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SALN Form 2017 Downloadable Word and PDF File

This document is a sworn statement of assets, liabilities, and net worth as required by law to be submitted by all public officials and employees in the Philippines. It was submitted on January 26, 2023 by Elvris C. Ramos, a teacher at Libas National High School. The statement lists his assets of 215,000 pesos including appliances, electronics, and a motorcycle. His only liability is a 200,000 peso salary loan. His net worth is calculated at 15,000 pesos. It also discloses his spouse, children, business interests, relatives in government, and is signed and notarized.

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Elvris Canoneo Ramos
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43 views

SALN Form 2017 Downloadable Word and PDF File

This document is a sworn statement of assets, liabilities, and net worth as required by law to be submitted by all public officials and employees in the Philippines. It was submitted on January 26, 2023 by Elvris C. Ramos, a teacher at Libas National High School. The statement lists his assets of 215,000 pesos including appliances, electronics, and a motorcycle. His only liability is a 200,000 peso salary loan. His net worth is calculated at 15,000 pesos. It also discloses his spouse, children, business interests, relatives in government, and is signed and notarized.

Uploaded by

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


As of _December 31, 2022
(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: RAMOS ELVRIS C POSITION: Teacher I


(Family Name) (First Name) (M.I.) AGENCY/OFFICE: DepEd/Libas National High School
ADDRESS: Puertobello, Merida, Leyte OFFICE ADDRESS: Libas, Merida, Leyte

SPOUSE: RAMOS CHARISA O. 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


XAVI EZEKIEL O. RAMOS August 4, 2016 6

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 YEAR MODE
use) Real Property)

NONE N/A N/A N/A N/A N/A N/A N/A

Subtotal:
b. Personal Properties*

DESCRIPTION YEAR ACQUIRED ACQUISITION


COST/AMOUNT

Appliances 2018 100, 000.00


Laptop and Cellphones 2022 50, 000.00
Motorcycle 2020 65, 000.00

Subtotal : 215, 000.00

TOTAL ASSETS (a+b): 215,000.00


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

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2. LIABILITIES*

NATURE NAME OF CREDITORS OUTSTANDING BALANCE

SALARY LOAN CITYSAVINGS BANK 200, 000.00

TOTAL LIABILITIES: 200, 000.00


NET WORTH : Total Assets less Total Liabilities = 15, 000.00
* 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 ENTITY/BUSINESS BUSINESS ADDRESS NATURE OF BUSINESS DATE OF ACQUISITION OF


ENTERPRISE INTEREST &/OR FINANCIAL INTEREST OR CONNECTION
CONNECTION
ST. RITA VARIETY POB. MERIDA, LEYTE OWNED 2021
STORE
ARJEN SARI - SARI PUERTOBELLO, MERIDA, OWNED 2021
STORE LEYTE

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
FLAVIANO A. RAMOS JR FATHER BRGY. KAGAWAD LGU Puertobello

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 26, 2023

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

Government Issued ID: Driver’s License Government Issued ID:


ID No.: 118435692 ID No.:
Date Issued: 07/26/2019 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)

Page 2 of ___

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