Saln As Of December 2018.docx

Revised as of January 2015 Per CSC Resolution No. 1500088 Promulgated on January 23, 2015

SWORN STATEMENT OF ASSETS, LIABILITIES AND NET WORTH As of DECEMBER 31, 2018 (Required by R.A. 6713) Note: Husband and wife who are both public officials and employees may file the required statements jointly or separately.

 Joint Filing DECLARANT: ADDRESS:

ROSALES

JOHN RALPH

 Separate Filing C.

(Family Name) (First Name) (M.I.) BLOCK 1 LOT 61 CASA MIRA LINAO SUBD., LINAO, MINGLANILLA, CEBU 6046

SPOUSE:

(First Name)

POSITION:

ADMIN ASSISTANT I

AGENCY/OFFICE: OFFICE ADDRESS:

PHILIPPINE NATIONAL POLICE POBLACION WARD IV, MINGLANILLA, CEBU 6046

POSITION:

N/A (Family Name)

 Not Applicable

(M.I.)

AGENCY/OFFICE: OFFICE ADDRESS:

N/A

UNMARRIED CHILDREN BELOW EIGHTEEN (18) YEARS OF AGE LIVING IN DECLARANT’S HOUSEHOLD NAME

DATE OF BIRTH

AGE

N/A

N/A

N/A

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*

DESCRIPTIO

KIND

EXACT

ASSESSED

CURRENT

N

(e.g. residential, commercial, industrial, agricultural and mixed use)

LOCATION

VALUE

FAIR MARKET

(e.g. lot, house and lot, condominium and improvements)

HOUSE AND LOT

ACQUISITION COST

VALUE (As found in the Tax Declaration of Real Property)

BLK 1 LOT 61 CASA RESIDENTIAL

ACQUISITION

MIRA LINAO SUBD., MINGLANILLA, CEBU

TO BE

TO BE

ASSESSED

ASSESSED

YEAR

2018

MODE

HOUSING LOAN

Subtotal:

1,182,000

1,182,000

b. Personal Properties* DESCRIPTION

YEAR ACQUIRED

ACQUISITION COST/AMOUNT

YAMAHA NMAX ABS

2018

119,000

HUAWEI NOVA 3 CELLPHONE

2018

25,990

APPLE IPHONE 7

2018

35,490

G-SHOCK WRIST WATCH

2014

14,000

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

Page 1 of ___

LIABILITIES* NATURE

NAME OF CREDITORS

OUTSTANDING BALANCE

HOUSING LOAN SALARY LOAN

PAG-IBIG FUND PSSLAI

1,170,905.06 104,139.72

TOTAL LIABILITIES: NET WORTH : Total Assets less Total Liabilities =

1,275,044.78 104,325.22

* 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 Declarant’s Household)

 I/We do not have any business interest or financial connection . NAME OF ENTITY/BUSINESS ENTERPRISE

BUSINESS ADDRESS

NATURE OF BUSINESS INTEREST &/OR FINANCIAL CONNECTION

DATE OF ACQUISITION OF INTEREST OR CONNECTION

RECREATIONAL

JULY 2017

POBLACION WARD II, MINGLANILLA, CEBU

RJ’S BILLAIRD CENTER

RELATIVES IN THE GOVERNMENT SERVICE (Within the Fourth Degree of Consanguinity or Affinity. Include also Bilas, Balae and Inso)

 I/We do not know of any relative/s in the government service) NAME OF RELATIVE

RELATIONSHIP

POSITION

NAME OF AGENCY/OFFICE AND ADDRESS

PERCYBELL C. ROSALES

MOTHER

DIETICIAN IV

DOH, MARGOSATUBIG REGIONAL HOSPITAL

JANETTE P. RAFTER

COUSIN

PSUPT

PNP, TOLEDO POLICE STATION

HARTZEL PETER R. BILLEDO

COUSIN

PCI

PNP, REGION IX HEADQUATERS

JENNIFER R. PRINCILLO

COUSIN

OFFICE STAFF

DAR, PAGADIAN CITY

MARY ANN S. SECRETARIO

COUSIN

TEACHER

DEPED, REGION IX

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:

February 20, 2019 N/A (Signature of Declarant)

Government Issued ID: ID No.: Date Issued:

(Signature of Co-Declarant/Spouse)

PNP ID 16B220088 2/22/2016

Government Issued ID: ID No.: Date Issued:

SUBSCRIBED AND SWORN to before me this government issued identification card.

day of

N/A

, affiant exhibiting to me the above-stated

_______________________________________ (Person Administering Oath)

Page 2 of ___

Revised as of January 2015 Per CSC Resolution No. 1500088 Promulgated on January 23, 2015

SWORN STATEMENT OF ASSETS, LIABILITIES AND NET WORTH As of (Sample additional sheet/s for the declarant) NAME:

POSITION: (Family Name)

(First Name)

(M.I.)

AGENCY/OFFICE:

ASSETS, LIABILITIES AND NETWORTH 1. ASSETS a.

Real Properties*

DESCRIPTION

KIND

EXACT

ASSESSED

CURRENT FAIR

(e.g. lot, house and lot, condominium and improvements)

(e.g. residential, commercial, industrial, agricultural and mixed use)

LOCATION

VALUE

MARKET VALUE

(As found in the Tax Declaration of Real Property)

ACQUISITION

ACQUISITION COST

YEAR

MODE

Subtotal: b. Personal Properties* DESCRIPTION

YEAR ACQUIRED

ACQUISITION COST/AMOUNT

APPLE IPHONE 6

2015

15,490

Subtotal : TOTAL ASSETS (a+b):

197,370 1,379,370

2. LIABILITIES* NATURE

NAME OF CREDITORS

OUTSTANDING BALANCE

TOTAL LIABILITIES: NET WORTH : Total Assets less Total Liabilities = BUSINESS INTERESTS AND FINANCIAL CONNECTIONS NAME OF ENTITY/BUSINESS ENTERPRISE

BUSINESS ADDRESS

NATURE OF BUSINESS INTEREST &/OR FINANCIAL CONNECTION

Page 3 of ___

DATE OF ACQUISITION OF INTEREST OR CONNECTION