a of January 2015 Per CSC Resolution No. 1500088 Promulgated on January 29,2015 SWORN STATEMENT OF ASSETS, LIABILITIES AND NET WORTH. As of December 31, 2018 (Required by R.A. 6713) Note: Husband and wife who are both publi ofcials and employees may file the required statements jointly or separately @ Joint Fiting G Separate Filing Not Applicable DECLARANT: GUIAO JAYSON s. Postrion: TEACHER | Family Name) (Firat Name) — (Li) AGRNCY/oFFICE: ____DEPED- TUMBAGAES ADDRESS: _CAYUMA, CAWAYAN 1, SAN FRANCISCO, QUEZON OFFICE ADDRESS: BRGY. PAGSANGAHAN EKG agnog JARMAN "SAN FRANCO, QUETON SPOUSE: eu1ao nome A POSITION: - TEACHER | Family Name) (rst Name) Bey AGENCY/OFFICE: —DEPED- BON JUAN VERCEIOS ES OFFICE ADDRESS: ~ BRGY. DON JUAN VERCELOS, SAN FRANCISCO, QUEION -ee UNMARRIED CHILDREN BELOW EIGHTEEN (18) YEARS OF AGE LIVING IN DECLARANT’S HOUSEHOLD NAME DATE OF BIRTH AcE BERNICE CIEL A. GUIAO 02/0/16 2 YEARS & 10 a Monts 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 8. Real Properties DESCRIPTION) KIND EXACT assnssep | CURRENT FAIR) acqutsimion | acquisition egies) pees i. zocaniog vawue | MARKET VALUE) ‘cost « HOUSE IMPROVEMEN| RESIDENTIAL | CAYUMA.CAWAYAN 1 SAN 2017 | casHy| 450,000.00 | FRANCISCO, QUEZON a : | - é ‘Subtotal: 450,000.00 _ b. Personal Properties DESCRIPTION ‘YEAR ACQUIRED ‘ACQUISITION ‘cost/amourer MOTORCYCLE i 2018 52,600.00 GADGETS a i 2018 12,000.00 WATER PUMP & PRESSURE TANK q 2018 10,000.00 ‘CLOTHING 2018 8,000.00 Page 1 of 22. LIABILITIES* NATURE [NAME OF CREDITORS SALARY LOAN. CITY SAVINGS | SALARY LOAN i CITY SAVINGS SALARY LOAN MTMAS _ ae NET WORTH : Total Assets less Total Liabilities * Additional sheet/s may be used, if necessary. BUSINESS INTERESTS AND FINANCIAL CONNECTIONS (ef Declarant /Declarant’s spouse/ Unmarried Children Below Eighteen (18) years of Age Living in Declarant’s Household) JA Y/ We do not have any business interest or financial connection. 143,179.41 ‘NAME OF ENTITY/BUSINESS: ‘BUSINESS ADDRESS: NATURE OF BUSINESS DATE OF ACQUISITION OF ENTERPRISE INTEREST &/OR FINANCIAL | INTEREST OR CONNECTION “ ‘CONNECTION N/A HEE RELATIVES IN THE GOVERNMENT SERVICE (Within the Fourth Degree of Consanguinity or Anity. Ince also Bilas, Balae and tnso) O I/We do not know of any relative/s in the government service) NAME OF RELATIVE RELATIONSHIP POSITION [NAME OF AGENCY/OFFICE AND ADDRESS NOIME A. GUIAO_ wiFE TEACHER 1 DON JUAN VERCELOS ELEM. SCHOOL SAN Ms ___ FRANCISCO. QUEZON. 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. Thereby 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 31, 2019 warsof ino nouitKASIIA© Senature ff Beearant) (Signature of Co-Declarart/ Spouse) Government lasued ID: _ PRC Government Issued ID: _PRC ID No. 123898 — ID No. 1311086 Date Issued: aig7201%8 Date issued! 11/19/2014 SUBSCRIBED AND SWORN to before me this 31% day of January 2019, affiant exhibiting to me the above- stated government issued identification card. y yi JOCELYN N. ALLAREY (Person Administering Oath) Page 2 of 2