it IC 7 TOTAL LIABILITIES: NET WORTH : Total Assets less Total Liabilities = 995,000 + Additional sheet/s may be used, if necessary. ante OF EREEFETBUSINESS | BUSINESS ADDRESS ‘ENTERPRISE BUSINESS INTERESTS AND FINANCIAL CONNECTIONS (ef Dectarant/Dvelarast'sspouse/ Unmarried Cntdren Below POMS? (18) years of Age Living in Declarant's Household) 0 I/We do not have | ee t T NONE, i 7“ Tiga tas Lr eh ie — —_—_— 1 a _— pies RELATIVES IN THE GOVERNMENT: oan the Fourth Degree of Consanguinity 0 1/ We do not know of any relative/' in the government service) ——_ Sauns OF RELATIVE. Tioxsme | __BOSTTION. ane GF AGERGy/OFFICH AND ADDRESS aol { i | | hereby cestify that these are true and correct statements of my assets, liabilities, net worth, pusiness 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 knowledges the above- ceimerated are names of my relatives in the government ‘githin the fourth civil degree of consanguinity oF affinity. 1 hereby authorize the Ombudsman or his/her duly authorized. representative to obtain and secure from all appropiate govemment agencies, including the Bureau of Internal Revenue such documents that may show my assets, liabilities, net worth, business interests and financial connections; fo include those of my spouse and unmarried children "pelow 18 years of age living with me in my hhouschold covering previous years to include the year [first assumed office in government. Date: 02/06/2020 Tas pinnae (Signature of Declarant) Signature of Co-Declarant/ Spouse) ‘vovernment Issued 1D: ‘Government Issted Nos Cee io: Date tested LEE. Date issued: FEB OZ 2028 GUBSCRIBED AND SWORN to before me this 5) % government issued identification card ALY.