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STATEMENT OF ASSETS, LIABILITIES AND NET WORTH AND DISCLOSURE OF BUSINESS INTERESTS, FINANCIAL CONNECTIONS AN 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: (Surname) Address: I am married. Spouse: (Surname) (First Name) (Middle Initial) I am not married. Position: Office: Office Address: (First Name) (Middle Initial) Position: Office: Office Address:

Unmarried Children below 18 years of age living in his/her household: (use additional sheet/s if necessary) Name 1. EARL JOHN L. VERDADERO 25-May-00 Date of Birth

I have no children below 18 years of age living in my household. ASSETS, LIABILITIES AND NET WORTH I. ASSETS (including that of declarant's spouse and unmarried children below 18 years of age living in his her household)
A. REAL PROPERTY/IES (use additional sheet/s, if necessary) ACQUISITION NATURE OF PROPERTY (Paraphernal, conjugal or community) LOCATION MODE YEAR ASSESSED VALUE FAIR MARKET VALUE

KIND

(Res./ Comm./ Agri., etc.)

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 TOTAL:

N/A

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

AC

INTANGIBLE

TOTAL: *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)=

II. LIABILITIES (including that of declarant's spouse and unmarried children below 18 years of age living in his her household) NATURE NAME OF CREDITOR'S

*OUTSTANDING

(use additional sheet/s, if necessary) *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. III. NET WORTH (TOTAL ASSETS (I) LESS TOTAL LIABILITIES (II) = NET WORTH (III)

TOTAL :

TOTAL NET WORTH:

AMOUNT AND SOURCES OF GROSS INCOME (ALL amounts received from ALL sources for the preceding calendar year) NATURE (salary/income, business, etc.) SOURCES

AMOU

(use additional sheet/s, if necessary TOTAL:

AMOUNT OF PERSONAL AND FAMILY EXPENSES (for the preceding calendar year) PERSONAL EXPENSES ESTIMATED AMOUNT FAMILY EXPENSES ESTIMATED

(use additional sheet/s if necessary) TOTAL: 0.00 AMOUNT OF INCOME TAXES PAID (for the preceding calendar year) NATURE Compensation Business Income Other Income (use additional sheet/s, if necessary) TOTAL: N/A N/A AMOUNT 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 don't have any business interests and financial connections. Name of Entity/Business Enterprise Business Address Nature of Business Interest and/or Financial Connection N/A N/A

Date of Acquisition of In

N/A

N/A

RELATIVE/S IN THE GOVERNMENT (Up to the 4th civil degree of relationship, either by consanguity or affinity, including bilas, inso and balae) (Use Additional Sheet/s, if necessary) I/We don't know of any relative/s in Government. Name of Relative

Relationship

Position

Name of Offic

I/We hereby authorize the Ombudsman or his duly authorized representative to obtain and secure from all appropriate agencies, including the Bureau of Intern Revenue, such documents that may show such assets, liabilities, net worth, business interests, and financial connections, including those of my spouse and my/our childre 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.

/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 income taxes paid, business interests, and financial connections, including those of my spouse and my/our below 18 children years of age living in my household, and t name/s of my relative/s in the Government, as of December 31, 2011, as required by and in accordance with Republic Act No. 3019 and 6713. I/We further undertake to produce all supporting documents for each of the entries herein made when required.

Declarant's Signature: Date: 15 February 2012 Date:

(For Separate Filing) Spouse's Signature: Date: SUBSCRIBED AND SWORN TO before me on this ___________ 15 February 2012 day of ______________, 2011,

affiant(s) exhibiting his/her/their tax identification number(s) ________________

and employee number (s) ____________________.

(Per

TS, LIABILITIES AND NET WORTH SS INTERESTS, FINANCIAL CONNECTIONS THE GOVERNMENT SERVICE December 31, 2011 R.A. Nos. 3019 and 6713)

o are both public officials or employees may statements jointly or separately.)

ving in his/her household: (use additional sheet/s if necessary) Date of Birth

ILITIES AND NET WORTH

e living in his her household)

ACQUISITION COST*

Land, Building, others

N/A N/A 0.00

ACQUISITION COST *

0.00 0.00

0.00

s of age living in his her household) *OUTSTANDING BALANCE

0.00 0.00

II) 0.00

OURCES OF GROSS INCOME ALL sources for the preceding calendar year) AMOUNT

0.00

ONAL AND FAMILY EXPENSES preceding calendar year) ESTIMATED AMOUNT

0.00

OF INCOME TAXES PAID preceding calendar year) AMOUNT 0.00 N/A N/A 0.00

S AND FINANCIAL CONNECTIONS elow 18 years of age living in the household of declarant) onal Sheet/s, if necessary)

Date of Acquisition of Interest or Connection

N/A

S IN THE GOVERNMENT er by consanguity or affinity, including bilas, inso and balae) onal Sheet/s, if necessary)

Name of Office/Address

o obtain and secure from all appropriate agencies, including the Bureau of Internal erests, and financial connections, including those of my spouse and my/our children including the year I/We first assumed office in Government.

net worth, amount and sources of income, personal and family expenses, amount of y spouse and my/our below 18 children years of age living in my household, and the d in accordance with Republic Act No. 3019 and 6713.

ein made when required.

(Person Administering Oath)

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