FORM C-1

LOCAL TREASURY OPERATIONS EVALUATION PROVINCIAL SUMMARY (LTOEPS) – REGULAR EVALUATION (RE)
Report No. ________
For the Year of ___________

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

Province Code: (e.g., 12) (Note: See Form B-1, Table 1, Row 6)
1 4

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.) (Note 2: 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)

Baliuag 0 3 0 0 05/18/2015 – 05/22/2015 05/29/2015 I A 2

I A 3
I D.1 3.2
I D.2 1.3
I D.4 2
Bustos 0 6 0 0 05/18/2015 – 05/22/2015 05/29/2015 I A 1
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.) (Note 2: 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)

I A 3
I D.1 2
I D.2 1.3
I D.4 2
II A.2 1
II A.8 2
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.) (Note 2: 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)

II A.12 13

PREPARED AND SUBMITTED BY: APPROVED BY:

PROVINCIAL TREASURER