SWORN STATEMENT OF ASSETS LIABILITIES AND NET WORTH

AS OF December 31,
2018
(Required by R.A. No. 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: CONDOR KERWIN JAY C POSITION: ENGINEER III

( Family Name) (First Name) ( M.I.) AGENCY/OFFICE: LGU PIO V. CORPUS
ADDRESS: POBLACION, CAWAYAN, MASBATE PIO V. CORPUS, MASBATE
SPOUSE MERALLES JAY-ANN E POSITION: N/A
(Family Name) (First Name) ( M.I.) AGENCY/OFFICE: N/A
OFFICE ADDRES:
NA

UNMARRIED CHILDREN BELOW EIGHTEEN (18) YEARS OF AGE LIVING IN DECLARANT’S HOUSEHOLD
NAME DATE OF BIRTH AGE
1. PRECIOUS SKYLER M. CONDOR DECEMBER 15, 2015 4
2.

1. ASSETS
a. Real Properties*

DESCRIPTION KIND LOCATION ASSESSED CURRENT FAIR ACQUISITION ACQUISITION

(e.g. lot, house and (e.g. residential, VALUE MARKET VALUE COST
lot, Condominium Commercial, industrial,
and Improvement) Agricultural and mixed (As found in the Tax Declaration of Real
Use)) Property)
YEAR MODE

HOUSE & LOT RESIDENTIAL CAWAYAN 800,000.00 2017 ACQUIRED 800,000.00

LOT RESIDENTIAL CAWAYAN 30,000.00 2018 30,000.00
LOT RESIDENTIAL PVC 200,000.00 2016 200,000.00

Subtotal: 1,030,000.00
b. Personal & Other Properties*
DESCRIPTION YEAR ACQUIRED ACQUISITION COST/AMOUNT
MOTOR 2019 76,000.00
CLOTHING 2019 20,000.00
LAPTOP 2019 48,000.00
TELEVISION 2019 68,000.00
CAR 2019 576,000.00
Subtotal: 788,000.00

TOTAL ASSETS (a+b): 1,818,000.00

2. LIABILITIES
NATURE NAME OF CREDITORS OUTSTANDING BALANCE
LOAN LAND BANK 134,000.00
CONSO-LOAN GSIS 47,000.00

TOTAL LIABILITIES: 181,000.00

NET WORTH: Total Assets less Total Liabilities 748,000.00

 Additional sheet/s may be used, if necessary.

B. BUSINESS INTERESTS AND FINANCIAL CONNECTIONS

(Of Declarant/Declarant’s spouse/ Unmarried Children Below Eighteen (18) years of Age Living in Declarant’s Household)
I/We do not have any business interest or financial connection

NATURE OF BUSINESS
INTEREST & OR FINANCIAL
NAME OF ENTITY/BUSINESS BUSINESS ADDRESS DATE OF ACQUISITION OF
CONNECTION
ENTERPRISE INTEREST OR CONNECTION
N/A

RELATIVES IN THE GOVERNMENT SERVICE

(Within the Fourth Degree of Consanguinity or Affinity. Include also Bilas, Balae and Inso)
I/We do not know of any relative/s in the government service

NAME OF RELATIVE RELATIONSHIP POSITION NAME OF AGENCY/OFFICE AND

ADDRESS
FRANZ MATHEUS C. COUSIN ASSISTANT SB LGU CAWAYAN
BIGORNIA SECRETARY
FRANCISCO ALFONSO D. FATHER MUNICIPAL LGU CAWAYAN
CONDOR ENGINEER

I hereby certify that these are true and correct statements of my assets, liabilities, net worth, business
interests and financial conditions, including those of my spouse and unmarried children below eighteen (18) years of 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 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:

KERWIN JAY CONDOR JAY-ANN M. CONDOR

(Signature of Declarant) (Signature of Co-Declarant/Spouse)

Government Issued ID:ID No. 088 LGU Pio V. Corpus, Mas. Government Issued ID:__________________________
Date Issue : 3/29/2019 Date Issue :
Place of Issue : PIO V. CORPUS Place of Issue :

SUBSCRIBED AND SWORN to before me this day of ,affiant exhibiting his/her

Residence Tax Certificate as indicated above.

(Person Administrative Oath)