STATEMENT OF ASSETS, LIABILITIES AND NET WORTH

AND DISCLOSURE OF BUSINESS INTERESTS, FINANCIAL CONNECTIONS

AND RELATIVE/S IN THE GOVERNMENT SERVICE
As of December 31,
2015
(Note: Husband and Wife who are both public officials or employees may
file the required statements jointly or separately.)
Jointly filed.
Separately filed.

Name

DIAZ

JUVY

A.

(Surname)

(First Name)

(Middle Initial)

Position

TEACHER III

Office

Address

BITANO ELEMENTARY SCHOOL

Office Address
I am married.

Spouse

BITANO LEGAZPI CITY

I am not married.

DIAZ

ARMANDO

R.(DECEASED)

(Surname)

(First Name)

(Middle Initial)

Position

Office
Office Address

Unmarried Children below 18 years of age living in his/her household: (use additional sheet/s if necessary.)
Name

Date of Birth

2
3
4
5
I have no children below 18 years of age living in my household.
ASSETS, LIABILITIES AND NET WORTH
I. ASSETS (including that of declarant's spouse and unmarried children below 18 years of age living in his/her household.)
A. REAL PROPERTY/IES (use additional sheet/s, if necessary)
NATURE OF
PROPERTY

KIND
(Res./Comm./ Agri.,
etc.

LOCATION

ACQUISITION
MODE

YEAR

OLV BITANO

Purchased

OLV BITANO

Purchased

OLV BITANO

Purchased

OLV BITANO

Purchased

1996
1998
2003
2009

ASSESSED
VALUE

(Paraphernal, conjugal
or community)
COMMUNITY

HOUSE &LOT

LOT
HOUSE
HOUSE

ACQUISITION COST
FAIR MARKET
Land, Building,
Improvement
VALUE
others

Php300,000
Php180,000
Php160,000
Php280,000
Php920,000

TOTAL:

B. PERSONAL PROPERTY/IES AND OTHER ASSETS (use additional sheet/s, if necessary)

TANGIBLE

Home appliances
PC & Printer
Laptop (2)
Home appliances

MODE

ACQUISITION

Purchased
Purchased
Purchased
Purchased

YEAR

2000 - 2005
2005
2007 - 2009
2008 - 2009

ACQUISITION COST*

PhP101,000.00
PhP47,000.00
PhP67,000.00
PhP83,900.00
TOTAL:

PhP298,900.00

*For computation purposes, use acquisition cost. Properties of unmaried children below 18 years of age living in his/her household shall be excluded as
well as the paraphernal/exclusive properties of spouse, in case of separate filing
TOTAL ASSETS (A+B) =

PhP1,218,900.00

II. LIABILITIES (including that of declarant's spouse and unmarried children below 18 years of age living in his/
her household.
NATURE

Conso Loan
Emergency Loan
Salary Loan
Provident Loan
(use additional sheet/s, if necessary)

NAME OF CREDITOR/S

GSIS
GSIS
East West Bank
DepEd

*OUTSTANDING BALANCE

Php. 150,000.00
PhP40,000.00
Php. 60,000.00
PhP60,000.00
TOTAL:

PhP310,000.00

*In the computation of outstanding balance, properties of unmarried children below 18 years of age living in his/her househol
shall be excluded as well as the paraphernal/exclusive properties of spouse, in case of separate filing.

III. NET WORTH (TOTAL ASSETS (I) LESS TOTAL LIABILITIES (II) = NET WORTH (III)
TOTAL NET WORTH:

PHP 908,900.00

AMOUNT AND SOURCES OF GROSS INCOME

(ALL amounts received from ALL source from preceeding calendar year.)
NATURE

SOURCES

AMOUNT

DepEd Fund

PHP 259,800.00

(salary/income, business, etc.)

Salary

(use additional sheet/s, if necessary)

TOTAL:
AMOUNT OF PERSONAL AND FAMILY EXPENSES
(for the preceeding calendar year)
PERSONAL EXPENSES

ESTIMATED EXPENSES

FAMILY EXPENSES

AMOUNT

Php24,000.00

Php. 250,000.00

Php180,000

204,000.00

(use additional sheet/s, if necessary)

TOTAL:

204,000.00

AMOUNT OF INCOME TAXES PAID

(for the preceeding calendar year)
NATURE

Compensation

AMOUNT

Php26,183

Business Income
Other Income
(use additional sheet/s, if necessary)
TOTAL:

Php26,182.80

BUSINESS INTERESTS AND FINANCIAL CONNECTIONS

(Declarant/Spouse/Unmarried Children below 18 years of age living in the household of declarant)
(Use additional sheet/s, if necessary.)
I/We don't have any business interests and financial connections.
Name of Entity/Business Enterprise

Business Address

Nature of Business Interest

and/or Financial Connection

Date of Acquisition of Interest

Connection

RELATIVE/S IN THE GOVERNMENT

(Up to 4th civil degree of relationship, either by consanguinity or affinity, including bilas, inso and balae)
(Use additional sheet/s, if necessary.)
I/We don't know of any relative/s in the Government.
Name of Relative

Relationship

Position

Name of Office/Address

I/We hereby certify that these are my/our true and detailed assets, liabilities, net worth and amount and sources of income, personal and family expenses
amount of income taxes paid, business interests, and financial connection including those of my spouse and my/our children below 18 years of age living in my
household, and the name/s of my relative/s in
the government, as of December 31,

2015

, as required by and in accordance with Republic Act No. 3019 and 6713.

I/We hereby authorize the Ombudsman or his duly authorized representative to obtain and secure from all appropriate agencies, including the Bureau of Inte
Revenue, such documents that may show such assets, liabilities, net worth, business interests and financial connections, including those of my spouse and my/our
children below 18 years of age living in my household, covering previous years, and if possible, including the year I/we first assumed office in the Government.

I/We further undertake to produce all supporting documents for each of the entries herein made when required.

Declarant's Signature:
Date:

January 28,2016

(For Separate Filing)

Spouse's Signature:

Date:

Date:
SUBSCRIBED AND SWORN TO before me on this
his/her/their in identification number(s)
3400181

31st

day of
January
and employee number(s)

2016

, affiant(s) exhibiting
4519571

MA. DULCE G. POBRE

(Person Administering Oath)

ARY SCHOOL

CITY

ACQUISITION COST
Improvement

Php160,000
Php280,000
Php920,000

QUISITION COST*

PhP101,000.00
PhP47,000.00
PhP67,000.00
PhP83,900.00
PhP298,900.00

ehold shall be excluded as

PhP1,218,900.00

NDING BALANCE

p. 150,000.00
hP40,000.00
hp. 60,000.00
P60,000.00
PhP310,000.00

g in his/her household

HP 908,900.00

AMOUNT

P 259,800.00

AMOUNT

204,000.00

of Acquisition of Interest or
Connection

Name of Office/Address

ersonal and family expenses,

ears of age living in my

13.

ncluding the Bureau of Internal

e of my spouse and my/our
ce in the Government.

ed.

, affiant(s) exhibiting
1