Republika ng Pilipinas

Lalawigan ng Sultan Kudarat

TANGGAPAN NG SANGGUNIANG PANLALAWIGAN
Isulan, Sultan Kudarat

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NAME
Alave, Sonia P./Alave Roger
Andang, Jimmy C.
Arsenia, Rosie B/Judito Arsenia.
Arzagon, Geronimo P.
Barroquillo, Jonathan Y.
Bebing, Cherry Lee M.
Cartujano, Perla A.
Coloma, Andrew Russel J.
De Guzman, Mardelyn B.
Dela Cerna, Leonidas L.
Dionela, Romel R.
Garcia, Danilo M.
Garcia, Rolando P.
Jacalan, Miguel Domingo III T.
Jamison, Melinda B.
Jamorabon, Ricardo Jr. A.
Latog, Nonie L.
Ligo, Donato A.
Lim, Joaquin D.
Macasayon, Ibrahim G.
Mamon, Nectar Precious Hope G,.
Ortiz, Joseph M.
Reforma, Ruth L.
Sabanilla, Rhoda P.
Segura, Orfelina P.
Serra, Helen P./Serra Stephen
Tamayo, Nelson T.

POSITION
Board Secretary II
Board Secretary IV
Clerk II
SP Member
SP Member
Clerk II
Secretary to the SP
SP Member
Stenograher I
SP Member
Clerk II
Local Legislative Officer I
SP Member
Vice Governor
Private Secretary I
SP Member
SP Member
SP Member
SP Member
SP Member
SP Member
SP Member
Librarian I
Clerk III
SP Member
Clerk II
Driver I

ANNUAL INCOME
147,206.00
236,784.00
105,852.00
281,064.00
281,064.00
80,208.00
291,036.00
281,064.00
100,752.00
281,064.00
82,212.00
100,752.00
242,172.00
292,308.00
126,420.00
281,064.00
281,064.00
281,064.00
281,064.00

ASSETS
190,000.00
548,000.00
780,000.00
697,000.00
320,000.00
45,000.00
3,530,000.00
2,558,000.00
628,800.00
2,245,000.00
710,000.00
628,800.00
655,000.00
7,890,000.00
330,000.00
2,125,000.00
1,910,000.00
1,755,000.00
780,000.00

NETWORTH
660,000.00
178,000.00
557,000.00
352,000.00
260,000.00
5,000.00
3,105,000.00
2,528,000.00
498,287.00
2,045,000.00
660,000.00
498,287.00
470,000.00
7,890,000.00
80,000.00
1,758,000.00
1,775,000.00
1,605,000.00
87,000.00

281,064.00
281,064.00
134,952.00
95,904.00
281,064.00
119,268.00
72,468.00

650,000.00
1,032,000.00
1,185,000.00
150,000.00
612,980.49
350,835.00
70,000.00

410,000.00
882,000.00
1,095,000.00
100,000.00
87,019.51
58,386.00
40,000.00

REMARKS

Filed at Lutayan

SWORN STATEMENT OF ASSETS, LIABILITIES, AND NET WORTH

DISCLOSURE OF BUSINESS INTERESTS AND FINANCIAL CONNECTIONS
AND IDENTIFICATION OF RELATIVES IN THE GOVERNMENT SERVICE
As of December 31, 2009
(Required by R.A. 6713)
Name:
Address:

SABANILLA
RHODA
P.
Surname
First Name
M.I.
KALAWAG I, ISULAN, SULTAN KUDARAT

N/A
Surname
First Name
Unmaried Children below 18 years of age

Position/Income:

Office:
Office Address:

Position:
Office:

Spouse Name:

M.I.

Clerk III/P141,636.00/A
SP Office
NEW CAPITOL, ISULAN, SK
N/A

Name
1
2
3
4
5

Date of Birth

N/A

A. ASSETS, LIABILITIES AND NET WORTH

1. ASSETS
A. Real Properties:
KIND

RICELAND
CORNLAND

HOUSE

LOCATION

KAL. I, SK
KAL. I, SK
KAL. I, SK

YEAR

MODE OF

ASSESSED

CURRENT

ACQUIRED

ACQUISITION

VALUE

FAIR MARKET

4/4/2007
6/27/2003
4/4/2007

INHERITANCE
INHERITANCE

50,839.98
41,956.68

ACQUISITION COST
LAND
IMPROVEMENTS
BUILDING
ETC.

74,680.00
78,600.00

INHERITANCE

TOTAL:

153,280.00

B. Pesonal and Other Properties:

KIND

YEAR ACQUIRED

FURNITURE
JEWELRIES
CASH ON HAND
OTHERS

TOTAL

ACQUISITION COST
50,000.00
20,000.00
15,000.00
10,000.00

95,000.00

2. LIABILITIES (Loans, Mortgages, Etc.)

NATURE

AMOUNT

PERSONAL LOANS
GSIS/PAG-IBIG LOANS
OTHERS

50,000.00
100,000.00
30,000.00

TOTAL

NET WORTH [1(A) + 1(B) less [(2)] .. P

180,000.00
(85,000.00)

Do you have any business and other financial connections including those of your spouse and unmarried children
below 18 years of age living with you in you household / /Yes / X /No. If yes, give particulars;
Name
Address
Nature of Business
Date of Acquisition
Name of Firm/
Company
interest and/or
Financial Connection
N/A

C. IDENTIFICATION OF RELATIVES IN THE GOVERNMENT SERVICE

To the best of your knowledge, are you related within the fourth degree of consanguinity and affinity to anyone
working in the government? / X /Yes / /No. If Yes, give particulars;
Name
Position
Relationship
Name/Address of Office
SISTER
PAO, ISULAN, SULTAN KUDARAT
1 FE S. ALMIA
Clerk II
BROTHER
NIA, SURALLAH, SOUTH COTABATO
2 PATRICIO P. SABANILLA
Radio Oprtr.
SISTER
MUN. ASSESSOR, ISULAN, SULTAN KUDARAT
Asst.
Clerk
3 JOSELINA S. CANTO
BROTHER
PNP, BAGUMBAYAN, SK
4 ANTONIO P. SABANILLA
PO3
BROTHER
PNP, GENSAN CITY
5 ALAN P. SABANILLA
PO3
6. ANTONIO R. ALMIA
BROTHER IN-LAW
BAS Officer
BUREAU OF AGRICULTURAL STATISTICS OFFICE, ISK
7. ROMEL C. CANTO
BROTHER IN-LAW
PNP, ISULAN, SK
SPO3
BROTHER IN-LAW
OFFICE OF THE MUN. TREASURER, BAG., SK
8. ALFONSO T. LAGNAODA Asst. Treasurer
SISTER
IN-LAW
DEP-ED, ISULAN, SK
9 SERONE E. SABANILLA
TEACHER
I hereby certify to the best of my knowledge and information that these are true statement of my assets,
liabilities, net worth business and financial connection those of my spouse and unmarried children below 18 years
of age names of my relative in the government as of December 31, 2006, as required by and in accordance with
Republic Act 6713.

I hereby authorize the Ombudsman or his 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 interest and financial connections, to include those of my spouse and
unmarried children below 18 years of age living with me in my house hold covering previous years to include the
year I first assumed office in the government.

Date:
Signature
Res. Cert. No:
Issued at:
Date Issued:

21966924
ISULAN, SULTAN KUDARAT

TIN:
B.

142-714-123

1/12/2011

SUBSCRIBED AND SWORN TO before me this _____________ day of _____________, 2008 exhibiting his
exhibiting his Residence Tax Certification as indicated above.

MACABANGAN A. ALAMADA
Provincial legal Officer
Person Administering Oath

SWORN STATEMENT OF ASSETS, LIABILITIES, AND NET WORTH

DISCLOSURE OF BUSINESS INTERESTS AND FINANCIAL CONNECTIONS
AND IDENTIFICATION OF RELATIVES IN THE GOVERNMENT SERVICE
As of December 31, 2010
(Required by R.A. 6713)
Name:

SEGURA
ORFELINA PABILONA Position/Income:
Surname
First Name
M.I.
Office:
CAOS SUBD., PUROK II, TACURONG, SK
Office Address:

Address:
Spouse Name:

SEGURA
Surname
Unmaried Children below 18 years of age

CARLOS
First Name

L.
M.I.

SP MEMBER/P546,060.00/A
SP Office
NEW CAPITOL, ISULAN, SK

Position:
Office:

Name

SELF EMPLOYED

Date of Birth

N/A

S, LIABILITIES AND NET WORTH

1. ASSETS
A. Real Properties:
KIND

FARMLOT

LOCATION

YEAR

MODE OF

ASSESSED

CURRENT

ACQUIRED

ACQUISITION

VALUE

FAIR MARKET

BARAS, TAC., SK

1979

INHERITANCE

760,753.00

ACQUISITION COST
LAND

IMPROVEMENTS

BUILDING

ETC.

152,150.00

TOTAL:

152,150.00

B. Pesonal and Other Properties:

KIND

YEAR ACQUIRED

RECEIVABLES
FURNITURE
JEWELRY
OTHERS

ACQUISITION COST
200,000.00
200,000.00
100,000.00
100,000.00

TOTAL

600,000.00

2. LIABILITIES (Loans, Mortgages, Etc.)

NATURE

AMOUNT

GSIS/PAG-IBIG salary loan

BANK LOANS
ACCOUNTS PAYABLES

200,000.00
100,000.00
170,000.00

TOTAL
NET WORTH [1(A) + 1(B) less [(2)] .. P

470,000.00
130,000.00

B. BUSINESS INTERESTS AND FINANCIAL CONNECTIONS

Do you have any business and other financial connections including those of your spouse and unmarried children
below 18 years of age living with you in you household / /Yes / X /No. If yes, give particulars;
Name
Address
Nature of Business
Date of Acquisition
Name of Firm/
Company
interest and/or
Financial Connection

C. IDENTIFICATION OF RELATIVES IN THE GOVERNMENT SERVICE

To the best of your knowledge, are you related within the fourth degree of consanguinity and affinity to anyone
working in the government? / X /Yes / /No. If Yes, give particulars;
Name
Position
Relationship
Name/Address of Office

I hereby certify to the best of my knowledge and information that these are true statement of my assets,
liabilities, net worth business and financial connection those of my spouse and unmarried children below 18 years
of age names of my relative in the government as of December 31, 2006, as required by and in accordance with
Republic Act 6713.

I hereby authorize the Ombudsman or his 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 interest and financial connections, to include those of my spouse and
unmarried children below 18 years of age living with me in my house hold covering previous years to include the
year I first assumed office in the government.

Date:
Signature
Res. Cert. No:
Issued at:
Date Issued:

TIN:
B:

SUBSCRIBED AND SWORN TO before me this _____________ day of _____________, 2007 exhibiting his
exhibiting his Residence Tax Certification as indicated above.

Person Administering Oath

SWORN STATEMENT OF ASSETS, LIABILITIES, AND NET WORTH

DISCLOSURE OF BUSINESS INTERESTS AND FINANCIAL CONNECTIONS
AND IDENTIFICATION OF RELATIVES IN THE GOVERNMENT SERVICE
As of DECEMBER 31, 2009
(Required by R.A. 6713)
Name:

FORRO
ROLANDO
Surname
First Name
Address:
POBLACION, BAGUMBAYAN, SULTAN
KUDARAT
FORRO
HERNANIE
Spouse Name:
Surname
First Name
Unmaried Children below 18 years of age

D.
M.I.

Position/Income:

Office:
Office Address:

D.
M.I.

Position:
Office:

SP MEMBER/P546,060.00/A
SP OFFICE
NEW CAPITOL, ISULAN, SK
C/CLERK I

Name
1 HEROLE MAY LOVE D. FORRO
2 MAVERIECK D. FORRO
3
4
5

Date of Birth
December 30, 1989
May 24, 1991

A. ASSETS, LIABILITIES AND NET WORTH

1. ASSETS
A. Real Properties:
KIND

LOCATION

LAND

BAGUMBAYAN

MOTORCYLE

BAGUMBAYAN

YEAR

MODE OF

ASSESSED

CURRENT

ACQUIRED

ACQUISITION

VALUE

FAIR MARKET

1982
2000

INHERITANCE
PURCHASE

TOTAL:

ACQUISITION COST
LAND
IMPROVEMENTS
BUILDING
ETC.
200,000.00
120,000.00

B. Pesonal and Other Properties:

KIND

YEAR ACQUIRED

TOTAL

ACQUISITION COST

2. LIABILITIES (Loans, Mortgages, Etc.)

NATURE

AMOUNT

TOTAL

NET WORTH [1(A) + 1(B) less [(2)] .. P

Do you have any business and other financial connections including those of your spouse and unmarried children
below 18 years of age living with you in you household / /Yes / /No. If yes, give particulars;
Name
Address
Nature of Business
Date of Acquisition
Name of Firm/
Company
interest and/or
Financial Connection

C. IDENTIFICATION OF RELATIVES IN THE GOVERNMENT SERVICE

To the best of your knowledge, are you related within the fourth degree of consanguinity and affinity to anyone
working in the government? / /Yes / /No. If Yes, give particulars;
Name
Position
Relationship
Name/Address of Office

I hereby certify to the best of my knowledge and information that these are true statement of my assets,
liabilities, net worth business and financial connection those of my spouse and unmarried children below 18 years
of age names of my relative in the government as of December 31, 2006, as required by and in accordance with
Republic Act 6713.

I hereby authorize the Ombudsman or his 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 interest and financial connections, to include those of my spouse and
unmarried children below 18 years of age living with me in my house hold covering previous years to include the
year I first assumed office in the government.

Date:
Signature
Res. Cert. No:
Issued at:
Date Issued:

TIN:
B:

SUBSCRIBED AND SWORN TO before me this _____________ day of _____________, 20___ exhibiting his
exhibiting his Residence Tax Certification as indicated above.

Person Administering Oath

SWORN STATEMENT OF ASSETS, LIABILITIES, AND NET WORTH

DISCLOSURE OF BUSINESS INTERESTS AND FINANCIAL CONNECTIONS
AND IDENTIFICATION OF RELATIVES IN THE GOVERNMENT SERVICE
As of December 31, 2010
(Required by R.A. 6713)
Name:

ANDANG
JIMMY
CABERTO Position/Income:
Surname
First Name
M.I.
Office:
Address:
Purok Liwayway, San Pablo Tacurong City
Office Address:
Sultan Kudarat
MONERA
A.
Position:
Spouse Name: ANDANG
Surname
First Name
M.I.
Office:
Unmaried Children below 18 years of age

Board Secretary IV/P 511,668.00/A

SP Office
Capitol, Isulan, Sul. Kud.
C/Clerk II
SP Office/Detailed in OPAG

Name
1
2
3
4
5

Date of Birth
September 18, 1996
August 30, 1997
May 25, 1999
August 30, 2001

Michelle Amina
Bai Anisah
Jimmy Faisal II
Bai Noredia

A. ASSETS, LIABILITIES AND NET WORTH

1. ASSETS
A. Real Properties:
KIND

H/L
H/L

LOCATION

YEAR

MODE OF

ASSESSED

CURRENT

ACQUIRED

ACQUISITION

VALUE

FAIR MARKET

Tacurong
General
Santos

2001 Donation
1999 Loan

250,000.00
190,000.00

TOTAL:

ACQUISITION COST
LAND
IMPROVEMENTS
BUILDING
ETC.
450,000.00
20,000
190,000.00
50,000.00

710,000.00

B. Pesonal and Other Properties:

KIND
Jewelries
Books
Appliances

YEAR ACQUIRED
1996
1991
1996/97/98

TOTAL

ACQUISITION COST
38,000.00
20,000.00
50,000.00

108,000.00

2. LIABILITIES (Loans, Mortgages, Etc.)

NATURE
GSIS (Policy, Salary, Summer Loan)
DBP/LBP/Network
PAG-IBIG

AMOUNT
90,000.00
270,000.00
45,000.00

TOTAL

NET WORTH [1(A) + 1(B) less [(2)] .. P

405,000.00
413,000.00

Do you have any business and other financial connections including those of your spouse and unmarried children
below 18 years of age living with you in you household / /Yes / X /No. If yes, give particulars;
Name
Address
Nature of Business
Date of Acquisition
Name of Firm/
Company
interest and/or
Financial Connection

C. IDENTIFICATION OF RELATIVES IN THE GOVERNMENT SERVICE

To the best of your knowledge, are you related within the fourth degree of consanguinity and affinity to anyone
working in the government? / X /Yes / /No. If Yes, give particulars;
Name
Position
Relationship
Name/Address of Office
1 Bayona, Elaine
Sister
RTC Br. XIX, Tacurong City
Interpreter
2 Andang, Abdulkadir
Planning
Brother
DENR XII, Koronadal City
Officer
3 Andang, Alimudin
Brother
PASSO, Isulan, Sultan Kudarat
Assessment
Clerk
4 Bayona, Rey
Laborer
Brother-in-Law
NFA, Isulan, Sultan Kudarat
5 Andang, Gina
Clerk II
Sister-in-Law
DECS SK, Tacurong City

I hereby certify to the best of my knowledge and information that these are true statement of my assets,
liabilities, net worth business and financial connection those of my spouse and unmarried children below 18 years
of age names of my relative in the government as of December 31, 2006, as required by and in accordance with
Republic Act 6713.

I hereby authorize the Ombudsman or his 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 interest and financial connections, to include those of my spouse and
unmarried children below 18 years of age living with me in my house hold covering previous years to include the
year I first assumed office in the government.

Date:

March 9, 2011
Signature
Res. Cert. No: 12232096
Issued at: San. Pablo

TIN:
B:

166-653-503

Tacurong City

Date Issued:

2/7/2011

SUBSCRIBED AND SWORN TO before me this _____________ day of _____________, 2007 exhibiting his
exhibiting his Residence Tax Certification as indicated above.

Person Administering Oath

SWORN STATEMENT OF ASSETS, LIABILITIES, AND NET WORTH

DISCLOSURE OF BUSINESS INTERESTS AND FINANCIAL CONNECTIONS
AND IDENTIFICATION OF RELATIVES IN THE GOVERNMENT SERVICE
As of December 31, 2010
(Required by R.A. 6713)
Name:

Position/Income:

Surname

First Name

M.I.

Office:

Address:

Office Address:

Spouse Name:

Position:
Office:

Surname
First Name
Unmaried Children below 18 years of age

M.I.

Name

Date of Birth

1
2
3
4
5
A. ASSETS, LIABILITIES AND NET WORTH
1. ASSETS
A. Real Properties:
KIND

LOCATION

YEAR

MODE OF

ASSESSED

CURRENT

ACQUIRED

ACQUISITION

VALUE

FAIR MARKET

TOTAL:

ACQUISITION COST
LAND
IMPROVEMENTS
BUILDING
ETC.

B. Pesonal and Other Properties:

KIND

YEAR ACQUIRED

ACQUISITION COST

Jewelries
Books
Appliances

TOTAL
2. LIABILITIES (Loans, Mortgages, Etc.)

NATURE

AMOUNT

TOTAL

NET WORTH [1(A) + 1(B) less [(2)] .. P

Do you have any business and other financial connections including those of your spouse and unmarried children
below 18 years of age living with you in you household / /Yes / /No. If yes, give particulars;
Name
Address
Nature of Business
Date of Acquisition
Name of Firm/
Company
interest and/or
Financial Connection

C. IDENTIFICATION OF RELATIVES IN THE GOVERNMENT SERVICE

To the best of your knowledge, are you related within the fourth degree of consanguinity and affinity to anyone
working in the government? / /Yes / /No. If Yes, give particulars;
Name
Position
Relationship
Name/Address of Office

I hereby certify to the best of my knowledge and information that these are true statement of my assets,
liabilities, net worth business and financial connection those of my spouse and unmarried children below 18 years
of age names of my relative in the government as of December 31, 2010, as required by and in accordance with
Republic Act 6713.

I hereby authorize the Ombudsman or his 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 interest and financial connections, to include those of my spouse and
unmarried children below 18 years of age living with me in my house hold covering previous years to include the
year I first assumed office in the government.

Date:
Signature
Res. Cert. No:
Issued at:
Date Issued:

TIN:
B:

SUBSCRIBED AND SWORN TO before me this _____________ day of _____________, 2010 exhibiting his
exhibiting his Residence Tax Certification as indicated above.

Person Administering Oath

SWORN STATEMENT OF ASSETS, LIABILITIES, AND NET WORTH

DISCLOSURE OF BUSINESS INTERESTS AND FINANCIAL CONNECTIONS
AND IDENTIFICATION OF RELATIVES IN THE GOVERNMENT SERVICE
As of December 31, 2011
(Required by R.A. 6713)
Name:

MATIAS

Address:

ERNESTO

F.

Surname
First Name
M.I.
KALAWAG II, ISULAN, SULTAN KUDARAT

Spouse Name:

MATIAS

WILMA

Surname
Unmaried Children below 18 years of age

First Name

Position/Income:

VICE GOVERNOR 582,948.00/A

Office:

Vice Governor's Office

NEW CAPITOL, ISULAN, SK

Office Address:

Position:
Office:

V.

M.I.

Name
1 ERNEST PATRICK VELASCO MATIAS
2
3
4
5

ADMINISTRATOR
MATIAS CLINIC & HOSPITAL
ISULAN, SULTAN KUDARAT
Date of Birth
January 10, 1994

A. ASSETS, LIABILITIES AND NET WORTH

1. ASSETS
A. Real Properties:
KIND

LOCATION

YEAR

MODE OF

ASSESSED

CURRENT

ACQUIRED

ACQUISITION

VALUE

FAIR MARKET

COMMERCIAL LOT

KAL. 2, ISK

1960

INHERITANCE

FARM LOT

KAL. 3, ISK

1980
1960
1982
1987
1996

PURCHASED

FARM LOT

DANSULI

HOUSE

KAL. 2, ISK

HOSPITAL

KAL. 2, ISK

COMMERCIAL BLDG

KAL. 2, ISK

INHERITANCE

496,470.00
160,880.00
100,370.00

CONSTRUCTED
CONSTRUCTED
CONSTRUCTED

TOTAL:

ACQUISITION COST
LAND
IMPROVEMENTS
BUILDING
ETC.

12,270,000.00
3,000,000.00
1,400,000.00
1,500,000.00
1,760,000.00
3,000,000.00

1,500,000.00
760,000.00

25,190,000.00

B. Pesonal and Other Properties:

KIND
TOYOTA FORTUNER
JEWELRIES
INTELLECTUAL PROPERTIES
FURNITURES & FIXTURES/ANTIQUES
HOSPITAL EQUIPMENTS/MEDICAL SUPPLIES
OTHERS (APPLIANCES, COMPUTERS. GADGETS, ETC.
BANK ACCOUNTS/CASH ON HAND
MITSUBISHI MONTERO

YEAR ACQUIRED
2006
VARIOUS DATES
DO
DO
DO
DO
DO
2010

ACQUISITION COST
1,500,000.00
1,200,000.00
300,000.00
500,000.00
2,000,000.00
2,000,000.00
800,000.00
1,350,000.00

TOTAL

9,650,000.00

2. LIABILITIES (Loans, Mortgages, Etc.)

NATURE

AMOUNT
2,400,000.00

BANK LOAN

TOTAL
NET WORTH [1(A) + 1(B) less [(2)] .. P

2,400,000.00
32,440,000.00

Do you have any business and other financial connections including those of your spouse and unmarried children
below 18 years of age living with you in you household / /Yes / X /No. If yes, give particulars;
Name
Address
Nature of Business
Date of Acquisition
Name of Firm/
Company
interest and/or
Financial Connection
ERNESTO F. MATIAS

MATIAS CLINIC & HOSPITAL

KALAWAG 2, ISULAN, SK

HOSPITAL

WILMA V. MATIAS

HEALTH CARE SPECIALIST

KALAWAG 2, ISULAN, SK

POLYCLINIC

1987

CENTER

C. IDENTIFICATION OF RELATIVES IN THE GOVERNMENT SERVICE

To the best of your knowledge, are you related within the fourth degree of consanguinity and affinity to anyone
working in the government? / X /Yes / /No. If Yes, give particulars;
Name
Position
Relationship
Name/Address of Office
N/A

I hereby certify to the best of my knowledge and information that these are true statement of my assets,
liabilities, net worth business and financial connection those of my spouse and unmarried children below 18 years
of age names of my relative in the government as of December 31, 2006, as required by and in accordance with
Republic Act 6713.

I hereby authorize the Ombudsman or his 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 interest and financial connections, to include those of my spouse and
unmarried children below 18 years of age living with me in my house hold covering previous years to include the
year I first assumed office in the government.

Date:

March 29, 2012

Res. Cert. No:

Issued at:
Date Issued:

ERNESTO F. MATIAS, M.D.

Signature
3925111

ISULAN, SULTAN KUDARAT

TIN:
B.

155422458

1/6/2012

SUBSCRIBED AND SWORN TO before me this

8th
exhibiting his Residence Tax Certification as indicated above.

day of

March

, 2011 exhibiting his

MACABANGAN A. ALAMADA
Provincial legal Officer
Person Administering Oath

Do you have any business and other financial connections including those of your spouse and unmarried children
below 18 years of age living with you in you household / /Yes / /No. If yes, give particulars;
Name
Name of Firm/
Address Nature of Business Date of Acquisition
Company
interest and/or
Financial Connection

rried children