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Wealth Declaration Form Sample

Eunice Juma Onudi, a principal at St. Mary's Kachar Girls Secondary School, submitted her declaration of income, assets, and liabilities as required by Kenyan law. She reported earning approximately 1,440,000 Kenyan shillings in salary from November 2021 to October 2023. Her assets included a home and car worth approximately 3,500,000 shillings. She listed a loan from Mwalimu Sacco of approximately 2,600,000 shillings as a liability. She declared under oath that her statement was true and complete, and it was witnessed.

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183 views3 pages

Wealth Declaration Form Sample

Eunice Juma Onudi, a principal at St. Mary's Kachar Girls Secondary School, submitted her declaration of income, assets, and liabilities as required by Kenyan law. She reported earning approximately 1,440,000 Kenyan shillings in salary from November 2021 to October 2023. Her assets included a home and car worth approximately 3,500,000 shillings. She listed a loan from Mwalimu Sacco of approximately 2,600,000 shillings as a liability. She declared under oath that her statement was true and complete, and it was witnessed.

Uploaded by

Cisco Inc
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

POEA.

REPUBLIC OF KENYA
THE PUBLIC OFFICE ETHICS ACT, 2003
(No. 4 of 2003)
Declaration of Income, Assets & Liabilities (Section 26)

1. Name of the Public Officer


Surname First Name Other Names

Onudi Eunice Juma

2. Birth Information
a). Date of Birth Jul 1, 1970

b). Place of Birth na

3. Marital Status: na

4. Address
a). Postal Address 57 - 4 notset

b). Physical Address 57 - 40611 NYILIMA

5. Employment Information
a). Designation Principal

b). Name of Employer TSC

c). Nature of Employment(Permanent, Temporary, Contract, e.t.c.) 1

d). T.S.C. No 351539

e). School/Institution St. Mary's Kachar Girls Secondary School

f). Sub County UPPER NYOKAL

6. Name of Spouse or Spouses


Surname First Name Other Names

---EMPTY---

7. Name of Dependent children under the ages of 18 years


Surname First Name Other Names

---EMPTY---

Page 1 of 3
POEA.1

REPUBLIC OF KENYA
THE PUBLIC OFFICE ETHICS ACT, 2003
(No. 4 of 2003)
8. Financial Statement for Nov 1, 2023

a). Statement Date


Statement date is the first date of the month preceding the month in which the declaration is due.

b). Income (as of Statement Date)

Income, including emoluments, for the period from Nov 1, 2021 to Oct 31, 2023 For an initial declaration, the period
is the year ending on the statement date.

Description Approximate Amount


Salary Ksh 1,440,000.00

c). Assets (as of Statement Date)

(Including, but not limited to land, buildings, vehicles, investment and financial obligations owed to the person for
whom the statement is made)

Description Approximate Amount


HOME ,CAR Ksh 3,500,000.00

d). Liabilities (as of Statement Date)

Description Approximate Amount


MWALIMU SACCO LOAN Ksh 2,600,000.00

Spouse(s) and children under 18 years Income, Asset and Liability Declaration

9. Other Information that may be useful or relevant


Description
---EMPTY---

I solemnly declare that the information I have given in this declaration is, to the best of my knowledge, true
and complete

Signature of officer: 10809274


Date: Dec 10, 2023

Witness:
Name: ODONGO ADOYO LUCY

Page 2 of 3
POEA.1

REPUBLIC OF KENYA
THE PUBLIC OFFICE ETHICS ACT, 2003
(No. 4 of 2003)
ID Number/
11282159
Passport:
Date: Dec 10, 2023

Page 3 of 3

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