LTO Form 28
Republic of the Philippines
City of Tagbilaran
Office of the City Treasurer
TAX DATA AND ASSESSMENT FORM
Name of Company President ___________________________ Mayor’s Permit No. _____________________
Business Name ______________________________________ Area _________________________________
Address ____________________________________________ Nature of Business ______________________
LOA # ______________________________________________ Date Issued ______________ Date Examined _________________________
Community Tax Certificate No. _________________________ Date Issued ______________ Place of Issue __________________________
Particulars Actual Sales Declared Sales Year Tax Due Tax Paid Difference Surcharge Interest
Findings and Recommendations We have examined, reviewed and evaluated the foregoing
__________________________________________________ accomplished data and assessment form concurs with the
__________________________________________________ findings and recommendations of the deputy
__________________________________________________
__________________________________________________
_______________ __________________ Approved by:
Revenue Examiner Sr. Revenue Examiner
_________________________