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 December 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.
 Joint Filing  Separate Filing  Not Applicable

DECLARANT: VALDEZ NATHALIE B. POSITION: Administrative Assistant V

(Family Name) (First Name) (M.I.) AGENCY/OFFICE: OPP-Nueva Vizcaya

ADDRESS: Purok 1, Bonfal West, OFFICE ADDRESS: Justice Hall, San Andres
Santiago City
Bayombong, Nueva Vizcaya

SPOUSE: VALDEZ CHRISTIAN M. POSITION: IT Specialist

(Family Name) (First Name) (M.I.) AGENCY/OFFICE: Cooperative Bank of Nueva Vizcaya
OFFICE ADDRESS: Ramon, Isabela

UNMARRIED CHILDREN BELOW EIGHTEEN (18) YEARS OF AGE LIVING IN DECLARANT’S HOUSEHOLD
NAME DATE OF BIRTH AGE
EZEKIEL B. VALDEZ MAY 14, 2012 7
NAJII IŃIGO B. VALDEZ OCTOBER 17, 2016 3

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*

DESCRIPTION KIND EXACT ASSESSED CURRENT FAIR ACQUISITION ACQUISITION

(e.g. lot, house and (e.g. residential, LOCATION VALUE MARKET VALUE COST
lot, condominium commercial, industrial,
(As found in the Tax Declaration of
and improvements) agricultural and mixed use)
Real Property)
YEAR MODE

N/A

Subtotal:

b. Personal Properties*

DESCRIPTION YEAR ACQUIRED ACQUISITION COST/AMOUNT

Jewelries Various Years P70,000.00

Furnitures & Appliances Various Years P120,000.00
Gadgets Various Years P75,000.00
Vehicle 2016 P300,000.00
Cash in bank and on hand Various Years P100,000.00

Subtotal : P665,000.00

TOTAL ASSETS (a+b): P665,000.00

* Additional sheet/s may be used, if necessary.

Page 1 of 2
2 . LIABILITIES*

NATURE NAME OF CREDITORS OUTSTANDING BALANCE

CONSOLIDATED SALARY LOAN GSIS P 75,000.00

REGULAR POLICY LOAN GSIS P 2,780.55
HDMF PAG-IBIG MULTI-PURPOSE LOAN PAG-IBIG P 10,720.00
(Reloan)
LANDBANK MULTI-PURPOSE LOAN LAND BANK P 94,703.74
(Reloan)

TOTAL LIABILITIES: P 183,204.29

NET WORTH : Total Assets less Total Liabilities = P481,795.71
* Additional sheet/s may be used, if necessary.

BUSINESS INTERESTS AND FINANCIAL CONNECTIONS

(of Declarant /Declarant’s spouse/ Unmarried Children Below Eighteen (18) years of Age Living in Declarant’s Household)

 I/We do not have any business interest or financial connection .

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

ENTERPRISE INTEREST &/OR FINANCIAL INTEREST OR CONNECTION
CONNECTION
N/A

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
VILMA OJADAS BARTOLOME MOTHER NURSE MUNICIPAL HEALTH OFFICE,BAYOMBONG,
NUEVA VIZCAYA
NAVIGAEL B. CALIP SISTER NURSE VETERANS REGIONAL HOSPITAL, BAYOMBONG,
NUEVA VIZCAYA

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: January 20,2020

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

Government Issued ID: GSIS UMID Government Issued ID:

ID No.: CRN-021-1650-3300-5 ID No.:
Date Issued: 05-21-2018 Date Issued:

SUBSCRIBED AND SWORN to before me this 20th day of J a n u a r y , 2 0 1 0 , affiant exhibiting to me the
above-stated government issued identification card.

_______________________________________
(Person Administering Oath)

Page 2 of 2
 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 December 31, 2017
(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: CASUMPANG ANTONETTE M. POSITION: Administrative Assistant V

(Family Name) (First Name) (M.I.) AGENCY/OFFICE: OPP-Nueva Vizcaya
OFFICE ADDRESS: Dumlao Justice Hall, Capitol
ADDRESS: Purok 4, Tapaya, Villaros
Compound, Bayombong,
Bagabag, Nueva Vizcaya Nueva Vizcaya

SPOUSE: N/A POSITION: N/A

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

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*

DESCRIPTION KIND EXACT ASSESSED CURRENT FAIR ACQUISITION ACQUISITION

(e.g. lot, house and (e.g. residential, LOCATION VALUE MARKET VALUE COST
lot, condominium commercial, industrial,
(As found in the Tax Declaration of
and improvements) agricultural and mixed use)
Real Property)
YEAR MODE

Lot Agriculture Baretbet, 2016 P 50,000.00

Bagabag,
Nueva Vizcaya

Subtotal: P50,000.00

b. Personal Properties*

DESCRIPTION YEAR ACQUIRED ACQUISITION

COST/AMOUNT

Jewelries Various Years P20,000.00

Furnitures & Appliances Various Years P70,000.00
Gadgets Various Years P60,000.00

Subtotal : P150,000.00

TOTAL ASSETS (a+b): P200,000.00

* Additional sheet/s may be used, if necessary.

Page 3 of 2
3 . LIABILITIES*

NATURE NAME OF CREDITORS OUTSTANDING BALANCE

CONSOLIDATED SALARY LOAN GSIS P 50,043.87

REGULAR POLICY LOAN GSIS P 3,895.55
HDMF PAG-IBIG MULTI- PAG-IBIG P 11,200.00
PURPOSE LOAN
LANDBANK MULTI-PURPOSE LAND BANK P 83,900.00
LOAN
CALAMITY LOAN GSIS P 28,565.76
TOTAL LIABILITIES: P 177,605.18
NET WORTH : Total Assets less Total Liabilities = P 22,394.82
* Additional sheet/s may be used, if necessary.

BUSINESS INTERESTS AND FINANCIAL CONNECTIONS

(of Declarant /Declarant’s spouse/ Unmarried Children Below Eighteen (18) years of Age Living in Declarant’s Household)

 I/We do not have any business interest or financial connection .

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

ENTERPRISE INTEREST &/OR FINANCIAL INTEREST OR CONNECTION
CONNECTION
N/A

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
N/A

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: February 8, 2018

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

Government Issued ID: DEPARTMENT OF JUSTICE Government Issued ID: N/A

ID No.: ADAS5-605-05 ID No.:
Date Issued: JUNE 23, 2015 Date Issued:

SUBSCRIBED AND SWORN to before me this 8th day of February, 2018, affiant exhibiting to me the above-
stated government issued identification card.

_______________________________________
(Person Administering Oath)

Page 4 of 2