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Sworn Statement of Assets, Liabilities and Net Worth: Valles Von Virchel E

This document is a sworn statement of assets, liabilities, and net worth that must be filed by public officials and employees in the Philippines according to Resolution No. 10500C85. It includes sections for the declarant's personal information and position, assets such as real estate and personal property, liabilities, business interests, relatives in government, and a signature certifying the accuracy of the statement. The declarant, Von Virchel E. Valles, files the statement separately and only claims personal electric gadgets worth 30,000 pesos as an asset with no other reported assets, liabilities, business interests, or relatives in government.

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Mabel Aruyal
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37 views3 pages

Sworn Statement of Assets, Liabilities and Net Worth: Valles Von Virchel E

This document is a sworn statement of assets, liabilities, and net worth that must be filed by public officials and employees in the Philippines according to Resolution No. 10500C85. It includes sections for the declarant's personal information and position, assets such as real estate and personal property, liabilities, business interests, relatives in government, and a signature certifying the accuracy of the statement. The declarant, Von Virchel E. Valles, files the statement separately and only claims personal electric gadgets worth 30,000 pesos as an asset with no other reported assets, liabilities, business interests, or relatives in government.

Uploaded by

Mabel Aruyal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Revised as of January 2015

Per CSC Resolution No. 10500C85


Promulgated on January 23, 2015

SWORN STATEMENT OF ASSETS, LIABILITIES AND NET WORTH


As of ___________________
(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: VALLES VON VIRCHEL E. POSITION: PHA-II


(Family Name) (First Name) (M.I.)
AGENCY/OFFICE: DOH-CARAGA
ADDRESS: P-2, PATIN-AY, PROSPERIDAD, AGUSAN DEL
SUR OFFICE ADDRESS: PIZARRO ST. CORNER
NARRA ROAD, BUTUAN
CITY, AGUSAN DEL NORTE

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


N/A N/A N/A

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

N/A N/A N/A N/A N/A N/A N/A N/A

Subtotal:

b. Personal Properties*

DESCRIPTION YEAR ACQUIRED ACQUISITION COST/AMOUNT

ELECTRIC GADGET 2020 Php 30,000.00

Subtotal : Php 30,000.00


TOTAL ASSETS (a+b): Php 30,000.00

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

2. LIABILITIES*

NATURE NAME OF CREDITORS OUTSTANDING


BALANCE

N/A N/A N/A

TOTAL LIABILITIES:
NET WORTH : Total Assets less Total Liabilities =
* Additional sheet/s may be used, if necessary.

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 BUSINESS ADDRESS NATURE OF BUSINESS INTEREST DATE OF


ENTITY/BUSINESS &/OR FINANCIAL CONNECTION ACQUISITION OF
ENTERPRISE INTEREST OR
CONNECTION
N/A N/A N/A 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
N/A N/A N/A N/A

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: ______________________

VON VIRCHEL E. VALLES N/A


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

Government Issued ID: PRC Government Issued ID: N/A


ID No.: 0099154 ID No.: N/A
Date Issued: 01/09/2020 Date Issued: N/A

SUBSCRIBED AND SWORN to before me this day of December 2020, affiant exhibiting to me the
above-stated government issued identification card.

(Person Administering Oath)

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