PROVINCIAL ASSESSOR'S OFFICE PROVINCIAL ASSESSOR'S OFFICE

G / F Provincial Capitol, Bonifacio Drive, Iloilo City G / F Provincial Capitol, Bonifacio Drive, Iloilo City
Contact No/s. 328-7902 / 328-7906 Contact No/s. 328-7902 / 328-7906
assessors@iloilo.gov.com assessors@iloilo.gov.com

PRE-INSPECTION DATA FORM PRE-INSPECTION DATA FORM

with Request Assessor's Initiative with Request Assessor's Initiative
Date Requested: Date Requested:
Owner: Owner:
Municipality: Municipality:
Lot No/s: Lot No/s:
Updated Real Property Tax Receipt / Tax Clearance Updated Real Property Tax Receipt / Tax Clearance
Official Receipt No/s: Official Receipt No/s:
Date of Issuance: Date of Issuance:
Updated Sworn Statement (Previos & Present) Updated Sworn Statement (Previos & Present)
Sworn Statement No: Sworn Statement No:
Date of Filling: Date of Filling:
If Late Filling of Sworn Statement: If Late Filling of Sworn Statement:
Official Receipt No: Place of Issuance: Official Receipt No: Place of Issuance:
Date : Date :
Tax Declaration to be Cancelled: Tax Declaration No/s: Tax Declaration to be Cancelled: Tax Declaration No/s:
PIN : PIN :
Previos FAAS Previos FAAS
FOR TRANSACTION WITH TRANSFER: TITLED UNTITLED DAR COVERED FOR TRANSACTION WITH TRANSFER: TITLED UNTITLED DAR COVERED
Title of Property Title No : Title of Property Title No :

Transfer Tax Transfer of Ownership Fee Transfer Tax Transfer of Ownership Fee
Official Receipt No: Official Receipt No: Official Receipt No: Official Receipt No:
Date : Date : Date : Date :
Updated Real Property Tax Receipt / Tax Clearance Updated Real Property Tax Receipt / Tax Clearance
CAR Serial No: Revenue District Office: CAR Serial No: Revenue District Office:
Date of Issuance : Date of Issuance :
O.R. CGT / DST : Name of RDO Officer: O.R. CGT / DST : Name of RDO Officer:
Deed of Conveyance Deed of Conveyance
CONSOLIDATION / SUBDIVISION: No of RPU's : CONSOLIDATION / SUBDIVISION: No of RPU's :
Approved Subdivision Plan Approved Subdivision Plan
Site Development Plan Site Development Plan
NEW DISCOVERY (BUILDINGS & MACHINERY): NEW DISCOVERY (BUILDINGS & MACHINERY):
Building Plan Certificate of Completion DTI / SEC Registration Building Plan Certificate of Completion DTI / SEC Registration
Building / Occupancy Permit Acquisition Cost of Machinery Others.: Building / Occupancy Permit Acquisition Cost of Machinery Others.:
Inspection Fee Inspection Fee
Amount : Amount :
Official Receipt No. : Official Receipt No. :
Date of Issuance : Date of Issuance :

Authorization Letter / Special Power of Attorney (SPA) Authorization Letter / Special Power of Attorney (SPA)

Remarks: Remarks:

Checked by: Checked by:

Noted by: Noted by:

Provincial Assessor / Assistant Provincial Assessor Provincial Assessor / Assistant Provincial Assessor
Travel Order No : Travel Order No :
Date & Time Received : Date & Time Received :
Prepared by : Prepared by :