Form No.

DECLARATION NO. _____0540______ PROPERTY INDEX NO._041-33-029-09-010_

DECLARATION OF REAL PROPERTY

(FILED UNDER Republic Act 7160)

ABC CORPORATON MAKATI CITY, METRO MANILA, PHILIPPINES

Owner______________________________________________________________________
(Address)
Administrator_________________________________________________________________
(Address)
DESCRIPTION AND OTHER PARTICULARS OF PROPERTY

DAVAO CITY, DAVAO 8000

Location of Property____________________________________________________________
(Street) (Barangay) (Municipality/City/Province)
T-00000
Certificate of Title No. ___________Cadastral Lot No. __________ Assessor’s Lot No. _______

Boundaries: Block No. _____________

North ____________________________ South ____________________________

East _____________________________ West _____________________________

I (a) LAND (AGRICULTURAL/MINERAL)

OWNER’S DECLARATION
ASSESSOR’S FINDINGS
Kinds Area Class Unit Values Market Value

Total
ADJUSTED MARKET VALUE
I (b) PLANTS AND TREES
ASSESSOR’S FINDINGS
Market Market
Kind No./Area Unit Value
Value__________100% Value
Adjustments
(a) Along or no

Road frontage_______%
(b) Kms. To all

Weather rd_________%
(c) Kms. To market (pob.)

Total
Adjustments________%
Adjusted Market
Value_______%
Total
Assessed Market Value
II LAND (RESIDENTIAL, COMMERCIAL, INDUSTRIAL, SPECIAL)
ASSESSOR’S FINDINGS
Kind Area Unit Value Adjustment Market Value

Total
 III (a) BUILDING AND OTHER IMPROVEMENTS

1. OWNER’S DECLARATION

Construction Materials
DESCRIPTION Floor Area st nd rd th Market Value
1 Story 2 Story 3 Story 4 Story
Three (3) storey building 70 million
used for fast food chain
business
`

2. ASSESSOR’S FINDINGS

Construction Materials
DESCRIPTION Floor Area st nd rd th Market Value
1 Story 2 Story 3 Story 4 Story
Three (3) storey building 70 million
used for fast food chain
business

III (b.) MACHINERY

1. OWNER’S DECLARATION
DESCRIPTION Date of Operation Replacement Cost Depreciation Market Value
n/a

2. ASSESSOR’S FINDINGS
DESCRIPTION Date of Operation Replacement Cost Depreciation Market Value
n/a

SWORN STATEMENT OF OWNER

Under the provision of Republic Act 7160, I HEREBY CERTIFY that the current fair market value (x) of the foregoing
described property of which I am owner/administrator, is to the best of my knowledge and belief, as follows:
Land___________________________ P____________________________
Seventy million pesos (P70,000,000.00)
Improvement __________________________________________________
Seventy million pesos 70,000,000.00
TOTAL VALUE___________________________P_________________________
__________________
Signature
Subscribed and sworn to before me this ____day of_____________20_______the__________ person taking oath
presenting Residence Certificate No.____________Issued on____________ 20___________, at_____________.

______________________________
(Signature of Official Administering Oath)

CITY/PROVINCIAL ASSESSOR
ASSESMENT BY (BOARD OF ASSESSMENT APPEALS)
(CENTRAL BOARD OF ASSESSMENT APPEALS)
Kind of Property Actual Use Market Value Assessment Value Assessed Value
BUILDING (3 STOREY) COMMERCIAL SEVENTY MILLION PESOS
(P70,000,000.00)

Total P_________________ Total P__________________

SEVENTY MILLION PESOS (P70,000,000.00)
TOTAL ASSESSED VALUE______________________________________________________

JAIME G. ADALIN
________________________
OIC/PGDH - CITY ASSESSOR'S
Provincial/Municipal OFFICE
Assessor
Date:____________________