Professional Documents
Culture Documents
Joint Filing
DECLARANT
MANALO
Separate Filing
T.
Not Applicable
SECONDARY SCHOOL TEACHER I
POSITION:
:
(Family Name)
(First Name)
(M.I.)
DEPED - QUEZON
AGENCY/OFFICE:
ADDRESS:
SAINT.PAUL ST.,
BRGY. G-GULANG
LUCENA CITY
QUEZO
N
(First Name)
(M.I.)
OFFICE ADDRESS:
N/A
SPOUSE:
(Family Name)
LUCENA CITY
POSITION:
N/A
AGENCY/OFFICE:
N/A
OFFICE ADDRESS:
N/A
UNMARRIED CHILDREN BELOW EIGHTEEN (18) YEARS OF AGE LIVING IN DECLARANTS HOUSEHOLD
NAME
DATE OF BIRTH
N/A
AGE
N/A
N/A
Real Properties*
DESCRIPTION
KIND
EXACT
ASSESSED
CURRENT FAIR
(e.g. residential,
commercial, industrial,
agricultural and mixed
use)
LOCATION
VALUE
MARKET VALUE
N/A
N/A
N/A
ACQUISITION
ACQUISITION
COST
YEAR
MODE
N/A
N/A
N/A
N/A
Subtotal:
N/A
N/A
b. Personal Properties*
DESCRIPTION
YEAR ACQUIRED
ACQUISITION
COST/AMOUNT
ACER LAPTOP
ACER SWITCH 10
2011
2015
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28,000
10,000
2014
2010
62,000
14,000
10,000
Subtotal : 62,000
TOTAL ASSETS (a+b):
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2. LIABILITIES*
NATURE
NAME OF CREDITORS
PERSONAL LOAN
OUTSTANDING BALANCE
10,000
DAHLIA T. MANALO
TOTAL LIABILITIES:
NET WORTH : Total Assets less Total Liabilities =
10,000
52,000
BUSINESS ADDRESS
NATURE OF BUSINESS
INTEREST &/OR FINANCIAL
CONNECTION
DATE OF ACQUISITION OF
INTEREST OR CONNECTION
N/A
N/A
N/A
N/A
RELATIONSHIP
POSITION
FATHER
MUNICIPAL
TREASURER
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 aboveenumerated 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:
(Signature of Declarant)
Government Issued ID:
ID No.:
Date Issued:
PROFESSIONAL REGULATORY
BOARD COMMISION I.D.
1347085
DECEMBER 5, 2014
(Signature of Co-Declarant/Spouse)
Government Issued ID:
N/A
ID No.:
Date Issued:
N/A
N/A
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SUBSCRIBED AND SWORN to before me this 15th day of JANUARY, 2016 , affiant exhibiting to me the
above-stated government issued identification card.
_______________________________________
(Person Administering Oath)
2
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