s PROPERTY INDEX NO. RPA Form No. ___ TAX

PROPERTY INDEX NO. _____________________
RPA Form No. ___
TAX DECLARATION NO. ____________________
DECLARATION OF REAL PROPERTY
(FILED UNDER REPUBLIC ACT NO. 7160)
Owner
Address
Administrator
s
Address
IMPORTANT: Issued for taxation purposes and should not be considered as title to the property.
DESCRIPTION AND OTHER PARTICULARS OF PROPERTY
s
Location of property __________________________________________________________________________________
Number and Street
(Barangay/District)
(Municipality/City/Province)
Certificate of Title No. __________________ Cadastral Lot No. ________________ Assessor’s Lot No. _________________
Boundaries
North_______________________________________ South____________________________________________
East________________________________________ West____________________________________________
(State streets, lots, or streams by which bounded or names of owners of adjoining lands)
I (a) LAND (AGRICULTURAL/MINERAL)
Kind
OWNER’S DECLERATION
Area
Value
ASSESSOR’S FINDINGS
Class
Unit Values
Area
Market Values
₱
₱
Total
Total Adjusted Market Value
₱
Total
Kind
I (b) PLANT &TREES
OWNER’S DECLERATION
Number and
Annual Product
Kind
(Quality)
Value
Base Market Value – 100%
Adjustments:
(a) Along – or no rd.
frontage ______%
(b)______Kms. to all
weather rd. ______%
(c)______Kms. to market
(pob) ______%
Total Adjustment ______%
Total
Total Adjusted Market Value
₱
Total
ASSESSOR’S FINDINGS
Number and
Annual Product
Kind
(Quality)
Unit
Value
Market Value
₱
₱
II LAND (RESIDENTIAL, COMMERCIAL, INDUSTRIAL, SPECIAL)
Kind
OWNER’S DECLERATION
Area
Value
Kind
Area
ASSESSOR’S FINDINGS
Unit Value
Adjustments
Market Value
₱
Total
₱
Total
₱
III (a) BUILDING AND OTHER IMPROVEMENTS
DESCRIPTION
Floor Area
1. OWNER’S DECLERATION
Construction Materials
st
nd
rd
1 Storey
2 Storey
3 Storey
Market Value
Roof
₱
₱
Total
DESCRIPTION
Floor Area
2. ASSESSOR’S FINDINGS
Construction Materials
st
nd
rd
1 Storey
2 Storey
3 Storey
Market Value
Roof
₱
₱
Total
III (b) MACHINERY
1. OWNER’S DECLERATION
j Date of Operation
Original Cost
Date of OpDESCRIPTION
Depreciation
Market Value
₱
₱
Total
2. ASSESSOR’S FINDINGS
j Date of Operation
Original Cost
Date of OpDESCRIPTION
Depreciation
Market Value
₱
₱
Total
SWORN STATEMENT OF OWNER
Under the provision of Republic Act No. 7160, I HEREBY CERTIFY that current and fair market value (x) of the foregoing described
property of which I am the owner/administrator, is to the best of my knowledge and belief, as follows:
Land _______________________________________ ₱__________________
Improvements _______________________________ ₱__________________
TOTAL VALUE _________________________ ₱__________________
(Signature)
TIN_________________________
Subscribed and sworn to before me this _______ day of __________________________ the __________ person taking oath
presenting Community Tax Certificate No. ______________________ issued on ____________________ ___________ at
________________________________________
(x) State in the nearest multiple of 10 as ₱ 950
instead of ₱ 948; ₱ 1,000 instead ₱ 1,004.
Signature of official administering oath
Official Title
TIN________________________
ASSESSMENT BY
Kind of Property
Actual Use
₱
(CITY/PROVINCIAL ASSESSOR
(BOARD OF ASSESSMENT APPEALS
(CENTRAL BOARD OF ASSESSMENT APPEALS
Market Value
Assessment Level
%
%
Assessed Value
₱
%
%
Total
Total
₱
₱
TOTAL ASSESSED VALUE__________________________________________________________________________________________
(Amount in words)
APPROVED:
Provincial/City Assessor
Provincial/City Assessor
By
Deputy
DATE
THIS DECLARATION CANCELS TAX NOS. _________________________________________________: IS CANCELLED BY TAX
NOS._____________________________________ TAX UNDER THIS DECLARATION BEGINS WITH THE YEAR ___________CEASES WITH
THE YEAR ____________ENTEREDIN THE REAL PROPERTY ASSESSMENT RCLL FOR ________ BY _________ PREVIOUS OWNER
____________________________________________________________ PREVIOUS ASSESSED VALUE: LAND ₱______________________
IMPROVEMENT ₱________________________________