Vous êtes sur la page 1sur 3

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 2016
(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 CAETE PANFILO V POSITION: CHF, PCRB


:
(Family Name) (First Name) (M.I.) AGENCY/OFFICE:
ADDRESS: 203 CAPITOL HOMES , MANKILAM, TAGUM CITY OFFICE ADDRESS:

SPOUSE: (SEPARATED)JAMISOLA ELISA L. POSITION: OFW


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

UNMARRIED CHILDREN BELOW EIGHTEEN (18) YEARS OF AGE LIVING IN DECLARANTS HOUSEHOLD

NAME DATE OF BIRTH AGE


SHAINE MAE A. CAETE JANUARY 19, 2005 12
REIGNANTE OMAR L. CAETE JANUARY 05, 2011 6

ASSETS, LIABILITIES AND NETWORTH


(Including those of the spouse and unmarried children below eighteen (18)
years of age living in declarants household)

1. ASSETS
a. Real Properties*

DESCRIPTION KIND ASSESSED CURRENT FAIR ACQUISITION


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

FARM LOT Agricultural Kingking, Pantukan, 300,000 150,000,000 2013 CASH 770,000.00
COMVAL
HOUSE AND RESIDENCIAL CAPITOL HOMES, 270,000 1500,000,000 2006 CASH 270,000.00
LOT MANKILAM, TAGUM
CITY
Subtotal: 104,000,000
b. Personal and other Properties*

DESCRIPTION YEAR ACQUIRED ACQUISITION


COST/AMOUNT

YAMAHA MOTOR CYCLE 2000 120,000


TOYOTA BB 2014 250,000
HONDA CBR MOTORCYCLE 2015 105,000
Subtotal : 475,000.00
1,479,000.00
TOTAL ASSETS (a+b):
2. LIABILITIES*

NATURE NAME OF CREDITORS OUTSTANDING BALANCE

HOUSE AND LOT PAG IBIG 370,000


SALARY LOAN AFPSLAI 384,000
SALARY LOAN MBAI 61,750
SALARY LOAN PSMBFI 56,000
SALARY AND EMERGENCY LOAN PSSLAI 50,000

Page 1 of ___
EMERGENCY LOAN TAGUM COOP 15,000
TOTAL LIABILITIES: 936,000
NET WORTH : Total Assets less Total Liabilities = 543,000

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

BUSINESS INTERESTS AND FINANCIAL CONNECTIONS


(of Declarant /Declarants spouse/ Unmarried Children Below Eighteen (18) years of Age Living in Declarants 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

NONE NONE NONE NONE

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


EVENGELINE CAETE JUMAWAN SISTER TEACHER DEP ED
RAMELYN CANETE VALDUEZA SISTER EMPLOYEE PROVINCIAL AGRICULTURE COMVAL
VIRGISARY ALICE J CANETE DAUGHTER TEACHER DEP ED
GLAIZA CANETE ORBE DAUGHTER NUP PNP
ABEGAIL J CAETE DAUGHTER JO TREASURERS OFFICE TAGUM CITY

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: ______________________________

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

Government Issued ID: PNP ID Government Issued ID:


ID No.: 16H250274 ID No.:
Date Issued: AUG 25, 2016 Date Issued:

SUBSCRIBED AND SWORN to before me this day of , affiant exhibiting to me the above-stated
government issued identification card.

Page 2 of ___
PSUPT EDITO S MANDI
_______________________________________
(Person Administering Oath)

Page 3 of ___