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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 December 31, 2019
(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: PARAS MARIA THERESA SP. POSITION: TEACHER II


(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 YEAR MODE
use) Real Property)

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

Car 2019 300,000


Gadgets Various Years 50,000
Appliances Various Years 30,000

2. LIABILITIES

NATURE NAME OF CREDITORS OUTSTANDING BALANCE

Salary Loan Eastern Peninsula Credit Cooperative 250,000


Personal Loan Private Lending 14,000

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

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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 December 31, 2019
(Sample additional sheet/s for the declarant)

NAME: PARAS MARIA THERESA SP. POSITION: TEACHER II


(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 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

Page __ of ___

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