SOP Exhibits
Title:Exhibit 3 - Statement of Utilization of Previously Withdrawn CDIF

SOP Number : TS-ES25
EXHIBIT 3
STATEMENT OF UTILIZATION OF PREVIOUSLY WITHDRAWN CDIF
PROVINCE :______________________
REGION :________________________


1. Date CDIF Withdrawn :________________________________________________
2. Amount :___________________________________________________________
3. Project Approved :____________________________________________________
4. Location of PHF :_____________________________________________________
5. Dealer of PHF/ Name of Service Provider/
Name of Lending Agency/ Title of Training/ __________________________________
6. Supporting Documents (See attached copies) :
_____ Official Receipt; Date ____________
______ Certificate of Acceptance; Date __________
______ Others ;Date____________


_______________________________________________________
SIGNATURE OVER PRINTED NAME OF FO CHAIRPERSON

- - - - - - - - - - - -
(THIS PORTION TO BE ACCOMPLISHED BY NFA)
INSPECTION REPORT ON UTILIZATION OF PREVIOUSLY WITHDRAWN CDIF
REGION :__________________________
PROVINCE :________________________


FINDINGS:



SUPPORTING DOCUMENTS/PHOTOGRAPHS/CERTIFICATION (attached)




____________________________________
Signature over Printed Name of Inspector
Position :_______________________