Saln Format
SWORN STATEMENT OF ASSETS, LIABILITIES AND NET WORTH
As of December 31, 2012
(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: | | | | |POSITION: | |
| |(Family Name) |(First Name) |(M.I.) | |AGENCY/OFFICE: | |
|ADDRESS: | | | | |OFFICE ADDRESS: | |
| | | | | | | |
| | | | | | | |
|SPOUSE: | | | | |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
As of December 31, 2012
(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: | | | | |POSITION: | |
| |(Family Name) |(First Name) |(M.I.) | |AGENCY/OFFICE: | |
|ADDRESS: | | | | |OFFICE ADDRESS: | |
| | | | | | | |
| | | | | | | |
|SPOUSE: | | | | |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