Scribd
Upload
11 views

2015 Saln Form

This document is a sworn statement of assets, liabilities, and net worth for a public official, Ivy T. Ade, as of December 31, 2024. The declarant has total assets amounting to Php 109,000.00 and no liabilities, resulting in a net worth of Php 109,000.00, with no business interests or relatives in government service reported.

Uploaded by

Ivy Ade
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
11 views

2015 Saln Form

This document is a sworn statement of assets, liabilities, and net worth for a public official, Ivy T. Ade, as of December 31, 2024. The declarant has total assets amounting to Php 109,000.00 and no liabilities, resulting in a net worth of Php 109,000.00, with no business interests or relatives in government service reported.

Uploaded by

Ivy Ade
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
You are on page 1/ 2

PRevised 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, 2024
(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 ADE IVY T. POSITION: TEACHER I


:
(Family Name) (First Name) (M.I.) AGENCY/OFFICE: IMPASUGONG NATIONAL HIGH
SCHOOL
ADDRESS: ZONE 6, KISOLON, OFFICE ADDRESS: POBLACION, IMPASUGONG

SUMILAO, BUKIDNON BUKIDNON 8702

SPOUSE: N/A POSITION: N/A


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

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*

DESCRIPTIO KIND EXACT ASSESSED CURRENT FAIR ACQUISITION ACQUISITION


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

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

Subtotal: Php 0.00

b. Personal Properties*

DESCRIPTION YEAR ACQUIRED ACQUISITION


COST/AMOUNT

CELLPHONE 2022 Php 24,000.00


CLOTHINGS VARIOUS YEAR Php 5,000.00
SAVINGS 2018 Php 80,000.00

Subtotal : Php
109,000.00
TOTAL ASSETS (a+b): Php
109,000.00
* Additional sheet/s may be used, if necessary.

Page 1 of ___
2. LIABILITIES*

NATURE NAME OF CREDITORS OUTSTANDING


BALANCE

N/A N/A N/A

Php 00.00
TOTAL LIABILITIES:
NET WORTH : Total Assets less Total Liabilities = Php 109,000.00
* 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 BUSINESS ADDRESS NATURE OF BUSINESS DATE OF ACQUISITION OF


ENTITY/BUSINESS INTEREST &/OR FINANCIAL INTEREST OR CONNECTION
ENTERPRISE 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: February 24, 2025


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

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


ID No.: 1738525 ID No.:
Date Issued: 01/23/2019 Date Issued:

SUBSCRIBED AND SWORN to before me this day of , affiant exhibiting to me the


above-stated government issued identification card.

CTC: 17507454
Issued at: Sumilao, Bukidnon
Issued on: January 14, 2025
Amount: P383.00

Page 2 of ___

You might also like