Revised as of January 2015

Per CSC Resolution No. 1500088

Promulgated on January 23, 2015

SWORN STATEMENT OF ASSETS, LIABILITIES AND NET WORTH

As of OCTOBER 31,2019
(Required by R.A. 6713)
Note: Husband and wife who are both public officials and employees may file the required statements jointly or separately.
ü
/ Joint Filing Separate Filing ü Not Applicable
Name : CODEROS MATILDE B. POSITION : Head Teacher I
(Surname) (First Name) (M.I.) AGENCY/OFFICE : DEPED-COMPOSTELA VALLEY
Address : P 6, CEBOLEDA,LAAK COMPOSTELA VA OFFICE ADDRESS : ANDAP,LAAK,COMPOSTELA VALLEY

Spouse : CODEROS JIMMY V. POSITION : FARMER/BARANGAY KAGAWAD

(Surname) (First Name) (M.I.)
AGENCY/OFFICE : LGU-CEBOLEDA
OFFICE ADDRESS : CEBOLEDA,LAAK,COMPOSTELA VALLEY

UNMARRIED CHILDREN BELOW EIGHTEEN (18) YEARS OF AGE LIVING IN DECLARANT'S HOUSEHOLD
NAME DATE OF BIRTH AGE
N/A

ASSETS, LIABILITIES AND NETWORTH

(Including those of the spouse and unmarried children below eighteen (18)
years of age living in declarant's household)
1. ASSETS
a. Real Properties*
CURRENT FAIR
KIND ASSESSED
DESCRIPTION MARKET ACQUISITION
VALUE ACQUISITION
(e.g. lot, house and (e.g. residential,
EXACT LOCATION VALUE
commercial, industrial, COST
lot, condominium and agricultural and mixed
improvements) use) (As found in the Tax Declaration of Real
Property) YEAR MODE

FARM LOT AGRICULTURAL CEBOLEDA,LAAK 31, 249.00 2010 PURCHASED 160,000.00

FARM LOT AGRICULTURAL CEBOLEDA,LAAK 1998-1999 PURCHASED 40,000.00
HOUSE&LOT RESIDENTIAL CEBOLEDA,LAAK 2000 BUILT/PURCHASED 160,000.00
FARM LOT AGRICULTURAL CEBOLEDA,LAAK 2010 PURCHASED 100,000.00

Subtotal: ₱ 460,000.00
b. Personal Properties*
DESCRIPTION YEAR ACQUIRED ACQUISITION COST/AMOUNT

FURNITURES/TELEVISION 2013-2017 ₱ 50,000.00

NETBOOK/COMPUTER/CELLPHONES 2010-2017 ₱ 86,000.00
JEWELRIES/CLOTHING/B OOKS 2005-2017 ₱ 26,000.00
MOTORCYCLE 2007 ₱ 100,000.00
Subtotal: ₱ 262,000.00

TOTAL ASSETS (a+b): ₱ 722,000.00

2. LIABILITIES*
NATURE NAME OF CREDITORS OUTSTANDING BALANCE

GSIS LOAN GSIS 329,314.20

HOUSING LOAN NHA 80,000.00
PRIVATE LOAN CSB/RBC 43,673.20

TOTAL LIABILITIES: ₱ 452,987.20

NET WORTH: Total Assets less Total Liabilities = ₱ 269,012.80

* Additional sheet/s may be used, if necessary Page 1 of 2 pages

BUSINESS INTERESTS AND FINANCIAL CONNECTIONS

(of Declarant/Declarant's spouse/Unmarried children Below Eighteen (18) years of Age in Declarant's Household)
I/We do not have any business interest or financial connection.

NAME OF ENTITY/BUSINESS NATURE OF BUSINESS INTEREST DATE OF ACQUISITION OF

BUSSINESS ADDRESS
ENTERPRISE AND/OR FINANCIAL CONNECTION INTEREST OR CONNECTION

N/A

RELATIVES IN THE GOVERNMENT SERVICE

(Within the Fourth 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 RELATVIE RELATIONSHIP POSITION NAME OF AGENCY/OFFICE AND ADDRESS

AMALIA C. GONZAGA NIECE TR- 2 DEPED NEW CORELLA

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 afinity.

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 the
government.

Date : OCTOBER 31,2019

MATILDE B. CODEROS JIMMY V. CODEROS

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

Government Issued ID: DEPED Government Issued ID: DRIVER'S LICENSE

ID No. : 0089003 ID No. : L06-06-003124
Date Issued : 7/9/1995 Date Issue : FEBRUARY 23,2018

SUBSCRIBED AND SWORN to before me, this 2nd of September 2019, affiant exhibiting to me the above-stated
government issued identification card.

Doc. No.
Page No. (Person Administering Oath)
Book No.
Series of

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