STATEMENT OF ASSETS, LIABILITIES, AND NET WORTH

v1.0

I. ABOUT USING THIS ELECTRONIC VERSION OF THE SALN (eSALN)

The eSALN is a Microsoft Excel version of the SALN which facilitates filling out and printing of the form. Make sure that Macros are enabled to run when you open the eSALN template.

With Excel 2003, you can do this by first selecting your macro security level. 1. On the Tools menu, point to Macro, and then click Security. 2. On the Security Level tab, select Medium or Low. With the Medium setting, you'll be given an option to enable macros when you open eSALN. You also need to allow unsigned macros to run, the Trust all installed add-ins and templates check box must be selected on the Trusted Publishers tab of the Security dialog box. This option is selected by default. If it is not selected (recommended), Excel allows you to run only macros that have trusted digital signatures. 1. On the Tools menu, point to Macro, and then click Security. 2. On the Trusted Publishers tab, select the Trust all installed add-ins and templates check box.
With Excel 2007, when the Security Warning appears that Macros have been disabled, just click Options... and select Enable this content. After changing the security settings, exit Excel first and re-open the eSALN template. SOME IMPORTANT TIPS: Pop-up comments are situated throughout the form whenever there is a small red triangle. Simply hover your mouse on it to see the comment. You can quickly move from one field to the next by pressing TAB. For entries which can be split into two lines, e.g. Address, press Alt-Enter to create a new line. Use Excel's built-in page breaking tool to insert page breaks when printing, i.e. go to where you want a page break, then on the Insert menu, click Page Break. To download the latest version of the eSALN, go to http://www.csc.gov.ph/cscweb/saln.html

II. ABOUT THE SALN

The SALN contains information about ownership of assets as well as ones liabilities. Every government employee, from the President to every rank-and-file employee, is required by law to submit this form. The governing law is Republic Act No. 6713, otherwise known as the Code of Conduct and Ethical Standards for Public Officials and Employees. The law is based on the Constitutional provision that A public officer or employee shall, upon assumption of office and as often thereafter as may be required by law, submit a declaration under oath of his assets, liabilities and net worth. Liabilities and Penalties You may note that you are not required to attach any documents to vouch or substantiate the information disclosed. However, the SALN is made under oath. Falsification of information or failure to file or report information required to be reported may subject you to disciplinary/criminal action. Knowing and willful falsification of information required to be reported may also subject you to criminal prosecution.
Penalties under RA 6713 may be any of the following: Imprisonment = five years Fine = P5,000 Dismissal from the service Assistance in Filling Out the SALN If you need assistance in completing the SALN form, contact the Integrated Records Management Office (IRMO) of the CSC at telephone numbers 931-7981, 931-7987, 932-2293, and 951-4628, or email queries to salninfo@csc.gov.ph.

III. ABOUT THE ANNUAL DECLARATION (AD)

The Statement of Assets, Liabilities, and Net Worth (SALN) consists of two forms:

III. ABOUT THE ANNUAL DECLARATION (AD)

The Statement of Assets, Liabilities, and Net Worth (SALN) consists of two forms: 1. The Baseline Declaration (BD), and 2. The Annual Declaration (AD). Remember that the BD is to be completed only once. Once you have submitted the BD, only changes in your status need to be reported in the next reporting periods using the AD.

Who Must File All public officials1 and employees, whether regular or under temporary status, are required to file the SALN.
Who do not need to file Public officials serving in an honorary capacity, without credit or pay; Temporary laborers; and, Casual or temporary (not in the regular plantilla of agency) and contractual workers.2
1Under

Section 2 (b) of Republic Act No. 3019, the term public officer includes elective and appointive officials and employees, permanent or temporary, whether in the classified or unclassified or exempt service, receiving compensation, even if nominal, from the government. Under Section 3 (b) of Republic Act No. 6713, the term public officials includes elective and appointive officials and employees, permanent or temporary, whether in the career or non-career service, including military and police personnel, whether or not they receive compensation, regardless of the amount.
2As

implemented by Section 1.a. Rule VIII of the Rules Implementing the Code of Conduct and Ethical Standards for Public Officials and Employees, as amended by CSC Resolution No. 06-0232 dated 1 February 2006.
When to File The AD is due on or before April 30 of each year, where the employee has previously submitted a BD. The first AD shall contain information starting from the day immediately following the cut-off date of an employees BD, up to December 31 of the year of the BD cut-off. The subsequent ADs of an employee shall be for the period January 1 to December 31 of each succeeding year.

The AD must also be accomplished within 30 days of an employees separation from Government service, statements of which must cover January 1 up to the employees last day in office. Where to File Accomplish the forms in triplicate and submit the same to your Human Resource Management Office (HRMO), Personnel Office, or Administration Office.
Further, under CSC Resolution No. 06-0231 dated February 1, 2006, the Chief/Head of the Personnel/Administrative Division or Unit/HRMO shall transmit all original copies of the SALNs received, on or before June 30 of every year, to the concerned offices, as indicated in the table of SALN Repository Agencies in the manual. Must all the forms in triplicate be originally signed? Since your SALN will be submitted to various repository agencies, it is best to submit the accomplished SALN forms in triplicate originals, that is, originally signed and originally subscribed on all three originals. Be sure to retain a copy of your SALN and have the same received as proof of your SALN submission.

SWORN STATEMENT OF ASSETS, LIABILITIES, AND NET WORTH DISCLOSURE OF BUSINESS INTERESTS AND FINANCIAL CONNECTIONS AND IDENTIFICATION OF RELATIVES IN THE GOVERNMENT SERVICE (Required by R.A. No. 6713) As of (Annual Declaration)

A. DECLARANT'S PERSONAL INFORMATION AND EMPLOYMENT

Joint Filing *For Joint Filing , make 2 entries for Name, Position, Declarant's Annual Gross Salary, Name of Agency, and Office Address * Annual Gross Salary refers to ALL amounts received by declarant from Government service

Last Name

First Name

Middle Name

Home Address

Position

Declarant's Annual Gross Salary

* Annual Gross Family Income refers to income of declarant, spouse, and declarant's children below 18 years of age living in declarant's household

Name of Agency/Office

Office Address

Annual Gross Family Income

I am married

I am not married

I have no children below 18 years of age living in my household

Spouse Information: Name: N/A

Position: N/A

Company: N/A

Additional Children of Declarant Below 18 Years of Age Living in Household of Declarant since last SALN submission Name Date of Birth Name Date of Birth

B. IF DECLARANT HAS NOTHING TO DECLARE

There have been no acquisitions and no disposals of real properties pertaining to me / my spouse / my children below 18 years of age living in my household since
my last SALN submission

There have been no acquisitions and no disposals of vehicles pertaining to me / my spouse / my children below 18 years of age living in my household since my
last SALN submission

There have been no acquisitions and no disposals/liquidations of investments pertaining to me / my spouse / my children below 18 years of age living in my household since my last SALN submission There have been no acquisitions and no disposals of other personal properties to declare pertaining to me / my spouse / my children below 18 years of age living in my household since my last SALN submission There have been no incurrence of new liabilities and no retirement/reduction of existing liabilities to declare pertaining to me / my spouse / my children below 18 years of age living in my household since my last SALN submission There have been no acquisitions and no terminations of business interests and financial connections to declare pertaining to me / my spouse / my children below 18 years of age living in my household since my last SALN submission I don't know of any relative who joined Government or was separated therefrom since my last SALN submission

C. IF DECLARANT HAS SOMETHING TO DECLARE

Instructions for Assets, Liabilities, and Business Interests/Financial Connections : Liquidation/disposal of assets, retirement/reduction of liabilities, and termination of business interests/financial connections must be enclosed in parenthesis (xxx) to distinguish the same from acquisitions of assets, incurrence of new liabilities, and creation of business interests and financial connections.

D. ACQUISITIONS AND DISPOSALS OF ASSETS AND LIABILITIES

Instructions for all assets : Declare assets whether the declarant/spouse/child is the legal owner (name appearing on the instrument of title) or the beneficial owner (property is in the name of another person but ownership pertains to declarant/spouse/child, under a trust arrangement ).

1. Acquisition/Disposals of Real Properties and/or Vehicles of Declarant/Spouse/Declarant's Children Below 18 Years of Age Living in the Household of Declarant, regardless of amount
Kind of Real Property/ Type of Vehicle and Plate No. Acquired (Disposed) Location of Real Property/ Cert. No. and Place of Reg of Vehicle Acquisition (Disposal of Asset) Mode Year Cost (Market
Value of Asset)

Estimated Fair Market Value (Php)

Assessed Value

(Not applicable to vehicles)

Total (Php)

2. Acquisitions/Disposals/Liquidations of Investments/Other Personal Properties; Incurrence/Retirement/ Reduction of Liabilities -- of Declarant/Spouse/Declarant's Children Below 18 Years of Age Living in the Household of Declarant
Instructions : Declare each item with a fair market value of Php 50,000 or more , even if the same was acquired at no cost or at less cost. Market value must be determined as of the date of declaration. Items with less value may be declared in lump sum as "Others". However, if "Others" amounts to more than Php 100,000 , each item must be listed. Mark the properties to be declared and make the corresponding entry for the Acquisition Cost/Value of Liquidated Asset.

D.2.1. Investment Acquired (Disposed)

Stocks (equity paid) Bonds Mutual funds Trust funds Private insurance (premiums paid) Educational plans (premiums paid)

Acquisition Cost N/A N/A N/A N/A N/A N/A Acquisition Cost N/A N/A N/A

(Value of D.2.1. Investment Acquired Liquidated Asset) (Disposed) N/A Pre-need plans (premiums paid) N/A Time deposits N/A Money market placements N/A Equity in partnerships N/A Options N/A (Value of Liquidated Asset) N/A N/A N/A Others

Acquisition Cost

(Value of Liquidated Asset) N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A (Amount Paid)

D.2.2. Other Personal Property Acquired (Disposed)

Cash on Hand/ Bank accounts Receivables Deposits/advanced payments on leases/rentals Furniture, antiques Jewelry Equity in installment purchases Intellectual properties Others

D.2.3. Liability Incurred (Paid)

Personal loans Bank loans Accounts payables GSIS, PAGIBIG loans

Outstanding Balance/Increase N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A

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

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

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

Mortgage payables Surety liabilities Guaranty liabilities Judgment debts Loans from other institutions Others

E. ACQUISITION/TERMINATION OF BUSINESS INTERESTS/FINANCIAL CONNECTIONS BY DECLARANT/SPOUSE/DECLARANT'S CHILDREN BELOW 18 YEARS OLD LIVING IN HOUSEHOLD OF DECLARANT
Instructions : Declare each acquired item which generates gross annual receipts of Php 50,000 or more . Items with less value may be declared in lump sum as "Others." However, if "Others" amounts to more than Php 100,000 , each item must be listed. Termination of Business Interests or Financial Connections previously reported, regardless of current gross annual receipts, must be reported.

Declarant, Spouse, or Child [Put Name]

Name of Entity

Address

Nature of Business Interest/Financial Connection

Date of Acquisition (Termination)

F. DECLARANT'S RELATIVES IN THE GOVERNMENT

Instructions : Up to the 4th civil degree of relationship, either of consanguinity or affinity, including bilas, inso, and balae.

Name of Relative

Relationship

Position (Separated)

Office/Address

G. INCORPORATION BY REFERENCE AND STATEMENT:

I am fully incorporating to this statement my Baseline Declaration for the year _2007_ and subsequent declarations from __N/A_ through __N/A__. I hereby certify to the best of my knowledge and information that these SALN statements collectively are complete and true statements of my assets, liabilities, net worth, business interests, and financial connections, including those of my spouse and my children below 18 years of age living in my household, and the names of my relatives in the Government, as of January 0, 1900, as required by and in accordance with Republic Act No. 6713. I further certify that no assets, liabilities, business interests, financial connections, and relatives in the Government other than those declared herein are known to me, my spouse, and my children below 18 years of age living in my household. 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 may show such assets, liabilities, net worth, business interests, and financial connections, including those of my spouse and my children below 18 years of age living in my household covering previous years, including the year I first assumed office in Government. I further undertake to produce all supporting documents for each of the entries herein made when required. Declarant's Signature: Community Tax Cert No: In case of joint filing: Spouse 's Signature: ________________________________________ Date: ___________ Community Tax Cert. No.: _________________ TIN: ___________________________________ Issued In: Date: TIN: Issued On:

Issued In: __________________________ Issued On: ___________________________________

SUBSCRIBED AND SWORN TO before me on this _______ day of ________________________, 20_____, affiant(s) exhibiting his/her/their Community Tax Certificate(s) as indicated above. (Person Administering Oath)
Notes to Sworn Statement of Assets, Liabilities, and Net Worth, Disclosure of Business Interests and Financial Connections, and Identification of Relatives in the Government Service:

SALN ANNUAL DECLARATION DETAILS for as of

Instructions : This AD Details worksheet will assist you in calculating the totals that you would need in the main AD form. It has four (4) main sections: 1) D.2.1. Investment Item 2) D.2.2. Other Personal Property 3) D.2.3. Liability 4) Annual Gross Family Income Some sections have a Help button that will show/hide the associated procedure in coming up with the calculations. If you would like to put a comment or justification for an item, write down a number at the Reference Note and write down a corresponding description at the Notes section at the bottom of the main AD form.

D.2.1. INVESTMENT ITEM

Option to Declare: Investments (If total of all items with FMV less than Php 50,000 is Php 100,000 or less)
Do not declare these items in the SALN at all
Declare in lump sum as Others (Items reclassified to Others will be marked with an asterisk *)

Declare in the respective kind of asset

D.2.2. OTHER PERSONAL PROPERTY

Option to Declare: Other Personal Properties
Do not declare these items in the SALN at all Declare in lump sum as Others (Items reclassified to Others will be marked with an asterisk *)
Declare in the respective kind of asset
(If total of all items with FMV less than Php 50,000 is Php 100,000 or less)

D.2.3. LIABILITIES
Option to Declare: Liabilities (If total of all items with OB less than Php 50,000 is Php 100,000 or less)
Do not declare these items in the SALN at all

Declare in lump sum as Others (Items reclassified to Others will be marked with an asterisk *)
Declare in the respective kind of liability

ANNUAL GROSS FAMILY INCOME

Income Source Type of Income Annual Income

Annual Gross Salary Declarant Income from Real Properties and Vehicles

Income from Investment Items Stocks Bonds Mutual funds Trust funds Private Insurance Educational plans Pre-need plans Time deposits Money market placements Equity in partnerships Options Others

Income from Other Personal Properties Cash on hand/Bank accounts Receivables Deposits/advanced payments on leases/rentals Furniture/antiques Jewelry Equity in installment purchases Intellectual properties Others Income from Liability Personal loans Bank loans Accounts payables GSIS, PAGIBIG loans Mortgage payables Surety liabilities Guaranty liabilities Judgment debts Loans from other institutions Others Income from Business Interests and Financial Connections

Income from Other Sources

TOTAL