SWORN STATEMENTS OF ASSETS, LIABILITIES AND NETWORTH

As of December 2019
(Required by RA 6713)

Note: Husband and wife who are both public officials and employees may file the required statements joint
Joint Filing Separate Filing

DECLARANT: SOLIS POSITION: TEACHER I

(Surname) (First Name) (M.I) AGENCY/OFFICE: IHAN NATIONAL
OFFICE ADDRESS: IHAN, KIBLAWAN
ADDRESS:
KIBLAWAN, DAVAO DEL SUR
SPOUSE: NONE POSITION: N/A
AGENCY/OFFICE: N/A
OFFICE ADDRESS: N/A

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

NAME DATE OF BIRTH
NONE NONE
NONE NONE
NONE NONE

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 *
CURRENT FAIR
KIND ASSESSED
DESCRIPTIO (e.g. residential, MARKET ACQUISITION
N (e.g. lot , house & commercial LOCATION VALUE VALUE
lot, condominium & industrial,
agricultural and (As found in the Tax Declaration of Real
improvements)
mixed use) Property) YEAR MODE

Subtotal:

b. Personal Properties
DESCRIPTION YEAR ACQUIRED ACQUISITION

Subtotal:
TOTAL ASSETS (a+b):

2. LIABILITIES*
NATURE NAME OF CREDITORS OUTSTAND
 TOTAL LIABILITIES:

NET WORTH : Total Assets less Total Liabilities

* Additional sheet/s may be used, if necessary.

BUSINESS INTERESTS AND FINANCIAL CONNECTIONS

(of Declarant / Declarant's spouse / Unmarried Children Below Eighteen (18) years of Age Living in D
I/We do not have any business interest of financial connection.

NAME OF NATURE OF BUISNESS

DATE OF AC
ENTITY/BUSINESS BUSINESS ADDRESS INTEREST &/ OR
INTEREST O
ENTERPRISE FINANCIAL CONNECTION
NONE NONE NONE N

RELATIVES IN THE GOVERNMENT SERVICE

(Within the Fourth Degree of Consanguinity or Affinity. Include also Bilas, Balae and
I/We do not know of any relative/s in the government service.

NAME OF RELATIVE RELATIONSHIP POSITION NAME OF AGENCY/OFFIC

I hereby certify to the best of my knowledge and information, that these are true statement
net worth, business interests and financial connections, including those of my spouse and my and unm
(18) years of age living in my household, and that to the best of my knowledge, the above-enumerated are
government within the fourth civil degree of consanguinity or affinity.

I hereby authorize the Ombudsman or his/her duly authorized representative to obtain and s
government agencies, including the Bureau of Internal Revenue such documents that may show my assets,
interests and financial connections, to include those of my spouse and unmarried children below 18 ye
in my household covering previous years to include the year I first assumed office in the government.
I first assumed office in the government .

Date: ____________

NONE
(Signature of Declarant) (Signature of Co-Decl

Government Issued ID Government Issued I

ID No: ID No:
Date Issued Date Issued

SUBSCRIBED AND SWORN to before me this ______day of _________________,affiant exhibit

the above stated government issued identification card.
(Person Administering Oath)
RTH

ments jointly or separately.

Not Applicable

ER I
NATIONAL HIGH SCHOOL
KIBLAWAN, DAVAO DEL SUR

LARANT'S HOUSEHOLD
AGE
NONE
NONE
NONE

en ( 18 )

Acquisition Cost

UISITION COST/AMOUNT

UTSTANDING BALANCE
 ving in Declarant's Household)

TE OF ACQUISITION OF
EREST OR CONNECTION

NONE

alae and Inso)

CY/OFFICE AND ADDRESS

statements of my assets, liabilities,

y and unmarried children below
erated are names of my relatives in the

btain and secure from all appropriate

my assets, liabilities, net worth, business
elow 18 years of age living with me
ent.

NONE
f Co-Declarant/Spouse)

NONE
NONE
NONE

ant exhibiting to me