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 2023
(Sample additional sheet/s for the exclusive properties of the declarant’s spouse and unmarried children
below eighteen (18) years of age living in declarant’s household)

NAME: BULIG JOY G. POSITION: TEACHER III

(Family Name) (First Name) (M.I.) AGENCY/OFFICE: DEPARTMENT OF EDUCATION

ASSETS, LIABILITIES AND NET WORTH

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

FARMLOT AGRICULTURAL BAGUIO N/A N/A 2017 PURCH 1,500,000.00

DISTRICT ASED

N/A N/A N/A N/A N/A N/A N/A N/A

N/A N/A N/A N/A N/A N/A N/A N/A

N/A N/A N/A N/A N/A N/A N/A N/A

b. Personal Properties

DESCRIPTION YEAR ACQUIRED ACQUISITION

COST/AMOUNT

CASH IN BANK 2023-PRESENT 650,000

JEWELRIES 2016- PRESENT 100,000
FURNITURES AND APPLIANCES 2001- PRESENT 200,000
N/A N/A N/A

2. LIABILITIES

NATURE NAME OF CREDITORS OUTSTANDING BALANCE

N/A N/A N/A

N/A N/A N/A
N/A N/A N/A
N/A N/A N/A

BUSINESS INTERESTS AND FINANCIAL CONNECTIONS

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

ENTERPRISE INTEREST &/OR FINANCIAL INTEREST OR CONNECTION
CONNECTION

N/A N/A N/A N/A

N/A N/A N/A N/A
N/A N/A N/A N/A
N/A N/A N/A N/A

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 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 ________________________________
(Sample additional sheet/s for the declarant)

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

ASSETS, LIABILITIES AND NET WORTH

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 YEAR MODE
use) Real Property)

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:

BUSINESS INTERESTS AND FINANCIAL CONNECTIONS

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

ENTERPRISE INTEREST &/OR FINANCIAL INTEREST OR CONNECTION
CONNECTION

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