Professional Documents
Culture Documents
GOVERNMENT SERVICE
Name:
TENEDOR
(Surname)
RESTITUTO
(First Name)
(Middle Initial)
Rank/SN/Position: TSG / 782238 / NCOIC Adjutant Office : Command Adjutant, Air Force Reserve Command Office Address: Clark Air Base Pampanga _______________________________________
H___
(MI)
Unmarried Children Below 18 Years of Age living in his/her household: (use additional sheet/s, if necessary): Name 1. John Restie H Tenedor . 2. John Paul H Tenedor . 3. _______________________________________________
I have no children below 18 years of age living in my household
ASSETS, LIABILITIES AND NET WORTH I. ASSETS (including that of declarant spouse and unmarried children below 18 years of age living in his/her household) A. KIND
(Res./Comm./ Agri., etc)
REAL PROPERTY/IES (Use additional sheet/s, if necessary): NATURE OF ACQUISITION PROPERTY LOCATION ASSESSED (Paraphernal, VALUE MODE YEAR
conjugal or community)
AFP Housing Bulihan Silang Cavite Installment
Residential Land
1991
PhP210,000
TOTAL: _________________ B. PERSONAL PROPERTY/IES AND OTHER ASSETS (Use additional sheet/s, if necessary): ACQUISITION TANGIBLE ACQUISITION COST* MODE YEAR Bicycle Cash 2011 5,000.00 Laptop (NEO) Cash 2011 11,999.00 Organ Cash 2011 4,500.00
INTANGIBLE
TOTAL: 21,499.00
*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.
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
ACDI ACCC
107,280.00 44,000.00
TOTAL -------P 151,280.00
*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) = NETWORTH (III) TOTAL NET WORTH: P-129,781.00
AMOUNT AND SOURCES OF GROSS INCOME (ALL amounts received from ALL sources for the preceding calendar year)
NATURE (Salary/income, business, etc.) SOURCES AMOUNT
49,722.00
TOTAL: _______________
AMOUNT
TOTAL: __________________________________ BUSINESS INTERESTS AND FINANCIAL CONNECTIONS (Declarant/ spouse/ unmarried children below 18 years of age living in the household of declarant)
(Use additional Sheets/s, if necessary)
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 Sheets/s, if necessary)
Position
Name of office/Address
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, 20___, 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 government, 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.
SUBSCRIBED AND SWORN TO before me this _____ day of _______________ 20____. Affiant(s) exhibiting his/her/their tax Identification Number(s) _____________________ and employee number(s)________________________. 2LT JOSEPH PETER E RAFUSON PAF (Person Administering Oath)