266-cA0-0P'50-801-108, Last rovsed 2262018 Republic of the Philippines OFFICE OF THE CITY ASSESSOR 3 Quezon City, Metro Manila S TAX DECLARATION APPLICATION & ROUTING FORM (TRANSFER) Date filed: Control No. [PLEAS wT PORTION LEG T0AVOO ERROR PERSONAL REFERENCE] SUBJECT TYPE OF PROPERTY: Land [Building Machinery Tax Declaration No. INAME OF DECLARED OWNER: ITCT/Building plan as reference] List of Co-owners' lOwneris’ Compete Mailing Address: (Administrator: lAoaress: [DOCUMENTARY REGUIRENENTS ATTACHED (Please check appropriate box): HTCTsiCCTs > Present onginal Tie or Ceriied True Copy of Tite from Registry of Deeds Cored copy of previous Transfer Gertiicae of TileiCondominium Cer, of Tile Dew t Covovarco any of et eas rac) PREVIOUS OWNERSHIP FOR CONTINUITY: SecrtaryGerlcae ie requred sali corporation Tern cea eed of Senn en Ben of Sloe Lana Extrajucicial settlement of estate Sea cat of Sef Acdston (lhe) a ‘Deed of conditional sale + Notarized affidavit of loss Otero [Copy of latest tax declaration Piease attach separate sheet, Wnecessary Transfer tax receipt (original or Cetifed copy from CTO & 1 photo copy) Salers Business Tax Receip/Business Permit (orginal & photo copy), Electronic-Certficate Authorizing Resistaton(@CAR), dupicae or photocopy (AO 108 52007) |Current Realty Tax Clearance -presenteriginal: andice photocopy latest year full payment (In case of old Tax Clearance) Picture of propery (3°xS" colored, photo paper) fontagetfacade showing full view of structure "PENALTY OF P2,000.00 PER TITLE SHALL BE IMPOSED FOR LATE DECLARATION OF PROPERTY FILED SIXTY (60) DAYS AFTER THE ISSUANCE OF TCTICCT FROM THE REGISTRY OF DEEDS (ORDINANCE NO. SP 2361, S-2014) ‘To show proof of release, submit Acknowledgement Slip reflecting EPEB No. or Certification of Release from RD. PreparedlFled by: FORM 104 Applicant Dale Receiving Officer Date |VALID CONTACT NO. IRKSTATION Received Time Record Out REMARKS |RECEIVING ISINT- = loss fap Cem [sTN2 ISTNS ERY APPROVAL ‘TRANSMIT Ista ISTNS ISTNG ACKNOWLEDGEMENTICLAIM SLIP Control No.: FILED BY: CONTACT NO, FOLLOW-UP BEFORE SCHEDULED RELEASE ON: TEL.NO. _ 988-4242 LOC. 8187/6189; 8291 ‘New TD/NOA wil be released upon presentation ofthis claim slip. Ie + >