TO: | ALL HEADS OF DEPARTMENTS, AGENCIES AND OFFICES OF THE GOVERNMENT AND OTHERS CONCERNED. |
SUBJECT: | Submission by Public Officers of Statement of Assets, Liabilities and Net Worth as of December 31, 1974 |
shall prepare and file, in the prescribed form (Annex "B"), a sworn comparative statement of assets, liabilities and net worth, as provided in Paragraph 2 hereof, which shall also include the assets, liabilities and net worth of the spouse and unmarried children below twenty-one years of age
- A Chief of Section or above; or
- Occupying a position allocated to range or above, whether chief of section or not; or
- Holding the rank of sergeant or above, in case of the military; or
- An officer or member of a law-enforcement agency of the Government;
- A statement of assets, liabilities and net worth as of December 31, 1974; and
- A statement of assets, liabilities and net worth as of December 31, 1965, or as of the date the public officer entered the government service, whichever date is later: Provided, That in case the public officer had availed himself of the tax amnesty, the statement of assets, liabilities and net worth shall be as of —
(1) December 31, 1971, if the public officer availed himself of the tax amnesty under Presidential Decree No. 23 only; or(2) December 31, 1972, if the public officer availed himself of the tax amnesty under Presidential Decree Nos. 23 and 157, and/ or Presidential Decree Nos. 213 and 370; or(3) December 31, 1973, if the public officer availed himself of the tax amnesty under Presidential Decree No. 631.
Name of Public Office __________________________________ | Position __________________________ | |
Address _______________________________________________ | ||
Name and Address of Office ________________________________ | ||
Civil Status _____________________ Name of Spouse ____________ | ||
Unmarried Children Below 21 Years of Age: | ||
Name | Date of Birth | |
1. __________________________ | _______________ | |
2. __________________________ | _______________ | |
3. __________________________ | ________________ | |
4. __________________________ | _____________________ | |
------------------------------------------------------------------------------------------------- | ||
A S S E T S | ||
Nature | Cost | |
Personal Properties: | ||
__________________________ | P _______________ | |
__________________________ | _______________ | |
__________________________ | _______________ | |
__________________________ | _______________ | |
__________________________ | _______________ | |
T O T A L | P | |
============== | ||
Real Properties: | ||
__________________________ | P _______________ | |
__________________________ | _______________ | |
__________________________ | _______________ | |
__________________________ | _______________ | |
T O T A L | P | |
============== | ||
TOTAL ASSESTS | P | |
=============== | ||
L I A B I L I T I E S | ||
Nature | Amount | |
__________________________ | P _______________ | |
__________________________ | _______________ | |
__________________________ | _______________ | |
__________________________ | _______________ | |
TOTAL LIABILITIES | P | |
============== | ||
NET WORTH (Total Assets Less Total Liabilities ) | P | |
============== |
Date _____________, 1975. | ____________________________________ |
Signature of Public Officer | |
TAN: ____________________________ | |
Res. Cert. No. A - _____________________ | B ______________ |
Issued at _____________________________ | ______________ |
Date Issued ___________________________ | ______________ |
____________________________________ | |
Person Administering Oath |
Name of Public Office _____________________________________ | Position ___________________ | ||
Address _____________________________________________________ | |||
Name of Address of Office _______________________________________ | |||
Civil Status __________________ Name of Spouse _____________________________________________ | |||
Unmarried Children Below Twenty-one Years of Age: | |||
Name | Date of Birth | ||
1. _________________________________________________ | _______________ | ||
2. _________________________________________________ | _______________ | ||
3. _________________________________________________ | _______________ | ||
Tax Amnesty Availed of _____________________________________________ | |||
(State Presidential Decree No. or Nos.) | |||
Tax Amnesty File No. _______________________________________________ | |||
------------------------------------------------------------------------------------------------- | |||
A S S E T S | |||
Nature | C o s t | ||
Personal Properties : _________________ 19 _____ December 31, 1974 Increase/Decrease | |||
__________________________ | P _________ | P _________ | P _________ |
__________________________ | _________ | _________ | _________ |
__________________________ | _________ | _________ | _________ |
T O T A L | P | P | P |
========== | ========== | ========= | |
Real Properties: | |||
__________________________ | P _________ | P _________ | P _________ |
__________________________ | _________ | _________ | _________ |
__________________________ | _________ | _________ | _________ |
T O T A L | |||
T O T A L A S S E T S | P | P | P |
========= | ======== | ======== | |
L I A B I L I T I E S | |||
Nature | A m o u n t | ||
__________________________ | P _________ | _________ | P _________ |
__________________________ | _________ | _________ | _________ |
__________________________ | __________ | _________ | _________ |
TOTAL LIABILITIES | P | P | P |
========= | ========= | ======== | |
NET WORTH | P | P | P |
======== | ========= | ======== |
Date ____________________________________ | ____________________________________ |
Signature of Public Officer | |
TAN: ____________________________ | |
Res. Cert. No. A - _____________________ | B ______________ |
Issued at _____________________________ | ______________ |
Date Issued ___________________________ | ______________ |
____________________________________ | |
Person Administering Oath |