SWORN STATEMENT OF ASSETS, LIABILITIES AND NET WORTH

As of February 6, 2018
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: CARO ROLDAN M. POSTION: TEACHER I
(Family Name)
(Family Name) (First
(FirstName)
Name) (M.I.)
(M.I.) AGENCY/OFFICE: DEPED - TAYUG
AGENCY/OFFICE: DEPEDI - BAYAWAN CITY
ADDRESS: 110 AGNO, TAYUG, PANGASINAN OFFICE ADDRESS: VILLAREAL, BAYAWAN CITY
SPOUSE: NA POSTION: NA
(Family
(FamilyName)
Name) (First Name)
(First Name) (M.I.)
(M.I.) AGENCY/OFFICE: DEPED
AGENCY/OFFICE: - TAYUG
NA I
OFFICEOFFICE ADDRESS:
ADDRESS: NA TAYUG, PANGASINAN

UNMARRIED CHILDREN BELOW EIGHTEEN (18) YEARS OF AGE LIVING IN DECLARANT'S HOUSELHOLD

NAME DATE OF BIRTH AGE

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 ASSESSED CURRENT FAIR

(e.g. lot, household (e.g. residential, EXACT VALUE MARKET VALUE ACQUISITION
lot, condominium commercial, Industrial, LOCATION ACQUISITION COST
and imrovements Agricultural and mixed (As found in the Tax Declaration of
YEAR MODE
use) Real Properties

Brgy. Agno,
HOUSE RESIDENTIAL Tayug, Pang. 2004 CONSTRUCTED 20000.00

Brgy. Agno,
LOT RESIDENTIAL Tayug, Pang. 2001 PURCHASED
5000.00

Subtotal: 25000.00
 a. Personal Properties*

DESCRIPTION YEAR ACQUIRED ACQUISITION COST

APPLIANCES 2014 30000.00
FUNITURES 2014 50000.00

Subtotal: 80000.00
TOTAL ASSETS (a+b): 105000.00
2. LIABILITIES*
NATURE NAME OF CREDITORS OUTSTANDING BALANCE
PAG - IBIG MULTI PURPOSE PAG - IBIG 18000.00

TOTAL LIABILITIES: 18000.00

NET WORTH : Total Assets less Total Liabilities = 87000.00
N CITY
 BUSINESS INTERESTS AND FINANCIAL CONNECTIONS
(of Declarant / Declarant's spouse / Unmarried Children Below Eighteen (18) years of age Living in Declarant's Houselhold)
I/We do not have any business interest or financial connection

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

ENTERPRISE BUSINESS ADDRESS INTEREST &/OR FINANCIAL INTEREST OR CONNECTION
CONNECTION
N/A N/A N/A N/A
N/A N/A N/A N/A
N/A N/A N/A N/A
N/A N/A N/A N/A

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

LIGAYA V. TABAGO SISTER-IN-LAW TEACHER III DEPED - SAN NICOLAS, PANGASINAN

ALICIA V. CATALAN SISTER-IN-LAW STENOGRAPHER III RTC - ROSALES, PANGASINAN
GRAYDAN V. TABAGO NEPHEW TEACHER II DEPED - NATIVIDAD, PANGASINAN
JONATHAN V. DE QUIROZ NEPHEW TEACHER I DEPED - TAYUG, PANGASINAN
DIONISIO P. SADUESTE BROTHER-IN-LAW TEACHER III DEPED - BAMBANG, NUEVA VIZCAYA

I hereby certify that these are true and correct statements of my assets, liabilities, ne 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 consaguinity 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 Re 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 21, 2015

(Signature of Declarant) (Signature of Co - Declarant)

Government Issued ID: PRC Government Issued ID: PRC

ID No: 412312 ID No: 51331
Date Issued: August 7, 1998 Date Issued: April 15, 1997

SUBSCRIBED AND SWORN to before me this 22nd day of January, affiant exhibiting to me the above-stated
government issued identification card.

SONNY P. BACALZO
Principal II
(Person Administering Oath)