SWORN STATEMENT OF ASSETS, LIABILITIES AND NET WORTH

FEBRUARY, 2014 As of ________________________________

(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
DECLARANT: ADDRESS:

Separate Filing

Not Applicable

ORONGAN
(Family Name)

JACILLO
(First Name)

D.
(M.I.)

PUROK 5, BOOY DISTRICT, TAGBILARAN CITY, BOHOL

(Family Name)

POSITION: AGENCY/OFFICE: OFFICE ADDRESS:

LGOO V DILG BOOY DISTRICT, TAGBILARAN CITY, BOHOL NA NA NA

SPOUSE:

ORONGAN

(First Name)

MELRIA

(M.I.)

L.

POSITION: AGENCY/OFFICE: OFFICE ADDRESS:

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

JANSSEN GABRIEL L. ORONGAN JOPHIEL ANGELO L. ORONGAN

SEPTEMBER 8, 2009 NOVEMBER 18, 2012

4 1

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*
KIND
(e.g. residential, commercial, industrial, agricultural and mixed use)

DESCRIPTION
(e.g. lot, house and lot, condominium and improvements)

LOCATION

ASSESSED VALUE

CURRENT FAIR MARKET VALUE

ACQUISITION YEAR MODE

ACQUISITION COST

(As found in the Tax Declaration of Real Property)

NONE

NA

NA

NA

NA

NA

NA

NA

Subtotal: b. Personal Properties*

DESCRIPTION YEAR ACQUIRED ACQUISITION COST/AMOUNT

LAPTOP COMPUTER (HP COMPAQ) LAPTOP COMPUTER (ACER ASPIRE) LAPTOP COMPUTER (LENOVO) MOTORCYCLE (HONDA XRM 125)

2010 2013 2012 2012

Subtotal : TOTAL ASSETS (a+b):

P24,000.00 P25,000.00 P10,100.00 P70,000.00 P129,100.00

OUTSTANDING BALANCE

2. LIABILITIES*
NATURE NAME OF CREDITORS

DILG MULTI-PURPOSE COOP. LOAN GSIS CONSO LOAN

DILG-BOHOL MULTI-PURPOSE COOPERATIVE GSIS

P 2,210.00 P124,000.00 P126,210.00 P2,890.00

TOTAL LIABILITIES: NET WORTH : Total Assets less Total Liabilities = * Additional sheet/s may be used, if necessary.

Page 1 of 2

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 ENTERPRISE BUSINESS ADDRESS NATURE OF BUSINESS INTEREST &/OR FINANCIAL CONNECTION DATE OF ACQUISITION OF INTEREST OR CONNECTION

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 aboveenumerated 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: ______________________________

JACILL O D. ORONGAN
(Signature of Declarant) Government Issued ID: ID No.: Date Issued:

(Signature of Co-Declarant/Spouse) Government Issued ID: ID No.: Date Issued:

DEPARTMENT ID 05860 2012

SUBSCRIBED AND SWORN to before me this government issued identification card.

day of

, affiant exhibiting to me the above-stated

_______________________________________ (Person Administering Oath)

Page 2 of 2

SWORN STATEMENT OF ASSETS, LIABILITIES AND NET WORTH

As of ________________________________ (Sample additional sheet/s for the exclusive properties of the declarants spouse and unmarried children below eighteen (18) years of age living in declarants household)

NAME: (Family Name) (First Name) (M.I.)

POSITION: AGENCY/OFFICE:

ASSETS, LIABILITIES AND NET WORTH

1. ASSETS a. Real Properties

KIND
(e.g. residential, commercial, industrial, agricultural and mixed use)

DESCRIPTION
(e.g. lot, house and lot, condominium and improvements)

LOCATION

ASSESSED VALUE

CURRENT FAIR MARKET VALUE

ACQUISITION YEAR MODE

ACQUISITION COST

(As found in the Tax Declaration of Real Property)

b. Personal Properties
DESCRIPTION YEAR ACQUIRED ACQUISITION COST/AMOUNT

2. LIABILITIES
NATURE NAME OF CREDITORS OUTSTANDING BALANCE

BUSINESS INTERESTS AND FINANCIAL CONNECTIONS

NAME OF ENTITY/BUSINESS ENTERPRISE

BUSINESS ADDRESS

NATURE OF BUSINESS INTEREST &/OR FINANCIAL CONNECTION

DATE OF ACQUISITION OF INTEREST OR CONNECTION

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SWORN STATEMENT OF ASSETS, LIABILITIES AND NET WORTH

As of ________________________________ (Sample additional sheet/s for the declarant)

NAME: (Family Name) (First Name) (M.I.)

POSITION: AGENCY/OFFICE:

ASSETS, LIABILITIES AND NET WORTH

1. ASSETS a. Real Properties

KIND
(e.g. residential, commercial, industrial, agricultural and mixed use)

DESCRIPTION
(e.g. lot, house and lot, condominium and improvements)

LOCATION

ASSESSED VALUE

CURRENT FAIR MARKET VALUE

ACQUISITION YEAR MODE

ACQUISITION COST

(As found in the Tax Declaration of Real Property)

Subtotal: b. Personal Properties

DESCRIPTION YEAR ACQUIRED ACQUISITION COST/AMOUNT

Subtotal : TOTAL ASSETS (a+b): 2. LIABILITIES

NATURE NAME OF CREDITORS OUTSTANDING BALANCE

TOTAL LIABILITIES:

BUSINESS INTERESTS AND FINANCIAL CONNECTIONS

NAME OF ENTITY/BUSINESS ENTERPRISE

BUSINESS ADDRESS

NATURE OF BUSINESS INTEREST &/OR FINANCIAL CONNECTION

DATE OF ACQUISITION OF INTEREST OR CONNECTION

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