Revised as of January 2015

Per CSC Resolution No. 1500088

Promulgated on January 23,2015
SWORN STATEMENT OF ASSETS, LIABILITIES AND NETWORTH
As of December 31, 2016
(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: FERNANDEZ VINCENT FRANCIZ T POSITION: Sec. Sch. Teacher-I

(Family Name) (First Name) (M.I.) AGENCY/OFFICE: DepEd-MCLLNHS
ADDRESS: 200 Brillantes Compound Sta. Maria, OFFICE ADDRESS: Divisoria,
Zamboanga City Zamboanga City

SPOUSE: FERNANDEZ GENIE CRIS D POSITION: N/A

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

UNMARRIED CHILDREN BELOW EIGHTEEN (18) YEARS OF AGE LIVING IN DECLARANT'S HOUSEHOLD

NAME DATE OF BIRTH AGE

FRANCIZ GENE D. FERNANDEZ June 7, 2013 5 YRS.

GIZELLE FAYE D. FERNANDEZ February 24, 2018 11 MOS.

ASSETS, LIABILITIES AND NETWORTH

(Including those of the spouse and unmarried children below eighteen (18)
years of age living in declarant's hose hold)

1. ASSETS
a. Real Properties*
DESCRIPTION KIND ASSESSED CURRENT FAIR
VALUE MARKET VALUE ACQUISITION
(e.g. residential,
(e.g. lot, house and lot, commercial, LOCATION ACQUISITION COST
condominium and industrial,
(As found in the Tax Declaration of
improvement) agricultural and
mixed use) Real, Property) YEAR MODE

Subtotal: -
b. Personal Properties*

DESCRIPTION YEAR ACQUIRED ACQUISITION COST/AMOUNT

Gadgets 2016 40,000.00
Appliances and Furnitures 2010-2016 50,000.00

Subtotal: 90,000.00

TOTAL ASSETS (a+b): 90,000.00

2. LIABILITIES*

NATURE NAME OF CREDITORS OUTSTANDING BALANCE

Salary Loan One Network Bank 214,539.60

Salary Loan 1st Valley Bank 97,380.48
Consol, Emergency loan and MPL GSIS/Pag-ibig/DECS Provident 381,366.10
Insurance Fortune Life 36,792.00
TOTAL LIABILITIES: 730,078.18

NET WORTH: Total Assets less Total Liabilities= (640,078.18)

*Additional sheet/s may be used, if necessary.

Page 1 of 2
 3098.52 1311.12 3098.52 677.68 78.64 2041
107 25 1311.12 8 300 2016
331541.6 32778 4409.64 5421.44 23592 25
331541.6 25
32778 32 550 12
364319.6 7 24
364319.6 25 1291.67 300
5421.44 9 13200
369741 13200
11625.03 23592
381366.1 36792
 BUSINESS INTERESTS AND FINANCIAL CONNECTIONS
to[ Declarant/Declarant's/ Unmarried Children Below Eighteen (18) years of Age Living in Declarant's Household]
I/We do not have any business interest or financial connection.

NAME OF ENTITY/BUSINESS NATURE OF BUSINESS INTEREST DATES OF ACQUISITION OF

ENTERPRISE
BUSINESS ADDRESS & /OR FINANCIAL CONNECTION INTEREST OR CONNECTION

NONE

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

I hereby certify that these are true and correct statements of my assets, liabalities, 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-enumarated
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 approriate 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 3, 2017

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

Government Issued ID: PRC Government Issued ID:

ID No. 753621 ID No.:
Date Issued: 9/8/2014 Date Issued:

SUBSCRIBED AND SWORN to before me this ____ day of _________. Affiant exhibiting to me the above-
stated government issued identification card.

(Person Administering Oath)

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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 NETWORTH
As of December 31, 2020
(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: Fernandez, Vincent Franciz T. POSITION: Teacher - I

(Family Name) (First Name) (M.I.) AGENCY/OFFICE: DepEd
ADDRESS: Pasobolong Zamboanga City OFFICE ADDRESS: MCLLNHS,
Divisoria ZC

SPOUSE: Fernandez, Genie Cris D.R. POSITION: n/a

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

UNMARRIED CHILDREN BELOW EIGHTEEN (18) YEARS OF AGE LIVING IN DECLARANT'S HOUSEHOLD

NAME DATE OF BIRTH AGE

FRANCIZ GENE D. FERNANDEZ June 7, 2013 8 years, 9 mos.
GIZELLE FAYE D. FERNANDEZ February 24, 2018 3 years, 11 mos.

ASSETS, LIABILITIES AND NETWORTH

(Including those of the spouse and unmarried children below eighteen (18)
years of age living in declarant's hose hold)

1. ASSETS
a. Real Properties*
CURRENT
DESCRIPTION KIND ASSESSED FAIR
(e.g. VALUE MARKET ACQUISITION
residential,
(e.g. lot, house and
commercial, LOCATION VALUE ACQUISITION COST
lot, condominium
industrial, (As found in the Tax
and improvement)
agricultural Declaration of Real, Property) YEAR MODE
and mixed use)

Subtotal: -
b. Personal Properties*

DESCRIPTION YEAR ACQUIRED ACQUISITION COST/AMOUNT

APPLIANCES AND FURNITURES various years 100,000.00
GADGETS / COMPUTERS various years 100,000.00

Subtotal: 200,000.00

TOTAL ASSETS (a+b): 200,000.00

2. LIABILITIES*

NATURE NAME OF CREDITORS OUTSTANDING BALANCE

SALARY LOAN ONE NETWORK BANK 320,000.00

TOTAL LIABILITIES: 320,000.00

NET WORTH: Total Assets less Total Liabilities= (120,000.00)

*Additional sheet/s may be used, if necessary.

Page 1 of 2
 BUSINESS INTERESTS AND FINANCIAL CONNECTIONS

I/We do not have any business interest or financial connection.

BUSINESS
INTEREST
NAME OF ENTITY/BUSINESS
ENTERPRISE
BUSINESS ADDRESS & /OR DATES OF ACQUISITION OF INTEREST OR CONNECTION
FINANCIAL
CONNECTIO

NONE

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

Date: January 21, 2022

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

Government Issued ID: PRC Government Issued ID:

ID No. 1084682 ID No.:
Date Issued: 2/9/2011 Date Issued:

SUBSCRIBED AND SWORN to before me this 21st day of January, 2022. Affiant exhibiting to me the above-stated
government issued identification card.

(Person Administering Oath)

Page 2 of 2