SWORN STATEMENT OF ASSETS, LIABILITIES AND NET WORTH

As of December 31, 2021

(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: FLORES AGAPITO P. POSITION: TEACHER III

(Family Name) (First Name) (M.I.) AGENCY/OFFICE: DEP-ED/LARRAZABAL, NAVAL,
BILIRAN
ADDRESS: CANEJA ST., NAVAL, BILIRAN OFFICE ADDRESS: CALUMPANG ELEMENTARY
P.I. GARCIA SCHOOL

SPOUSE: FLORES NELDA C. POSITION: HOUSEWIFE

(Family Name) (First Name) (M.I.) AGENCY/OFFICE: NONE
OFFICE ADDRESS: NONE

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

NAME DATE OF BIRTH AGE

MARIA GRETCHEN C. FLORES SEPTEMBER 18, 2010 11

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 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
Real Property)
YEAR MODE
use)

Villacaneja, Naval,
LOT residential 120,000.00 120,000.00 2006 Purchase 40,000.00
Biliran
HOUSE AND Villacaneja, Naval,
residential 100,000.00 240,000.00 1996 Purchase 100,000.00
LOT Biliran
Subtotal: 140,000.00
b. Personal Properties*

DESCRIPTION YEAR ACQUIRED ACQUISITION

COST/AMOUNT

Android Phone Vivo Y11 2019 7,500.00

EPSON Printer L3110 2020 7,500.00

Subtotal : 15,000.00
TOTAL ASSETS (a+b): 155,000.00
2. LIABILITIES*

NATURE NAME OF CREDITORS OUTSTANDING BALANCE

Consolidated Loan GSIS 84,000.00

NET WORTH : Total Assets less Total Liabilities = 71,000.00

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

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 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.

NAME OF ENTITY/BUSINESS BUSINESS ADDRESS NATURE OF BUSINESS DATE OF ACQUISITION OF

ENTERPRISE INTEREST &/OR FINANCIAL INTEREST OR CONNECTION
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
Leo Niño C. Flores son Private Charlie Coy, 24th IB, 7th ID, Philippine Army, Langangilang, Abra

Ramon P.Flores brother Colonel CO, Army Recruitment Center, Fort Bonifacio
Agnes Lynette R. Almayda sister-in-law Colonel Professor, Corps of Professor, PMA, Fort del Pilar

I hereby certify 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
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 12, 2022

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

Government Issued ID: PRC ID Card Government Issued ID: PHILPOST Postal ID
ID No.: 0555455 ID No.: G78210189025
Date Issued: MAY 24, 1999 Date Issued: MAY 10, 2021
Com.Cert. No. 29271064
Date Issued: JANUARY 11, 2022
Issued at: MTO Naval, Naval Biliran

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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