Joint Filing
DECLARANT
Separate Filing
MACALINO
JEFFREY
(Family Name)
(First Name)
(M.I.)
Not Applicable
SST I
POSITION:
ADDRESS:
SPOUSE:
DEPED-MABALACAT COMMUNITY
HIGH SCHOOL
RIZAL ST., DOLORES,
AGENCY/OFFICE:
OFFICE ADDRESS:
MACALINO
GRACE
(Family Name)
(First Name)
(M.I.)
POSITION:
N/A
AGENCY/OFFICE:
N/A
OFFICE ADDRESS:
N/A
UNMARRIED CHILDREN BELOW EIGHTEEN (18) YEARS OF AGE LIVING IN DECLARANTS HOUSEHOLD
NAME
DATE OF BIRTH
SYRILL A. MACALINO
DENICE FIONA A. MACALINO
JEAN LORRAINE C. MACALINO
AGE
DECEMBER 9, 2003
JANUARY 15, 2007
JANUARY 14, 2011
12
8
4
Real Properties*
DESCRIPTION
KIND
EXACT
ASSESSED
CURRENT FAIR
(e.g. residential,
commercial, industrial,
agricultural and mixed
use)
LOCATION
VALUE
MARKET VALUE
N/A
N/A
N/A
ACQUISITION
COST
YEAR
MODE
N/A
N/A
N/A
N/A
ACQUISITION
N/A
Subtotal: P 0.00
b. Personal Properties*
DESCRIPTION
YEAR ACQUIRED
ACQUISITION
COST/AMOUNT
N/A
N/A
N/A
Subtotal : P 0.00
Page 1 of _2_
Page 2 of _2_
2. LIABILITIES*
NATURE
NAME OF CREDITORS
SALARY LOAN
SALARY LOAN
SALARY LOAN
OUTSTANDING BALANCE
MTMAS
CITY SAVINGS BANK
PR SAVINGS
P 80,000
P 92,000
P 54,000
TOTAL LIABILITIES: P 226,000
BUSINESS ADDRESS
NATURE OF BUSINESS
INTEREST &/OR FINANCIAL
CONNECTION
DATE OF ACQUISITION OF
INTEREST OR CONNECTION
RELATIONSHIP
POSITION
I hereby 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
eighteen (18) years of age living in my household, and that to the best of my knowledge, the aboveenumerated are names of my relatives in the government within the fourth civil degree of consanguinity or
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 interests 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:
PRC LICENSE
0997682
12/19/2008
(Signature of Co-Declarant/Spouse)
Government Issued ID:
ID No.:
Date Issued:
Page 3 of _2_
day of
_______________________________________
(Person Administering Oath)
Page 4 of _2_