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Revised as of January 2015

Per CSC Resolution No. 1500088


Promulgation on January 23, 2015

SWORN STATEMENT OF ASSETS, LIABILITIES, AND NET WORTH


As of _December 31, 2020
(Required by R.A. No. 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: VELASCO JR CLARITO P POSITION: POLICE CORPORAL


(Family Name) (First Name) (M.I.) AGENCY/OFFICE: PHILIPPINE NATIONAL POLICE
ADDRESS: BLOCK 7 LOT 15 VILLA GRANDE LIZADA TORIL OFFICE ADDRESS: DCPO-PRO XI____________
DAVAO CITY
SPOUSE: VELASCO JIERIZA LYN M POSITION: PROJECT DEVELOPMENT OFFICER
(Family Name) (First Name) (M.I.) AGENCY/OFFICE: DSWD F. O. XI
OFFICE ADDRESS: DAVAO CITY

UNMARRIED CHILDREN BELOW EIGHT (18) YEARS OF AGE LIVING IN DECLARANT’S HOUSEHOLD

NAME DATE OF BIRTH AGE


KAEL M. VELASCO MARCH 15, 2018 2 YEARS OLD

KLEA M. VELASCO OCTOBER 5, 2020 3 MONTH OLD


_______________________________________________________________________________________
ASSETS, LIABILITIES AND NETWORTH
(Including those of the spouse and unmarried childrenbelow eighteen (18)
years of age living in declarant’s household)
1. ASSETS:
a. Real Properties*

KIND
DESCRIPTION CURRENT FAIR ACQUISITION
(e.g. residential, EXACT ASSESSED
(e.g Lot, House and MARKET VALUE ACQUISITION COST
commercial, industrial LOCATION VALUE
Lot, Condominium
agricultural and Mixed (As found in the Tax Declaration of
and Improvements) YEAR MODE
use) Real Property)
N/A N/A N/A N/A N/A N/A N/A N/A

Subtotal: P N/A

b. Personal and other Properties*


DESCRIPTION YEAR ACQUIRED ACQUISITION COST/AMOUNT
HYUNDAI EON 2017 240,000
GOLD RING 2017 6,000
YAMAHA MIIO MOTORCYCLE 2017 65,000

Subtotal: P 311,000

TOTAL ASSETS (a+b): P 311,000

Page 1 of _____
2. LIABILITIES*
NATURE NAME OF CREDITORS OUTSTANDING BALANCE
SALARY LOAN PSSLAI 200,000
SALARY LOAN AFPSLAI 200,000

TOTAL LIABILITIES: P 400,000

NETWORTH: Total Assets less Total Liabilities = P (89,000)

*Additional sheet/s may be used if necessary.

BUSINESS INTEREST AND FINANCIAL CONNECTIONS


(Of Declarant/Declarants 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

DATE OF
NAME OF
NATURE OF BUSINESS ACQUISITION OF
ENTITY/BUSINNES BUSINESS ADDRESS
INTERESTS &/OR FINANCIAL INTEREST OR
ENTERPRISE
CONNECTION CONNECTION

RELATIVES IN THE GOVERNMENT SERVICE


(Within the Fourth Degree of Consanguinity or Affinity Include also Bilas, Baiao and Inso)
/ I/We do not know of any relative/s in the government service.

NAME OF RELATIVE RELATIONSHIP POSITION NAMEOF AGENCY/OFFICE AND ADDRESS


CLARITO J. VELASCO SR FATHER GOVERNMENT LGU, MALITA DAVAO OCCIDENTAL
EMPLOYEE
CLEOPERE P VELASCO BROTHER DEPED DEPED, DAVAO OCCIDENTAL
TEACHER
CLARIZ P VELASCO SISTER DEPED DEPED, DAVAO OCCIDENTAL
TEACHER
I hereby certify that these are true and correct statements of my assets, liabilities, net worth business
interest 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 to secure
from all appropriate government agencies, including the Bureau of Internal Revenue, such documents that may
shown my assets, liabilities, net worth, business interest 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: JANUARY 25, 2021

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

Government Issued ID: DSWD ID Government Issued ID: PRC ID


ID No.: 11-9394 ID No.: 0072001
Date Issued: JANUARY 15 2021 Date Issued: 11/27/2012

SUBSCRIBED AND SWORN to before this 25 of JANUARY, 2021 affiant exhibiting to me the above-
stated government issued identification card.
_______________________
(Person Administering Oath)

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