SWORN STATEMENT NO.

SS126 -_______________
SWORN STATEMENT OF THE TRUE CURRENT AND FAIR MARKET VALUE OF REAL PROPERTIES
(Taxable or Exempt)
Required under Sec. 202 of R.A. 7160
and Art. 11, Sec 123 of Muntinlupa Revenue Code

I, ___________________________________, of legal age, _____________, ___________, and with postal address at______________________________________________________
(Citizenship) (Civil Status)
____________________________________ after having been duly sworn in accordance with law, despose and say:

1. That I am the OWNER_______________________________________________________of the following real properties (lands, building, machineries, and other Improvement located in the City of Muntinlupa.
(Owner or Administrator or Authorized Representative)

Owned by _______________________________________________________ of which the description and true current and fair market value/s as follows:
(State name owner/s if filed by administrator or authorized representative)

A. LANDS (Residential, Commercial, Industrial, Agricultural, Special

Existing
Tax Dec. Classification Location of Property True Current & Fair Market
Lot Block No. Title Area (sq.m.)
No. (Res., Agri. Comm., etc.) (St./Dist./Barangay(Barrio) Value

B. BUILDING AND OTHER STRUCTURES

Existing Year Owner of Lot Where
Floor Area No. Of Location of Property True Current & Fair Market
Tax Dec. General Description Completed/ Actual Use Bldg.
(in sq.m.) Storey (St./Dist./Barangay(Barrio) Value
No. Occupied Is Constructed
C. MACHINERIES

Existing Date
Original Acquisition Cost of Installation True Current & Fair
Tax Dec. Description Commenced Value of Depreciation Value of Installation
Aquired Cost On site Market Value
No. Operation

2. That I am executing this sworn statement in compliance with Section 202 of R.A. 7160 and ART. SEC 123 of Muntinlupa Revenue Code.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __________________ day of ______________________20_____ at _____________________, If thumbmark, require signature of two (2) witness:

______________________________ ______________________________
(Witness) (Witness)

SUBSCRIBED AND SWORN to before me this ________ day of ______________________20_____, affiant exhibiting his/her Community Certificate No. __________________, Issued on ____________________ at
______________________, Philippines.

____________________________________
(Signature of Administering Officer)
TIN ____________________________________

Note:
(1) Include in this sworn statement only real property administered by tha affiant in the City of Muntinlupa.
(2) Prepared two (2) copies and after having been subscribed by the affiant, submit the same to the City Assessor of the city where the property is located, the original to be retained by the receiving office and the duplicate to be returned to the affiant after receipt
thereof has been duly acknowledged.
(3)Write “NEW” under column “Existing Tax Dec No. “For property not previously declared and attach corresponding proof of ownership and technical description and boundaries thereof.
(4) Original Acquisition Cost of Machinery include such cost 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