BLGF Memorandum Re Change Request Forms (CRFS) For The FY 2022 SGLG Assessment

BLGF Change Request Form No 1
Correction on the Average Local Revenue Collection Growth Rate

Fiscal Years 2018-2020
City/Municipality of SAN ANTONIO Region III

Province of ZAMBALES
Instructions: Fill out the form accordingly and attach supporting documents.
This is to request action on the following discrepancy/ies noted in the Statement of Receipts and
Expenditures (SRE) report submitted through the electronic SRE system for Fiscal Year/s 2018
Request for Change/Correction of SRE Report, Fiscal Y e a r 2018

Amount Reported Corrected Amount Reason/Justification for
Revenue Sources in the eSRE (Php) (Php) Correction/Change
Real Property Tax
Tax on Business
Other Taxes
Regulatory Fees
The User’s fee amounting to

Service/User Charges 4,618,432.82 1,198,581.50 Php3,029,892.00 should not be
included in the General Fund based
on Municipal Ordinance No. 15-
068, Article XXIV, Section 79, the
User’s fee is under Trust Fund
exclusively for environmental and
tourism programs and projects.
Receipts from
Economic Enterprises
Certified correct: Noted by:
LUZVIMINDA P. ASIO HON. PRECILIANO M. RUIZ, MNSA

Provincial/City/Municipal Treasurer Governor/ City/Municipal Mayor
JOSIE R. ALMERO
Provincial/City/Municipal Accountant
KRISHNA O. GARCIA
Provincial/City/Municipal Budget Officer
Date:_____________________ Date:_____________________



Real Property Tax
Tax on Business
Other Taxes
Regulatory Fees

Service/User Charges 3,853,445.10 1,447,741.50 Php2,405,703.60 should not be
Receipts from

JOSIE R. ALMERO
KRISHNA O. GARCIA
Date:_____________________ Date:_____________________



Real Property Tax
Tax on Business
Other Taxes
Regulatory Fees

Service/User Charges 2,364,181.40 1,983,695.00 Php380,486.40 should not be
Receipts from

JOSIE R. ALMERO
KRISHNA O. GARCIA
Date:_____________________ Date:_____________________
BLG F Change Request Form No. 2
Justification on the Average Local Revenue Collection Growth Rate


This is to request action on the three-year average local revenue growth for FYs 2018-2020, as
certified by the BLGF.
Request for Change of Average Local Revenue Growth, FYs 2018-2020
Proposed Change/Correction
FROM TO Reason/Justification
(in %, currently reflected (in %, if reason/
as BLGF data) justification is considered)
The User’s Fee from 2018 up to 2020, which is enumerated
-4% 1% hereunder should not be included in the General Fund:
2018 – Php3,029,892.00
2019 – Php2,405,703.60
2020 – Php380,486.40
Based on Municipal Ordinance No. 15-068, Article XXIV,
Section 79, The User’s Fee is under a Trust Fund exclusively for
environmental and tourism programs and projects.

JOSIE R. ALMERO
KRISHNA O. GARCIA
Date:_____________________ Date:_____________________
BLGF Change Request Form No. 3
Correction on the Utilization of the 20% Internal Revenue Allotment (IRA)

for Local Development Project (LDP) - Fiscal Year 2020
City/Municipality of SAN ANTONIO

Region III
This is to request action on the following discrepancy/ies noted in the Statement of Receipts
and Expenditures (SRE) report submitted through the electronic SRE system for Fiscal Year 2020.
Request for Change/Correction of the SRE Report, FY 2020
Expenditure Amount Reported Corrected Reason/Justification

in the eSRE (Php) Amount (Php) for Correction/Change
General Public Services
Education, Culture &

Sports/Manpower
Development
Health, Nutrition &
Population Control
Labor and Employment
Housing and Community

Development
Social Services and

Social Welfare
Economic Services
Debt Service
Provincial/City/Municipal Treasurer Governor/

City/Municipal Mayor
Date: Date:
BLGF Change Request Form No. 4
Justification on the Utilization of the 20% Component of the Internal Revenue Allotment (IRA)
for Local Development Project (LDP) - Fiscal Year 2020
City/Municipality of Region
Province of
This is to request action on the % utilization of IRA for LDP for FY 2020, as certified by the BLGF.
Request for Change of Utilization of the 20% Component of IRA, FY 2020
Proposed Change/Correction
FROM TO Reason/ Justification

(in %, currently (in %, if reason/
reflected as BLGF d ata) justification is considered )
Provincial/City/Municipal Treasurer Governor/

City/Municipal Mayor
Date: Date:

BLGF Memorandum Re Change Request Forms (CRFS) For The FY 2022 SGLG Assessment

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BLGF Change Request Form No 1

Correction on the Average Local Revenue Collection Growth Rate

City/Municipality of SAN ANTONIO Region III

Request for Change/Correction of SRE Report, Fiscal Y e a r 2018

Real Property Tax

The User’s fee amounting to

Certified correct: Noted by:

LUZVIMINDA P. ASIO HON. PRECILIANO M. RUIZ, MNSA

Correction on the Average Local Revenue Collection Growth Rate

City/Municipality of SAN ANTONIO Region III

Request for Change/Correction of SRE Report, Fiscal Y e a r 2019

Real Property Tax

The User’s fee amounting to

Certified correct: Noted by:

LUZVIMINDA P. ASIO HON. PRECILIANO M. RUIZ, MNSA

Correction on the Average Local Revenue Collection Growth Rate

City/Municipality of SAN ANTONIO Region III

Request for Change/Correction of SRE Report, Fiscal Y e a r 2020

Real Property Tax

The User’s fee amounting to

Certified correct: Noted by:

LUZVIMINDA P. ASIO HON. PRECILIANO M. RUIZ, MNSA

Justification on the Average Local Revenue Collection Growth Rate

City/Municipality of SAN ANTONIO Region III

Request for Change of Average Local Revenue Growth, FYs 2018-2020

Certified correct: Noted by:

LUZVIMINDA P. ASIO HON. PRECILIANO M. RUIZ, MNSA

Correction on the Utilization of the 20% Internal Revenue Allotment (IRA)

City/Municipality of SAN ANTONIO

Request for Change/Correction of the SRE Report, FY 2020

Expenditure Amount Reported Corrected Reason/Justification

General Public Services

Education, Culture &

Labor and Employment

Housing and Community

Social Services and

Certified correct: Noted by:

Provincial/City/Municipal Treasurer Governor/

Provincial/City/Municipal Budget Officer

Request for Change of Utilization of the 20% Component of IRA, FY 2020

FROM TO Reason/ Justification

Certified correct: Noted by:

Provincial/City/Municipal Treasurer Governor/

Provincial/City/Municipal Budget Officer

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