Revised as of Janus.

ry 2015
Per CSC Resolution No. 1500088
Promulgated on January 23, 2015

SWORN STATEMENT OF ASSETS, LIABILITIES AND NET WORTH

As of
(Required by RA 6713)

Note: Husband and wife who are both public officials and employees may file the required statements jointly or separately.
0 Joint Filing 0 Separate Filing U Not Applicable

DECLARANT: JAMAD BYRON E. POSITION: BRGY. SECRETARY

(Family Name) (First Name) (Ml.) AGENCY/OFFICE: DILG
ADDRESS: BRGY.TAMBARA MALABANG L.D.S OFFICE ADDRESS: MALABANG LANAO DEL SUR

SPOUSE: MANAN ROSAID A. POSITION: N/A

(Family Name) (First Name) (Mt) AGENCY/OFFICE:
OFFICE ADDRESS:

UNMARRIED CHILDREN BELOW EIGHTEEN (18) YEARS OF AGE LIVING IN DECLARANT'S 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 declarant's household)
1. ASSETS
Real Properties*

DESCRIPTION KUM EJCASIF ASSESSED CURRENT FAIR ACQUISITION ACQUISITION

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

Wooden house Residential BRGY.TAMBARA N/A N/A 2018 105,000

Subtotal: 105,000
Personal Properties*

DESCRIPTION YEAR ACQUIRED ACQUISITION

COST/AMOUNT

CELLPHONE 2024 11,000

Subtotal: 11,00

TOTAL ASSETS (a+b): 116,000

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

Page 1 of
2. LIABILITIES*

NATURE NAME OF CREDITORS OUTSTANDING BALANCE

N/A
N/A
N/A
N/A
N/A TOTAL LIABILITIES:
N/A
NET WORTH : Total Assets less Total Liabilities =
* Additional sheet/ s may be used, ((necessary.

BUSINESS INTERESTS AND FINANCIAL CONNECTIONS

(of Declarant /Declarant's spouse/ Unmarried Children Below Eighteen (18) years of Age Luring in Declarant's Household)
ci 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 136/OR FINANCIAL INTEREST OR CONNECTION
CONNECTION

RELATIVES IN THE GOVERNMENT SERVICE

(Within the Fourth Degree of Consanguinity or Affinity. Include also Biles, Balae and Inso)
l/ We do not know of any relative/sin 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: APRIL ,2024

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

Government Issued ID: NATIONAL I.D Government Issued ID:

ID No.: 3487-0918-4906-9507 ID No.:
Date Issued: February 10, 2023 Date Issued:

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

(Person Administering Oath)

Page 2 of
 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
(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: POSITION:
(Family Name) (First Name) (ML) AGENCY/OFFICE:

ASSETS, LIABILITIES AND NET WORTH

1. ASSETS
Real Properties

DESCRIPTION KIND EXACT : T FAIR ACQUISITION ACQUISITION

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

Personal Properties

DESCRIPTION YEAR ACQUIRED ACQUISITION

COST/AMOUNT

2. LIABILITIES

NATURE NAME OF CREDITORS OUTSTANDING BALANCE

BUSINESS INTERESTS AND FINANCIAL CONNECTIONS

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

ENTERPRISE INTEREST 8i/OR FINANCIAL INTEREST OR CONNECTION
_I _ CONNECTION

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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
(Additional sheet/ s for the declarant)

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

ASSETS, LIABILITIES AND NET WORTH

1. ASSETS
Real Properties

DESCRIPTION KIND EXACT ASSESSED CURRENT FAIR ACQUISITION ACQUISITION

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

Subtotal:
Personal Properties

DESCRIPTION YEAR ACQUa ACQUISITION COST/AMOUNT

Subtotal:
TOTAL ASSErs (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 di/OR FINANCIAL INTEREST OR CONNECTION
CONNECTION

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