Sworn Statement Of The True Current And Fair Market Value Of Real Properties
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1SWORN STATEMENT INDEX NO.
SWORN STATEMENT OF THE TRUE CURRENT AND FAIR MARKET VALUE OF REAL PROPERTIES
(Taxable or Exempt)
(Required under Section 202/203 of Republic Act No. 7160)
I,
, of legal age,
and with postal address at
(Citizenship)
(Civil Status)
after having duly sworn to in accordance with law hereby depose and say:
1.
That I am the _________________________________ of the following real properties, (lands, buildings, machineries
(Owner or Administrator or Authorized Representative)
or other improvements) located in the city/municipality of _______________________, province of _______________________
owned by ________________________________________________ of which the description and true current and fair market
(State Name of Owner/s if filed by administrative or authorized representative
value/s are as follows:
A. LAND (Residential, Commercial, Industrial, Agricultural, Special)
Existing
Lot
Block
Cadastral/
Area
Classification
Location of Property
Total Current and
Title
Tax Dec. No.
No.
No.
PLS No.
Ha./Sq.M.
(Res.,Agr.,Com.,etc.)
(St./Dist./Barangay)
Fair Market Value
B. BUILDING AND OTHER STRUCTURES
Location of
True Current
Total
Year
Existing
No.
Actual
Owner of Lot Where
Property (No./St./
and Fair
Floor Area
General Description Completed/
Tax Dec. No.
Storey
Use
Bldg. is Located
Dist./Barangay)
Market Value
in (Sq.M.)
Occupied
C. MACHINERIES
Location of
True Current
Date
Original
Cost of
Existing
Value of
Property (No./St./
and Fair
Description
Acquired
Commenced
Acquisition
Installation
Tax Dec. No.
Depreciation
Dist./Barangay)
Market Value
Operation
Cost
Site
OTHER IMPROVEMENTS (Perennial Trees/Plants)
No. of Trees/
True Current and Fair Market Value
Existing
Kinds of
No. of Trees/
Annual Product
Hec. & Ages
Tax Dec. No.
Trees/Plants
Hec./ Productive
per Tree/Plant
Productive
Non-Productive
Non-Productive
2.
That I am executing this sworn statement in compliance with Republic Act No. 7160
IN WITNESS WHEREOF, I have hereunto affixed my signature this ____ day of ___________, ______ at __________,
if thumbmarks require signatures of two (2) witnesses:
Signature
(Witness)
(Witness)
TIN
SUBSCRIBED AND SWORN to before me this ____ day of ___________, 20___, affiant exhibiting his/her Community
Tax Certificate No. A-_____________ issued on _____________ at _________________, Philippines.
(Signature of Administering Officer)
TIN
Note:
1) Include in this sworn statement only real property owned or administered by the affiant in one municipality or city.
2) Prepare three (3) copies and after having been subscribed to by the affiant, submit the same to the Provincial, City, Municipal Assessor or
Municipal Deputy Assessor or Ex-Officio Deputy Assessor of the province, city or municipality where the property is located; the original and
duplicate to be retained by receiving office and the triplicate to be returened to the affiant after receipt thereof has been duly acknowledged.
3) Write "NEW" under column "Existing Tax Dec. No." for property not previously declared.
4) Original acquisition cost of Machinery include such costs as freight and insurance charges, brokerage, arrastre and handling, custom duties and
taxes, cost of inland transportation and handling.
5) Write additional information in another sheet, if necessary.
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