Revised as of January 2015

Per CSC Resolution No. 1500088

Promulgated on January 23, 20 I 5

SWORN STATEMENT OF ASSETS, LIABILITIES AND NET WORTH

As of ___D_e_ce_m_b_er_3_1_,_,_2_02_1_ _ _ __
(Required by R.A. 6713)

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

DECLARANT: BAACIO MA. NERIZA D. POSITION: Teacher I

(Family Name) (First Name) (M.I.) AGENCY/OFFICE: DepEd Elementary
ADDRESS: Barangay Bariga, Banate, lloilo OFFICE ADDRESS: Poblacion, Banate, lloilo

SPOUSE: NIA NIA NIA POSITION: NIA

(Family Name) (First Name) (M.I.) AGENCY /OFFICE: NIA
OFFICE ADDRESS: NIA

UNMARRIED CHILDREN BELOW EIGHTEEN (181 YEARS OF AGE LIVING IN DECLARANT'S HOUSEHOLD

NAME DATE OF BIRTH AGE

NIA NIA NIA
NIA NIA NIA
NIA NIA NIA

N/A N/A NIA

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
a. Real Properties*
...
DESCRIPTION KIND EXACT ASSESSED CURRENT FAIR ACQUISITION ACQUISITIQN
(e.g. lot, house and (e.g. res identi a l, LOCATION VALUE MARKET VALUE COST
lot, condomini um commercial, industrial,
(As found i n t he Tax Declaration of
and improvements} agricultu ra l a nd mixed Rea l Property) YEAR MODE
u s el '

BARANGAY BARIGA, CASH P250,000.00

HOUSE RESIDENTIAL 2016
BANATE, ILOILO

Subtotal:
- -P250,000.00
-----
b. Personal Properties*
DESCRIPl'ION YEAR ACQUIRED ACQUISl'nON
COST /AMOU?lr
'".
APPLIANCES 2019-2020 P25, 000.00

GADGETS 2019-2020 P37,000.00

CLOTHING 2017 P10,000.00
2020 P73,000.00
HONDA RS 125 Fi MOTORCYCLE
Subtotal : __P_1_4_5'-,o_o_o_
.o_o_

TOTAL ASSETS (a+b): _ _P3_9_s.,.o_o_o_.o_o_

• Additional sheet/ s may be used, if necessary.
Page 1 of _j_
2. LIABILITIES*
NATURE ( ... NAME or CREDITORS OUTSTANDING BALANCE
"
PERSONAL LOAN CSB
P62 931.00
GSIS MPL GSIS P74 052.00

TOTAL LIABILITIES: _ _P_1_36_,_98_3_.o_o_ __

NET WORTH: Total Assets less Total Liabilities= P258,062.00
* Additional sheet/s may be used, if necessary.

BUSINESS INTERESTS AND FINANCIAL CONNECTIONS

(of Declarant I Declarant's spouse/ Unmarried Children Below Eighteen (18) years of Age Living in Declarant's Household)
IJ I/ We do not have any business interest or financial connection.
NAME OF ENTITY /BUSINBSS BUSINES8 ADDRESS NATURE or BUSINESS DATE or ACQmSITION OF •
. E~~iu:Rl~ E I ? f l ' ~ ·&/OR r~~CIAI, 1x INTEREST OR CONNECTION
J'l I." .. '
.,1 CONNECTION " . ''"' '=, .-. ~=· - ". ¾!.'·:
NIA NIA NIA NIA
NIA NIA NIA NIA
NIA NIA NIA NIA
NIA NIA NIA NIA

RELATIVES IN THE GOVERNMENT SERVICE

(Within the Fourth Degree of Consanguinity or Affinity. lncb.lde also Bilas, Balae and Inso)
II We do not know of any relative/ s in the government service)
NAME· OF RELATIVE RELATIONSHIP' ,POSITION NAME OF AGBXCY/OFFICE AND ADDRESS
Ger1y S. Baacio First Cousin Teacher I DepEd Elementary - Banate

I hereby -,::ertify 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 co-nnections,
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 11, 2022

,JJ:i. of"'.''""''"')
Government Issued ID: PRC ID Government Issued ID:
NIA
(Signature ofCo-Declarant/ Spouse)

N/A
ID No.: 1306825 ID No.: N/A
Date Issued: 09/04/14 Date Issued: N/A

SUBSCRIBED AND SWORN to before me above-stated

government issued identification card.

th)
Page 2 of _1_( Pursua nt to R.A. 9406)