You are on page 1of 4

Revised as of January 2015

Per CSC Resolution No. 1500088


Promulgated on January 23, 2015

SWORNSTATEMENT OF ASSETS, LIABILITIES AND NETWORTH


As of December 31, 2023
(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
: Lucena Marilou B POSITION : Police Corporal
(Family Name) (First Name) (M.I.) AGENCY /OFFICE: Philippine National Police
ADDRESS: Prk. 6, Katidtuan, Kabacan, North Cotabato OFFICE ADDRESS: Camp Crame , Quezon City

SPOUSE: N/A POSITION:


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

UNMARRIED CHILDREN BELOW EIGHTEEN (18) YEARS OF AGE LIVING IN DECLARANT’S HOUSEHOLD
NAME DATE OF BIRTH AGE
Driyannah Louise L Llaban July 04, 2011 12 yrs old
Denz Nathaniel L Umali July 07, 2014 10 yrs old
Denize Natasha L. Umali March 9, 2019 4 yrs old
Denize Natalia L Umali March 9, 2019 4 yrs old
Denize Ncrishian L Umali August 19, 2020 3 yrs old

ASSETS,LIABILITIESANDNETWORTH
(Including those of the spouse and unmarried children below eighteen (18)
years of age living in declarant’s household)
1. ASSETS
a. RealProperties*

KIND EXACT ASSESSED CURRENT FAIR


DESCRIPTION (e.g. residential,
ACQUISITION ACQUISITION COST
(e.g. lot, houses and lot, commercial, LOCATION VALUE MARKET VALUE
condominium and industrial,
improvements) agricultural and
(As found in the Tax Declaration of
mixed use) Real Property) YEAR MODE

N/A

Subtotal: 135,000.00
b. PersonalProperties*

DESCRIPTION YEAR ACQUIRED ACQUISITION COST/AMOUNT

Honda beat- motorcycle 2017 65,000.00


Appliances (TV, Refrigerator,,Aircon) 2018 50,000.00

Subtotal :

TOTAL ASSETS (a+b):


115,000.00

Page 1 of 2
2. LIABILITIES*

NATURE NAME OF CREDITORS OUTSTANDING BALANCE

Salary loan AFPSLAI 200,000.00


Salary loan PSSLAI 300,000.00

TOTAL LIABILITIES: 500,000.00


NET WORTH : Total Assets less Total Liabilities = (385,000.00)
*Additional sheet/s may be used, if necessary.

BUSINESSINTERESTSANDFINANCIALCONNECTIONS
(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 INTEREST DATE OF ACQUISITION OF


ENTERPRISE AND/OR FINANCIAL INTEREST OR CONNECTION
CONNECTION

N/A

RELATIVESINTHEGOVERNMENTSERVICE
(Within the Fourth Degree of Consanguinity or Affinity. Include also Bilas, Balae andInso)
I/We do not know of any relative/s in the government service)
NAME OF RELATIVE POSITION RELATIONSHIP NAME OF AGENCY/ OFFICE AND ADDRESS
Ryan O’nell B Lucena Police Staff Sergeant Brother Matalam Municipal Police Station, Matalam, Cotabato
Erwin B. Lucena Surveyor Brother NIA, Amas, Kidapawan City

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 on 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 17, 2024

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

Government Issued ID: PNP ID Government Issued ID:


ID No.: 23C2100146 ID No.:
Date Issued: 03/21/2023 Date Issued:

SUBSCRIBEDANDSWORN to before me this_________day of ________________________, affiant exhibiting to me the above-stated government issued
identification card.

_________________________
(Person Administering Oath)
Page 2 of 2
Revised as of January 2015
Per CSC Resolution No. 1500088
Promulgated on January 23, 2015

SWORNSTATEMENT OF ASSETS, LIABILITIES & NETWORTH


As of ________________________

(Sample additional sheet/s for exclusive properties of the declarant’s spouse and unmarried children below
eighteen (18) years of age living in declarants household)
NAME:_____________________________________ POSITION_________________________________________
(Family Name) (First Name) (M.I) Agency/Office____________________________________________
___________________________________________________________________________________________
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. RealProperties*

KIND EXACT ASSESSED CURRENT FAIR


DESCRIPTION ACQUISITION ACQUISITION COST
(e.g. residential, VALUE MARKET VALUE
(e.g. lot, houses and lot,
commercial, industrial,
LOCATION
condominium and
agricultural and mixed (As found in the Tax Declaration of
improvements) YEAR MODE
use) Real Property)

Subtotal
b. Personal Properties*

DESCRIPTION YEAR ACQUIRED ACQUISITION COST/AMOUNT

Subtotal :
TOTAL ASSETS (a+b):
2. LIABILITIES*
NATURE NAME OF CREDITORS OUTSTANDING BALANCE

TOTAL LIABILITIES:

BUSINESSINTERESTSANDFINANCIALCONNECTIONS
(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 INTEREST DATE OF ACQUISITION OF INTEREST
ENTERPRISE AND/OR FINANCIAL CONNECTION OR CONNECTION

Page 3 of 2
Page 4 of 2

You might also like