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Sworn Statement of Assets, Liabilities and Networth

1) Juana Moana J. filed a separate sworn statement of assets, liabilities, and net worth as of December 31, 2021 as required by law. 2) Her reported assets totaled 883,000 PHP including a house and lot worth 657,000 PHP and personal properties worth 226,000 PHP. 3) She reported no liabilities, resulting in a net worth of 883,000 PHP.

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68 views2 pages

Sworn Statement of Assets, Liabilities and Networth

1) Juana Moana J. filed a separate sworn statement of assets, liabilities, and net worth as of December 31, 2021 as required by law. 2) Her reported assets totaled 883,000 PHP including a house and lot worth 657,000 PHP and personal properties worth 226,000 PHP. 3) She reported no liabilities, resulting in a net worth of 883,000 PHP.

Uploaded by

marianne pendon
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Revised as of January 2015

Per CSC Resolution No. 150008


Promulgated on January 23, 2015

SWORN STATEMENT OF ASSETS, LIABILITIES AND NETWORTH


As of December 31, 2021
(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 X Separate Filing Not Applicable

NAME: JUANA MOANA J. POSITION Administrative Officer II


(Family Name) (First Name) (M.I.) AGENCY/OFFICE DEPED-Division of South Cotabato
ADDRESS: PUROK MABUHAY, BARANGAY SAN ISIDRO, OFFICE ADDRESS: Koronadal City, So. Cotabato

KORONADAL CITY, SOUTH COTABATO, 9506


SPOUSE: JUANA JOHN D. POSITION NONE
(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


DWYANE J. JUANA 12/31/2017 3

A. 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 ACQUISITION
VALUE
e.g. lot, house EXACT MARKET VALUE ACQUISITION
and lot, "e.g. residential, LOCATION COST
condominium commercial, industrial,
YEAR MODE
and agricultural and mixed (As found in the Tax Declaration of
improvements used) Real Property
Brgy. San Isidro,
House and Lot Residential Koronadal City N/A N/A 2017 Deed of Sale 657,000.00

Subtotal: 657,000.00
b. Personal and Other Properties*

DESCRIPTION YEAR ACQUIRED ACQUISITION COST/AMOUNT


1 UNIT DESKTOP COMPUTER 2017 10,000.00
HOME APPLIANCES 2017 42,000.00
2 UNITS OF SMART PHONE 2016 16,000.00
1 UNIT TRICYCLE (HONDA CV 125) 2016 98,000.00
1 UNIT LAPTOP 2016 21,000.00
CASH ON HAND 2021 25,000.00
CASH IN BANK 2021 14,000.00
Subtotal: 226,000.00
TOTAL ASSETS (a+b) 883,000.00
2. LIABILITIES *

NATURE NAME OF CREDITORS AMOUNT


NONE N/A N/A

TOTAL LIABILITIES: -

NET WORTH; Total Assests less Total Liabilities = 883,000.00

* Additional sheet/s may be used, if necessary

Page 1 of 2
BUSINESS INTEREST AND FINANCIAL CONNECTIONS:
(of Declarant/Delarant's spouse/Unmarried Children Below Eighteen (18) years of Age Living in Declarant's Household)
X

DATE OF ACQUISITION
NAME OF ENTITY/BUSINESS NATURE OF BUSINESS INTEREST
BUSINESS ADDRESS OF INTEREST OR
ENTERPRISE AND/OR FINANCIAL CONNECTION
CONNECTION
NONE N/A N/A N/A

RELATIVES IN THE GOVERNMENT SERVICE


(Within the Fourth Degree of Consanguinity or Affinity. Include also Bilas, Balae an Inso)

NAME POSITION RELATIONSHIP NAME/ADDRESS OF OFFICE

1ST SPECIAL FORCES BATTALION,


SPECIAL FORCES REGIMENT
SHAIDER B. JUANA 2ND LIEU SIBLING
(AIRBORNE), SOCOM, PHILIPPINE
ARMY, PALAYAN CITY, NUEVA ECIJA

PROVINCIAL AGRICULTURE OFFICE-


INGRID J. DACAYO AGRICULTURIST I SIBLING SOUTH COTABATO, ALUNAN AVENUE,
KORONADAL CITY

I herby 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 eigtheen (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 degree of consanguinity of 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 interest 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: 10/14/2020 Date: 10/14/2020

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

Government Issued ID: PRC Government Issued ID: DRIVER'S LICENSE


ID No.: 7983153 ID No.: L04-15-000317
Date Issued: 12/15/2019 Date Issued: 04/16/2020

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

Person Administering Oath

* Additional sheet/s may be used, if necessary

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