Forms C1 To C3

DRAFT FINAL VERSION: 21May 2015
FORM C-2
LOCAL TREASURY OPERATIONS EVALUATION REGIONAL SUMMARY (LTOERS) – REGULAR EVALUATION (RE)
For the Year of ___________
Region:________________________
Region Code: (e.g., Region 1 –01)
Province Provincial Municipality or Municipal or Inclusive Dates Date of Function (e.g., Performance Area Compliance
Code (e.g., City City Code (e.g., of Evaluation Submission of Fund (e.g., Tax Indicator (e.g., 1.1)
(Note 1: For 011) 0121) Report to LGU Management – Information
Component (Note 1: For (BLGF Office II) Campaign – C) or (Note 1: For
Cities and (Note 1: For Component (Note 1: For Order No. 09- (Note 1: For Sub-Area (e.g., Component Cities
Municipalities, Component Cities and Component 2012 dated Component (Note 1: For Real Property Tax and Municipalities,
See Form C-1) Cities and Municipalities, Cities and February 1, Cities and Component – D.1) See Form C-1,
Municipalities, See Form C-1, Municipalities, 2012) Municipalities, Cities and Table1, Column (7))
(Note 2: For See Form C-1) Table 1, Column See Form C-1, See Form C-1,
Provinces, See (Note 1: For Municipalities, (Note 1: For
(1)) Table 1, Table 1, Column See Form C-1, Component Cities
Form B-1, Table (Note 2: For Column (2)) Component (4))
1, Row 2) Provinces (Note 2: For Cities and Table 1, Column and (Note 2: For
Metro Manila Highly- (Note 2: For Municipalities, (Note 2: For (5)) Municipalities, Provinces and
(Note 3: If Form LGUs, See Urbanized and Highly- See Form C-1, Provinces and See Form C-1, Highly-Urbanized
B-3 has been Form B-1, Independent Urbanized and Table 1, Highly-Urbanized (Note 2: For Table 1, Column and Independent
prepared even Table 1, Row Component Independent Column (3)) and Independent Provinces and (6)) Component Cities
if there is a 6) Cities and Metro Component Component Highly- and Metro Manila
Form B-1 also Manila LGUs, Cities and (Note 2: For Cities and Metro Urbanized and (Note 2: For LGUs, See Form B-
prepared, do (Note 3: If See Form B-1, Metro Manila Provinces and Manila LGUs, Independent Provinces and 1, Table 2, Column
not fill.) Form B-3 has Table 1, Row 2) LGUs, See Highly- See Form B-1, Component Highly-Urbanized 4).
been prepared Form B-1, Table Urbanized and Table 1, Row 8) Cities and Metro and Independent
even if there is (Note 3: If Form 1, Row 6). Independent Manila LGUs, Component Cities (Note 3: For
a Form B-1 B-3 has been Component (Note 1: If Form See Form B-1, and Metro Manila Provinces and
also prepared, prepared even if (Note 3: If Form Cities and B-3 has been Table 2, Column LGUs, See Form Highly-Urbanized
do not fill.) there is a Form B-3 has been Metro Manila prepared even if 2) B-1, Table 2, and Independent
B-1 also prepared even LGUs, See there is a Form Column 3). Component Cities
prepared, do not if there is a Form B-1, Table B-1 also (Note 3: For and Metro Manila
fill.) Form B-1 also 1, Row 7) prepared, do not Provinces and (Note 3: For LGUs, If Form B-1,
prepared, do fill.) Highly- Provinces and Table 2, Column 7 is
not fill.) (Note 3: If Form Urbanized and Highly-Urbanized Yes, Do Not Fill
B-3 has been Independent and Independent Column ).
prepared even Component Component Cities
if there is a Cities and Metro and Metro Manila
Form B-1 also Manila LGUs, If LGUs, If Form B-1, (Note 4: If Form B-3
prepared, do Form B-1, Table Table 2, Column 7 has been prepared
not fill.) 2, Column 7 is is Yes, Do Not Fill even if there is a
Yes, Do Not Fill Column ). Form B-1 also
Column ). prepared, do not
fill.)
(Note 4: If Form B-
(Note 4: If Form 3 has been
B-3 has been prepared even if
prepared even if there is a Form B-
there is a Form 1 also prepared,
B-1 also do not fill.)
prepared, do not
fill.)
(1) (2) (3) (4) (5) (6) (7) (8) (9)

PREPARED AND SUBMITTED BY: APPROVED BY:
BLGF Regional Director

FORM C-1
LOCAL TREASURY OPERATIONS EVALUATION PROVINCIAL SUMMARY (LTOEPS) – REGULAR EVALUATION (RE)
Province: ______________________________(Note: See Form B-1, Table 1, Row 4)

Province Code: (e.g., 12) (Note: See Form B-1, Table 1, Row 6)
Table 1: Provincial LGUs Summary:

Municipality Municipal or Inclusive Dates of Evaluation Date of Submission of Function (e.g., Performance Area Compliance
or City Code Report to LGU Fund (e.g., Tax Indicator (e.g.,
Component (e.g., 0121) (BLGF Office Order No. 09-2012 dated Management – II) Information 1.1)
City February 1, 2012) (Note 1: If Form B-3 has Campaign – C) or
(Note 1: If been prepared even if there Sub-Area (e.g., Real
(Note 1: If Form B-3 (Note 1: If Form B-3 has been prepared is a Form B-1 also prepared, (Note 1: If Form B- (Note 1: If Form B-
even if there is a Form B-1 also prepared, Property Tax – D.1)
Form B-3 has has been do not fill.) 3 has been 3 has been
been prepared do not fill.) prepared even if prepared even if
prepared even if there (Note 2: See Form B-1, Table there is a Form B- (Note 1: If Form B-3 there is a Form B-
(Note 2: See Form B-1, Table 1, Row 7) 1, Row 8)
even if there is a Form B- 1 also prepared, has been prepared 1 also prepared,
is a Form B-1 1 also do not fill.) even if there is a do not fill.)
also prepared, Form B-1 also
prepared, do do not fill.) (Note2: See Form prepared, do not (Note 2: See Form
not fill.) B-1, Table 2, fill.) B-1, Table 2,
(Note 2: See Column (2)) Column (4))
(Note 2: See Form B-1, (Note 2: See Form
Form B-1, Table 1, (Note 3: If Form B-1, Table 2, (Note 3: If Form B-
Table 1, Row Row 6) B-1, Table 2, Column (3)) 1, Table 2,
2) Column 7 is Yes, Column 7 is Yes,
Do Not Fill (Note 3: If Form B-1, Do Not Fill
Column) Table 2, Column 7 is Column)
Yes, Do Not Fill
Column)
(1) (2) (3) (4) (5) (6) (7)

Yes, Do Not Fill
Column)
(1) (2) (3) (4) (5) (6) (7)

Yes, Do Not Fill
Column)
(1) (2) (3) (4) (5) (6) (7)

Yes, Do Not Fill
Column)
(1) (2) (3) (4) (5) (6) (7)

Yes, Do Not Fill
Column)
(1) (2) (3) (4) (5) (6) (7)

Yes, Do Not Fill
Column)
(1) (2) (3) (4) (5) (6) (7)

Provincial Treasurer
FORM C-3
LOCAL TREASURY OPERATIONS EVALUATION FULL COMPLIANCE PROVINCIAL SUMMARY (LTOEFCPS) – REGULAR EVALUATION (RE)
Province: ______________________________ (Note: See Form B-3, Table 1, Row 4)

Province Code: (e.g., 12) (Note: See Form B-3, Table 1, Row 6)
Table 1: Provincial LGUs Summary:

Municipality Municipal or Inclusive Dates of Evaluation Date of Submission of
or City Code Report to LGU
Component (e.g., 0121) (BLGF Office Order No. 09-2012 dated
City February 1, 2012) (Note: See Form B-3, Table
(Note: See 1, Row 8)
(Note See Form B-3, (Note: See Form B-3, Table 1, Row 7)
Form B-3, Table 1,
Table 1, Row Row 6)
2)
(1) (2) (3) (4)


Form B-3, Table 1,
Table 1, Row Row 6)
2)
(1) (2) (3) (4)


Form B-3, Table 1,
Table 1, Row Row 6)
2)
(1) (2) (3) (4)
Provincial Treasurer
FORM C-4
LOCAL TREASURY OPERATIONS EVALUATION FULL COMPLIANCE REGIONAL SUMMARY (LTOERS) – REGULAR EVALUATION (RE)
Region:________________________
Region Code: (e.g., Region 1 – 01)
Province Provincial Municipality or Municipal or Inclusive Dates of Date of

Code (e.g., 12) City City Code Evaluation Submission of
(Note 1: For (e.g., 0121) Report to LGU
Component Cities (Note 1: For (Note 1: For (BLGF Office Order No.
and Component Component (Note 1: For 09-2012 dated February 1, (Note 1: For
Municipalities, Cities and Cities and Component 2012) Component
See Form C-3) Municipalities, Municipalities, Cities and Cities and
See Form C-3) See Form C-3, Municipalities, (Note 1: For Component Municipalities,
(Note 2: For Table 1, See Form C-3, Cities and Municipalities, See Form C-3,
Provinces, See (Note 2: For Column (1)) Table 1, See Form C-3, Table 1, Table 1,
Form B-3, Table 1, Provinces and Column (2)) Column (3)) Column (4))
Row 2) Metro Manila (Note 2: For
LGUs, See Highly- (Note 2: For (Note 2: For Provinces (Note 2: For
Form B-3, Urbanized and Highly- and Highly-Urbanized and Provinces and
Table 1, Row Independent Urbanized and Independent Component Highly-
6) Component Independent Cities and Metro Manila Urbanized and
Cities and Component LGUs, See Form B-3, Independent
Metro Manila Cities and Table 1, Row 7) Component
LGUs, See Metro Manila Cities and
Form B-3, LGUs, See Metro Manila
Table 1, Row 2) Form B-3, LGUs, See
Table 1, Row Form B-3,
6) Table 1, Row 8)
(1) (2) (3) (4) (5) (6)

BLGF Regional Director

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Forms C1 To C3

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DRAFT FINAL VERSION: 21May 2015

(1) (2) (3) (4) (5) (6) (7) (8) (9)

PREPARED AND SUBMITTED BY: APPROVED BY:

BLGF Regional Director

Province: ______________________________(Note: See Form B-1, Table 1, Row 4)

Table 1: Provincial LGUs Summary:

(1) (2) (3) (4) (5) (6) (7)

(1) (2) (3) (4) (5) (6) (7)

(1) (2) (3) (4) (5) (6) (7)

(1) (2) (3) (4) (5) (6) (7)

(1) (2) (3) (4) (5) (6) (7)

(1) (2) (3) (4) (5) (6) (7)

PREPARED AND SUBMITTED BY: APPROVED BY:

Province: ______________________________ (Note: See Form B-3, Table 1, Row 4)

Table 1: Provincial LGUs Summary:

(1) (2) (3) (4)

Municipality Municipal or Inclusive Dates of Evaluation Date of Submission of

(1) (2) (3) (4)

Municipality Municipal or Inclusive Dates of Evaluation Date of Submission of

(1) (2) (3) (4)

PREPARED AND SUBMITTED BY: APPROVED BY:

Province Provincial Municipality or Municipal or Inclusive Dates of Date of

(1) (2) (3) (4) (5) (6)

PREPARED AND SUBMITTED BY: APPROVED BY:

BLGF Regional Director

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