STATEMENT OF ASSETS, LIABILITIES AND NET WORTH

AND DISCLOSURE OF BUSINESS INTERESTS, FINANCIAL CONNECTIONS

AND RELATIVE/S IN THE GOVERNMENT SERVICE
As of December 31, 2011
(Required by R.A. Nos. 3019 and 6713)
(Note: Husband and Wife who are both public officials or employees may
file the required statements jointly or separately.)
Jointly filed.
Separately filed.
Name MALGAPO,
GERRY
(Surname)
(First Name)

PAGUIO
(Middle Initial)

Position LABOR AND EMPLOYMENT OFFICER I

Office DOLE-NCR

Address #412 Tulip, Magnolia Place,

Tandang Sora, Quezon City
I am married.

Office Address 967 DOLE-NCR Bldg., Maligaya St.,

Malate, Manila____________________

I am not married.

Spouse MALGAPO, JESSICA MARIE POLICARPIO

(Surname) (First Name) (Middle Initial)

Office

Position _____N/A________________________________
_____N/A________________________________
Office Address ___N/A____________________________

Unmarried Children below 18 years of age living in his/her household: (use additional sheet/s, if necessary)
Name
Date of Birth
1. _______Gabriel P. Malgapo___________________
2. _____________N/A____________________________
3. _____________N/A____________________________

__________September 12, 2011_____

_____________N/A__________________
_____________N/A__________________

I have no children below 18 years of age living in my household.

ASSETS, LIABILITIES AND NET WORTH
I. ASSETS (including that of declarants spouse and unmarried children below 18 years of age living in his/her household)
A. REAL PROPERTY/IES (use additional sheet/s, if necessary)
KIND
NATURE OF
LOCATION
ACQUISITION
(Res./Comm./
PROPERTY
MODE
YEAR
Agri., etc.)
(Paraphernal,

ASSESSED
VALUE

FAIR
MARKET
VALUE

N/A

N/A

conjugal or
community)

N/A

N/A

N/A

N/A

N/A

B. PERSONAL PROPERTY/IES AND OTHER ASSETS (use additional sheet/s, if necessary)

TANGIBLE
ACQUISITION
MODE
YEAR
MOTORCYCLE (MOTORSTAR)
INSTALLMENT
2008
WEDDING RING
CASH
2011
NOKIA CELLPHONE (CHINA PHONE)
CASH
2010
CASIO KEYBOARD (2ND HAND)
CASH
2005
INTANGIBLE
N/A
N/A
N/A

ACQUISITION COST*
Land,
Building,
others

Improvement/s

N/A
N/A
TOTAL: ________________
ACQUISITION COST*
P78, 000.00
P10, 000.00
P 3, 500.00
P 8, 000.00

TOTAL:

N/A
P99, 500.00

*For computation purposes, use acquisition cost. Properties of unmarried children below 18 years of age living in his/her household shall be
excluded as well as the paraphernal/exclusive properties of spouse, in case of separate filing.
TOTAL ASSETS (A+B)=
P99, 500.00
II. LIABILITIES (including that of declarants spouse and unmarried children below 18 years of age living in his/her household)
NATURE
NAME OF CREDITOR/S
*OUTSTANDING BALANCE
N/A
N/A
N/A

TOTAL: ___________________________
*In the computation of outstanding balance, properties of unmarried children below 18 years of age living in his/her household shall be excluded as
well as the paraphernal/exclusive properties of spouse, in case of separate filing.
(use additional sheet/s, if necessary)

III. NET WORTH (TOTAL ASSETS (I) LESS TOTAL LIABILITIES (II) = NET WORTH (III)
TOTAL NET WORTH:

P99, 500.00

AMOUNT AND SOURCES OF GROSS INCOME

(ALL amounts received from ALL sources for the preceding calendar year)
NATURE
SOURCES
(salary/income, business, etc.)
SALARY
DOLE-NCR

AMOUNT
P47,073.56

(use additional sheet/s, if necessary)

TOTAL:

PERSONAL EXPENSES
FOOD
CLOTHING ALLOWANCE
TRANSPORTATION ALLOWANCE

AMOUNT OF PERSONAL AND FAMILY EXPENSES

(for the preceding calendar year)
ESTIMATED AMOUNT
FAMILY EXPENSES
(P150x365) P54,750.00
GROCERIES
P5,000.00
CELLPHONE LOAD
(P500x48wks.)P24,000.00

P47,073.56

ESTIMATED AMOUNT
(P5,000x12)P60,000.00
(P300x12mos)P3,600.00

(use additional sheet/s, if necessary)

TOTAL : P83,750.00

TOTAL : P63,600.00

AMOUNT OF INCOME TAXES PAID

(for the preceding calendar year)
NATURE

AMOUNT

Compensation
Business Income
Other Income

N/A
N/A

(use additional sheet/s, if necessary)

TOTAL : _____________________________
BUSINESS INTERESTS AND FINANCIAL CONNECTIONS
(Declarant/Spouse/Unmarried Children below 18 years of age living in the household of declarant)
(Use Additional Sheet/s, if necessary)
I/We dont have any business interests and financial connections.
Name of Entity/Business Enterprise
Business Address
N/A

Nature of Business Interest

and/or Financial
Connection
N/A

N/A

Date of Acquisition of
Interest or Connection
N/A

RELATIVE/S IN THE GOVERNMENT

(Up to the 4th civil degree of relationship, either by consanguinity or affinity, including bilas, inso and balae)
(Use Additional Sheet/s, if necessary)
I/We dont know of any relative/s in Government.
Name of Relative
Relationship
N/A
N/A

Position
N/A

Name of Office/Address
N/A

I/We hereby certify that these are my/our true and detailed assets, liabilities, net worth, amount and sources of income, personal and family expenses,
amount of income taxes paid, business interests, and financial connections, including those of my spouse and my/our children below 18 years of age living in my
household, and the name/s of my relative/s in the Government, as of December 31, __________, as required by and in accordance with Republic Act No. 3019 and
6713.
I/We hereby authorize the Ombudsman or his duly authorized representative to obtain and secure from all appropriate agencies, including the Bureau of
Internal Revenue, such documents that may show such assets, liabilities, net worth, business interests, and financial connections, including those of my spouse and
my/our children below 18 years of age living in my household, covering previous years, and if possible, including the year I/we first assumed office in Government.
I/We further undertake to produce all supporting documents for each of the entries herein made when required.
Declarants Signature: __________________________
Date: ____________________________

______________________________
Date: ____________________________

(For Separate Filing) Spouses Signature: _________________________

Date: ____________________________
SUBSCRIBED AND SWORN TO before me on this _______ day of ______________, 20______, affiant(s) exhibiting his/her/their tax identification number(s)
_______________________________ and employee number(s) ______________________________.
______________________________
(Person Administering Oath)