SWORN STATEMENT OF ASSETS, LIABILITIES AND NETWORTH DISCLOSURE OF BUSINESS INTEREST AND FINANCIAL CONNECTIONS

AS OF DECEMBER 31, 2012 NAME Position Title Office Address Spouse Name Position Title Office Address N/A N/A RARIO
(Surname

JULIUS
First Name

CAHILIG
Middle Name)

TEACHER-I BANGA, AKLAN RARIO

(Surname

Incom e JUSIE
First Name

P207,816

PALMON
Middle Name)

Unmarried Children Below 18 years of age

Name of Child PRINCE WILLIAM P. RARIO

(Use additional sheets if necessary)

Date of Birth JULY 11, 2011

A.

ASSETS AND LIABILITIES 1. Assets a. Real Properties (Use additional sheets if necessary)
Kind & Location Year Acquire d Mode of Acquisition Assessed Value Current Fair Market Value ACQUISITION COST Buildings Improv & Others e ments

N/A N/A N/A N/A N/A N/A N/A N/A

Kind

TOTAL
(Use additional sheets if necessary)

b. Personal and Other Properties

CIGNAL DIGITAL TV 29 INCH COLORED TV LENOVO B45 LAPTOP

Year Acquired

Acquisition Cost

2011 2011 2010

P 3,800.00 P 15,000 P 32,000.00

P 50,800.00 TOTAL ASSETS: P 50,800.00

TOTAL

2. Liabilities (Loans, Mortgages, etc.)

Nature CITY SAVINGS BANK LOAN PAG-IBIG CALAMITY LOAN

[Use additional sheets if necessary]

Amount P 150,000.00

P 11, 205.24

TOTAL LIABILITIES

161,205.24

NETWORTH (Total Assets (1a+1b) Less Total Liabilities: B. DISCLOSURE OF CONNECTIONS BUSINESS INTERESTS AND

(P 109,405.24)

FINANCIAL

Do you have interests and/or financial connections including those of your spouse and unmarried children below 18 years of age living with you in your household? Yes No If Yes, give particulars.
Name of Firm or Company Address of Firm or Company Nature of Business Interests and/or Financial Connections Date of Acquisition or Connection

Name

N/A N/A N/A N/A N/A N/A

C.

IDENTIFICATION OF RELATIVES IN THE GOVERNMENT SERVICE

To the best of your knowledge, are you related within the fourth degree of consanguinity or affinity to anyone working in the government? Yes No. If Yes, give particulars. Name
DESIDERIO D. RARIO JUPITER C. RARIO

Position Title
BRGY. KAGAWAD TEACHER

Relationshi p
FATHER BROTHER

Name & Address of Office

Dingle, Banga, Aklan BACAN NATIONAL HIGH SCHOOL

I HEREBY CERTIFY to the best of my knowledge and information that these are true statement of my assets, liabilities, net worth, business interests and financial connections including those of my spouse and unmarried children below 18 years of age and names of my relatives in the government as of 31 December 2012 as required by and in accordance with RA 6713. I 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 my assets, liabilities, net worth, business interests and financial connections including those of my spouse and unmarried children below 18 years of age living with me in my household covering previous years to include the first year I assumed office in the government. Date: APRIL , 2013

Signature of Spouse

Signature of Employee

TIN
Comm. Tax Cert. No.

: : :

N/A N/A N/A

Issued at

TIN Comm. Tax Cert. No. Issued at

: : :

943-338-069 19882312 Banga, Aklan

Date Issued

N/A

Date Issued

01-02-2013

SUBSCRIBED AND SWORN TO before me this _____ day of _____________, __________, affiants exhibiting to me their Community Tax Certificates bearing the number indicated hereinabove. PERSON ADMINISTERING OATH