Scribd
Upload
4 views2 pages

2015 SALN Form

The document is a sworn statement of assets, liabilities, and net worth for Kathleen Jay P. Sombrio as of December 31, 2024, required by R.A. 6713. It details her total assets amounting to P230,500.00, total liabilities of P430,760.47, resulting in a net worth of -P200,260.47. The declaration also includes information about her family, business interests, and relatives in government service.

Uploaded by

kathleenjay.sombrio
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
4 views2 pages

2015 SALN Form

The document is a sworn statement of assets, liabilities, and net worth for Kathleen Jay P. Sombrio as of December 31, 2024, required by R.A. 6713. It details her total assets amounting to P230,500.00, total liabilities of P430,760.47, resulting in a net worth of -P200,260.47. The declaration also includes information about her family, business interests, and relatives in government service.

Uploaded by

kathleenjay.sombrio
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
You are on page 1/ 2

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, 2024
(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 SOMBRIO KATHLEEN JAY P. POSITION: TEACHER I


:
(Family Name) (First Name) (M.I.) AGENCY/OFFICE: DEPED – SAN PEDRO IS
ADDRESS: PUROK CENTRO,DON LEON BALANTE, CARAGA, OFFICE ADDRESS: SAN PEDRO, CARAGA, DAVAO
DAVAO ORIENTAL ORIENTAL

SPOUSE: SOMBRIO MARK GARY G. POSITION: N/A


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

UNMARRIED CHILDREN BELOW EIGHTEEN (18) YEARS OF AGE LIVING IN DECLARANT’S HOUSEHOLD

NAME DATE OF BIRTH AGE


ATHALIAH ELISE P. SOMBRIO MAY 16, 2022 2 YEARS OLD

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*

DESCRIPTIO KIND EXACT ASSESSED CURRENT FAIR ACQUISITION ACQUISITION


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

NONE NONE NONE NONE NONE NONE NON NONE


E
Subtotal:
b. Personal Properties*

DESCRIPTION YEAR ACQUIRED ACQUISITION


COST/AMOUNT

VIVO SMART PHONE 2023 P13,000.00


ACER LAPTOP 2023 P28,000.00
EPSON PRINTER L3210 2024 P10,000.00
CLOTHING 2024 P25,000.00
REFRIGERATOR/SMART TV/SMART PHONE 2024 P54,500.00
INSURANCES 2024 P100,000.0
0
Subtotal : P230,500.00

TOTAL ASSETS (a+b): P230,500.00


2. LIABILITIES*

NATURE NAME OF CREDITORS OUTSTANDING


BALANCE

SALARY LOAN CITY SAVINGS BANK P62,482.66


SALARY LOAN EAST WEST BANK P158,277.81
SALARY LOAN CHINA BANK P100,000.00
SALARY LOAN BDO NETWORK P110,000.00
Page 1 of 2
TOTAL LIABILITIES: P430,760.47
NET WORTH : Total Assets less Total Liabilities = -P200,260.47
* 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 BUSINESS ADDRESS NATURE OF BUSINESS DATE OF ACQUISITION OF


ENTITY/BUSINESS INTEREST &/OR FINANCIAL INTEREST OR CONNECTION
ENTERPRISE 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
JHEE-IAN C. PALMA GIL BROTHER PATROLMAN PHILIPPINE NATIONAL POLICE, DAVAO CITY
LEONARD JIM P. DUMADANGON COUSIN MASTER TEACHER BINATON INTEGRATED SCHOOL, PM SOBRECAREY,
I DAVAO ORIENTAL
MICHELLE P. LANQUIBO COUSIN MASTER TEACHER TIGBAWAN ELEMENTARY SCHOOL, DON LEON
I BALANTE, CARAGA, DAVAO ORIENTAL

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: January 17, 2025

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

Government Issued ID: PHILIPPINE REGULATION Government Issued ID: PHILIPPINE IDENTIFICATION
COMMISSION CARD CARD
ID No.: 1878942 ID No.: 6538-6485-1327-6208
Date Issued: JULY 27, 2020 Date Issued: DECEMBER 23, 2021

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

_______________________________________
(Person Administering Oath)
Doc. No.:______
Book No.:______
Page No.:______
Series of 2025

Page 2 of 2

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy