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COMMUNITY TAX CERTIFICATEINDIVIDUALYEARPLACE OF ISSUE (City/ Mun/ Prov)DATE ISSUEDTAXPAYER'S COPYNAME (SURNAME)(FIRST)(MIDDLE)TIN (If Any):ADDRESSSEXCITIZENSHIPICR NO. (If an Alien)PLACE OF BIRTHHEIGHTCIVILDATE OF BIRTHWEIGHTSTATUSPROFESSION/ OCCUPATION/ BUSINESSTAXABLECOMMUNITYAMOUNTTAX DUEABASIC COMMUNITY TAX (P5.00) Voluntary or Excempted (P1.00)PBADDITIONAL COMMUNITY TAX (tax not to exceed P5.00)
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community tax, community tax certificate, City Mun Prov

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