Republic of the Philippines

City of Manila
LOCAL BOARD OF ASSESSMENT APPEALS

________________, 20__ LBAA CASE NO. _____________

Location of Property: ___________________________________ Area: ____________
TCT No./Nos.: ________________________________________ Barangay No. ________
____________________________________________________ Zone No.: _______________

I, the owner/person having legal interests in the above-described

property, with address at _______________________________________, do hereby
appeal the assessment made by the City Assessor of Manila on the said
property covered by Tax Declaration No.
_______________________________________________ valued in the sum of
P______________ for land and P______________ for improvements for being
excessive, erroneous and/or unjust.

I hereby certify and declare that the true and correct value of the
aforesaid property is P______________ for land and P______________ for
improvements, for the following reasons:

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

In support hereof, attached herewith are the following: (Sworn

Statements, documents, Articles of Incorporation, By-Laws, Charters, etc.)

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

That I respectfully request that action upon this appeal be taken in

accordance with law. (To be made out in six (6) copies).

______________________________
(Name and Signature of Owner)

______________________________
(Address)
Tel.No., if any: _______________

SUBSCRIBED AND SWORN TO before me this ______ day of

__________________________, Appellant exhibited to me his/her Community Tax
Certificate No. ____________, dated _________________ issue at _________________.

NOTARY PUBLIC
Doc. No.:__________
Page No.:__________
Book No.:__________
Series of 20___________