BGO.CASSO.F.
001                                              JOB ORDER NO:
   REPUBLIC OF THE PHILIPPINES
   CITY OF BAGUIO- OFFICE OF THE CITY ASSESSOR
   DUE DATE:
                                                                               INITIAL INSTRUCTION/SPECIFIC REQUEST:
       NEW ASSESSMENT                               NCA
       RE- ASSESSMENT
    ARP #:
R E Q U E S T E R ' S N A M E : FIRST NAME MIDDLE NAME SURNAME                    N A M E O F O W N E R : FIRST NAME MIDDLE NAME SURNAME
                                                                                  MARRIED TO:
COMPLETE ADDRESS:                                                                 COMPLETE BILLING/MAILING ADDRESS:
CONTACT NUMBER:                                                               LOCATION OF PROPERTY:
SIGNATURE/RELATIONSHIP TO OWNER:
                                                                              TIN:
       CHECKLIST OF REQUIRED DOCUMENTS                       B. TAX MAPPING AND IDENTIFICATION DIVISION (TMD-TMDH) PIN:
                                                             _
                                                             T MDH BY:
   BUILDING/ HOUSE ASSESSMENT
                                                             _________
                                                                     REMARKS:
      (4) DIFFERENT PICTURES IN A LONG BOND PAPER                                                                                                G
      (COLORED) - PASTED/ PRINTED
       A.     P I CT U R E OF H O U SE WI T H TH E O WNER
       B.     EXTERIOR VIEW OF WHOLE HOUSE (FRONT AND                                                                    CAESAR L. ONOZA
       ALL SIDES)                                                                                                             LAOO III- OIC
       C.     INTERIOR VIEW WHICH SHOWS FLOORING,
       CEILING AND WALLS
      LOT TAX DECLARATION/ TITLE (OPTIONAL)
                                                               C. ASSESSMENT AND APPRAISAL DIVISION (ADAP-ADCOD)
      PHOTOCOPY OF CEDULA (PRESENT YEAR)/
      VALID GOVERNMENT I. D WITH PHOTO                       PS:                                  ADAP BY:
      SWORN STATEMENT                                          E
                                                               D.APPROVAL
                                                                  REVIEW OFOF REAL
                                                                            REAL   PROPERTY
                                                                                 PROPERTY   ASSESSMENT
                                                                                          ASSESSMENT   CA)
                                                                                                     (ACA)
      BARANGAY CERTIFICATE INDICATING HOUSE
      OWNERS' NAME, YEAR WHEN HOUSE WAS BUILT
      AND COMPLETED/OCCUPIED
   H BUILDING PERMIT/ OCCUPANCY PERMIT
   HAS BUILT FLOOR PLAN
      TAX DECLARATION OF THE BUILDING (OLD)
   OTHERS:_________________________________________
      I F APPLICATION I S PROCESSED BY A
      REPRESENTATIVE:
       1.       OWNER'S AUTHORIZATION LETTER
       2.       P HO T O CO P Y OF OWNER ' S V ALI D I .D
       WI TH P HO T O
       3.    PHOTOCOPY OF REPRESENTATIVE'S VALID I.D
       WITH PHOTO
      OTHERS (FOR OLD BUILDING)
   MOTHER'S NAME:_______________________________________
   FATHER'S NAME:________________________________________
   SPOUSES NAME:________________________________________
   MOTHER-IN-LAW'S NAME:________________________________
   FATHER-IN-LAW'S NAME: ________________________________
   CANCEL' ATION
      BARANGAY CERTIFICATE INDICATING YEAR
      BUILDING/ STRUCTURE WAS DEMOLISHED
      PHOTOS OF DEMOLISHED BUILDING/
      STRUCTURE
                                                                                                                                  DATE INSPECTED:
      STATEMENT OF ACCOUNT FROM TREASURY                     DOCUMENTS RECEIVED BY:
      OFFICE AS TO LAST PAYMENT OF TAXES                                                         (NAME AND SIGNATURE]
      DEMOLITION PERMIT/ DEMOLITION ORDER                       REMARKS:RELEASE OF ARP/ NOA OWNER'S
   : O T H E R S : ______________________________________                                                       COPY OF AUTHORIZED REQUESTER/ OWNER
                                                                                                                AND FILE DOCUMENTS.
   EXAMINATION & ACCEPTANCE OF DOCUMENTS
   NAME/ SIGNATURE:____________________________________                                                            JESUSA C. ESCOLASTICO
                                                                                                                        LAOOIV
   DATE:__________________________________________________
   APPRAISER/ INSPECTOR:_______________________________
                                                             NOTE: ADDITIONAL DOCUMENTS OTHER THAN STATED ABOVE MAY BE REQUIRED IF FOUND
                                                             NECESSARY AFTER EVALUATION. REVISED AUG2022. D.5 GCW