2015 SALN Form From CSC

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 2019_____________
(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: DESCALLAR NAOMI E. POSITION: Teacher II

(Family Name) (First Name) (M.I.) AGENCY/OFFICE: DepEd - Bohol
ADDRESS: OFFICE ADDRESS:
Poblacion Talibon, Bohol
SPOUSE: DESCALLAR HECTOR A. POSITION: N

(Family Name) (First Name) (M.I.) AGENCY/OFFICE:
OFFICE ADDRESS:
UNMARRIED CHILDREN BELOW EIGHTEEN (18) YEARS OF AGE LIVING IN DECLARANT’S HOUSEHOLD
NAME DATE OF BIRTH AGE
Ghiyan Vincent E. Descallar 01/09/04 16
Gianena Venice E. Descallar 02/07/04 15
Shamcey E. Descallar 07/12/12 7
Giahenna Vencey E. Descallar 08/25/15 4
ASSETS, LIABILITIES AND NETWORTH

(Including those of the spouse and unmarried children below eighteen (18)
years of age living in declarant’s household)
1. ASSETS
a. Real Properties*
DESCRIPTION KIND EXACT ASSESSED CURRENT FAIR ACQUISITION ACQUISITION

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

al Talibon 2007 120,000
Subtotal: 120,000
b. Personal Properties*
DESCRIPTION YEAR ACQUIRED ACQUISITION

COST/AMOUNT
Motorcycle (Yamaha) 2007 68,000

Automobile (Estrada) 2018 600,000
Cellphone 2018 18,000
Laptop (TOSHIBA, HP) 2018 48,000
Jewelries 2018 40,000
Printer ( Epson), 2018 8,000
Furniture 2018 88,000
Subtotal : 870,000.00
Page 1 of ___
2. LIABILITIES
NATURE NAME OF CREDITORS OUTSTANDING BALANCE
Salary Loan East West Bank 300,000

Salary Loan First Consolidated 48,000
Salary Loan BPESTEMP 50,000
TOTAL LIABILITIES: 398,000.00
NET WORTH : Total Assets less Total Liabilities = P 592,000.00
* Additional sheet/s may be used, if necessary.
BUSINESS INTERESTS AND FINANCIAL CONNECTIONS

(of Declarant /Declarant’s spouse/ Unmarried Children Below Eighteen (18) years of Age Living in Declarant’s 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
GHIVEN’S STORE Poblacion , Talibon Grocery 7/28/2007
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
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: PRC Government Issued ID:

ID No.: 1390016 ID No.:
Date Issued: 10/29/2015 Date Issued:
SUBSCRIBED AND SWORN to before me this day of , affiant exhibiting to me the above-stated
government issued identification card.
_______________________________________
(Person Administering Oath)
Page 2 of ___

2015 SALN Form From CSC

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2015 SALN Form From CSC

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Revised as of January 2015

Per CSC Resolution No. 1500088

SWORN STATEMENT OF ASSETS, LIABILITIES AND NET WORTH

DECLARANT: DESCALLAR NAOMI E. POSITION: Teacher II

SPOUSE: DESCALLAR HECTOR A. POSITION: N

ASSETS, LIABILITIES AND NETWORTH

DESCRIPTION KIND EXACT ASSESSED CURRENT FAIR ACQUISITION ACQUISITION

Store Commerci- Poblacion,

DESCRIPTION YEAR ACQUIRED ACQUISITION

Motorcycle (Yamaha) 2007 68,000

NATURE NAME OF CREDITORS OUTSTANDING BALANCE

Salary Loan East West Bank 300,000

BUSINESS INTERESTS AND FINANCIAL CONNECTIONS

 I/We do not have any business interest or financial connection .

NAME OF ENTITY/BUSINESS BUSINESS ADDRESS NATURE OF BUSINESS DATE OF ACQUISITION OF

RELATIVES IN THE GOVERNMENT SERVICE

 I/We do not know of any relative/s in the government service)

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

Government Issued ID: PRC Government Issued ID:

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