Book No. ________;
Series of 20______.
cc : Farmer Producer-Seller
NTA Branch Office