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    Sworn Statement of Assets, Liabilities and Net Worth

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    Ex AtingGuro Partylist Cebrian
    This document is a sworn statement of assets, liabilities, and net worth that must be filed by public officials and employees in the Philippines. It requires the declarant to disclose their personal information and positions held, as well as assets, liabilities, business interests, financial connections, and relatives in government. The declarant and their spouse authorize the Ombudsman to obtain documents from government agencies to verify the information provided in the statement covering the declarant's time in government service.

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    Sworn Statement of Assets, Liabilities and Net Worth

    Uploaded by

    Ex AtingGuro Partylist Cebrian
    17 views2 pages
    This document is a sworn statement of assets, liabilities, and net worth that must be filed by public officials and employees in the Philippines. It requires the declarant to disclose their personal information and positions held, as well as assets, liabilities, business interests, financial connections, and relatives in government. The declarant and their spouse authorize the Ombudsman to obtain documents from government agencies to verify the information provided in the statement covering the declarant's time in government service.

    Original Description:

    SALN for those who are working either in private or public sector should have a copy of this.

    Original Title

    Saln 2012 Form

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    This document is a sworn statement of assets, liabilities, and net worth that must be filed by public officials and employees in the Philippines. It requires the declarant to disclose their personal information and positions held, as well as assets, liabilities, business interests, financial connections, and relatives in government. The declarant and their spouse authorize the Ombudsman to obtain documents from government agencies to verify the information provided in the statement covering the declarant's time in government service.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    17 views2 pages

    Sworn Statement of Assets, Liabilities and Net Worth

    Uploaded by

    Ex AtingGuro Partylist Cebrian
    This document is a sworn statement of assets, liabilities, and net worth that must be filed by public officials and employees in the Philippines. It requires the declarant to disclose their personal information and positions held, as well as assets, liabilities, business interests, financial connections, and relatives in government. The declarant and their spouse authorize the Ombudsman to obtain documents from government agencies to verify the information provided in the statement covering the declarant's time in government service.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    Page 1 of ___

    SWORN STATEMENT OF ASSETS, LIABILITIES AND NET WORTH


    As of ________________________________
    (Required by R.A. 6713)

    Note: Husband and wife who are both public officials and employees may file the required statements jointly or separately.
    Joint Filing Separate Filing Not Applicable

    DECLARANT: POSITION:
    (Family Name) (First Name) (M.I.) AGENCY/OFFICE:
    ADDRESS: OFFICE ADDRESS:


    SPOUSE: POSITION:
    (Family Name) (First Name) (M.I.) AGENCY/OFFICE:
    OFFICE ADDRESS:



    UNMARRIED CHILDREN BELOW EIGHTEEN (18) YEARS OF AGE LIVING IN DECLARANTS HOUSEHOLD

    NAME DATE OF BIRTH AGE






    ASSETS, LIABILITIES AND NETWORTH
    (Including those of the spouse and unmarried children below eighteen (18)
    years of age living in declarants household)
    1. ASSETS
    a. Real Properties*
    DESCRIPTION
    (e.g. lot, house and
    lot, condominium
    and improvements)
    KIND
    (e.g. residential,
    commercial, industrial,
    agricultural and mixed
    use)
    LOCATION ASSESSED
    VALUE
    CURRENT FAIR
    MARKET VALUE
    ACQUISITION ACQUISITION COST

    (As found in the Tax Declaration of
    Real Property)
    YEAR MODE




    Subtotal:
    b. Personal Properties*
    DESCRIPTION YEAR ACQUIRED ACQUISITION COST/AMOUNT




    Subtotal :
    TOTAL ASSETS (a+b):
    2. LIABILITIES*
    NATURE NAME OF CREDITORS OUTSTANDING BALANCE




    TOTAL LIABILITIES:

    NET WORTH : Total Assets less Total Liabilities =
    * Additional sheet/s may be used, if necessary.
    Page 2 of ___


    BUSINESS INTERESTS AND FINANCIAL CONNECTIONS
    (of Declarant /Declarants spouse/ Unmarried Children Below Eighteen (18) years of Age Living in Declarants Household)
    I/We do not have any business interest or financial connection.
    NAME OF ENTITY/BUSINESS
    ENTERPRISE
    BUSINESS ADDRESS NATURE OF BUSINESS
    INTEREST &/OR FINANCIAL
    CONNECTION
    DATE OF ACQUISITION OF
    INTEREST OR CONNECTION






    RELATIVES IN THE GOVERNMENT SERVICE
    (Within the Fourth Degree of Consanguinity or Affinity. Include also Bilas, Balae and Inso)
    I/We do not know of any relative/s in the government service)
    NAME OF RELATIVE RELATIONSHIP POSITION NAME OF AGENCY/OFFICE AND ADDRESS








    I hereby certify that these are true and correct statements of my assets, liabilities, net worth,
    business interests and financial connections, including those of my spouse and unmarried children below
    eighteen (18) years of age living in my household, and that to the best of my knowledge, the above-
    enumerated are names of my relatives in the government within the fourth civil degree of consanguinity or
    affinity.


    I hereby authorize the Ombudsman or his/her duly authorized representative to obtain and
    secure from all appropriate government agencies, including the Bureau of Internal Revenue such
    documents that may show my assets, liabilities, net worth, business interests and financial connections,
    to include those of my spouse and unmarried children below 18 years of age living with me in my
    household covering previous years to include the year I first assumed office in government.

    Date: ______________________________



    (Signature of Declarant) (Signature of Co-Declarant/Spouse)

    Government Issued ID: Government Issued ID:
    ID No.: ID No.:
    Date Issued: Date Issued:





    SUBSCRIBED AND SWORN to before me this day of , affiant exhibiting to me the above-stated
    government issued identification card.




    _______________________________________
    (Person Administering Oath)

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