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, 2017
(Sample additional sheet/s for the exclusive properties of the declarant’s spouse and unmarried children
below eighteen (18) years of age living in declarant’s household)

NAME: ANDRADE JOSIE ALONZO POSITION: Court Stenographer III

(Family Name) (First Name) (M.I.) AGENCY/OFFICE: Supreme Court-RTC, Branch 6

ASSETS, LIABILITIES AND NET WORTH

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)

b. Personal Properties
DESCRIPTION YEAR ACQUIRED ACQUISITION
COST/AMOUNT

Epson Printer 2017 P 4,600

Furniture: Dining Set 2012 27,500
Living Set 2015 20,000
Law Books Various years 17,178

2 . LIABILITIES

NATURE NAME OF CREDITORS OUTSTANDING BALANCE

Regular Policy GSIS P 32,842.76

Multi-Purpose SCSLA 55,782.03

BUSINESS INTERESTS AND FINANCIAL CONNECTIONS

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

ENTERPRISE INTEREST &/OR FINANCIAL INTEREST OR CONNECTION
CONNECTION

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 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 2017
(Sample additional sheet/s for the declarant)

NAME: ANDRADE JOSIE ALONZO POSITION: Court Stenographer III

(Family Name) (First Name) (M.I.) AGENCY/OFFICE: Supreme Court-RTC,Branch 6

ASSETS, LIABILITIES AND NET WORTH

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)

Subtotal:
b. Personal Properties
DESCRIPTION YEAR ACQUIRED ACQUISITION COST/AMOUNT

Epson Printer 2017 P 4,600

Furniture: Dining set 2012 27,500
Living room set 2015 20,000
Law Books Various years 17, 178
Subtotal :
TOTAL ASSETS (a+b):
2 . LIABILITIES

NATURE NAME OF CREDITORS OUTSTANDING BALANCE

Regular Policy GSIS P 32,842.76

Multi-purpose SCSLA 55,782.03

TOTAL LIABILITIES:

BUSINESS INTERESTS AND FINANCIAL CONNECTIONS

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

ENTERPRISE INTEREST &/OR FINANCIAL INTEREST OR CONNECTION
CONNECTION

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