(SELF ASSESSMENT CALCULATION SHEET) WARD NO. LIST OF NEW/ IMPROVED HOLDINGS ASSESSED UNDER SECTION 155 G.M.C. ACT 1969 FOR .......... QUARTER 20........ No of Holding with previous A.R.V. If any Name of Road Name of Assessee with Father's/Husband's Name Whether Self/Rented/ Residence/B ussiness use House cover land Area, Vacant land area Description of the Holding and A.R.V. Calculation Property Tax Qtly Annual Urban Immovable Property Tax Remarks Previous Holding No. if any General Scavenging Water Rs. P. Light Previous A.R.V. if any Total Rs. Calculation checked by Assessment Officer G.M.C. THE ANNUAL RATEABLE VALUE FIXED AT RS....... (In words........Site verification done and found correct Prepared by Field Officer, G.M.C. (Signature full name and code no of CTP) Signature and Full Name of Owner/Occupier Dy. Commissioner Commissioner G.M.C. G.M.C.