SWORN STATEMENT OF ASSETS, LIABILITIES AND NET WORTH

As of December 2017
(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  Separate Filing  Not Applicable

DECLARANT: MALUBAG RODERICK A. POSITION: MASTER TEACHER I

(Family Name) (First Name) (M.I.) AGENCY/OFFICE: DEPED-QUEZON DISTRICT
ADDRESS: SAN ANDRES I, QUEZON, NUEVA ECIJA OFFICE ADDRESS: SAN ANDRES I, QUEZON NUEVA ECIJA

SPOUSE: MALUBAG GERALDINE T. POSITION: DISTRICT CLERK

(Family Name) (First Name) (M.I.) AGENCY/OFFICE: DEPED-QUEZON DISTRICT
OFFICE ADDRESS: BRGY.II, QUEZON NUEVA ECIJA

UNMARRIED CHILDREN BELOW EIGHTEEN (18) YEARS OF AGE LIVING IN DECLARANT’S HOUSEHOLD
NAME DATE OF BIRTH AGE
FRINZ KIAN T. MALUBAG OCTOBER 9, 2007 10

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*

DESCRIPTION KIND EXACT ASSESSED CURRENT FAIR ACQUISITION ACQUISITION

(e.g. lot, house and (e.g. residential, LOCATION VALUE MARKET VALUE COST
lot, condominium commercial, industrial,
(As found in the Tax Declaration of
and improvements) agricultural and mixed use)
Real Property)
YEAR MODE

HOUSE AND RESIDENTIAL SAN ANDRES I , 350,000.00 400,000.00 2007 INHERITED 350,000.00
LOT QUEZON, NUEVA
ECIJA
LOT AGRICULTURAL SAN ANDRES I , 160,000.00 20015 RENT 160,000.00
QUEZON, NUEVA
ECIJA

Subtotal: 510,000.00
b. Personal Properties*

DESCRIPTION YEAR ACQUIRED ACQUISITION

COST/AMOUNT

MOTORCYCLE 2007 & 2015 120,000.00

GEWELRY 2016 & 2017 50,000.00
CELL PHONE 2016 & 2017 29,000.00

Subtotal : 199,000.00

TOTAL ASSETS (a+b): 709,000.00

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

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2. LIABILITIES*

NATURE NAME OF CREDITORS OUTSTANDING BALANCE

SALARY LOAN GSIS 240,000.00

SALARY LOAN EASTWEST BANK 120,000.00
SALARY LOAN CITY SAVINGS 150,000.00
SALARY LOAN PRODUCERS 40,000.00
TOTAL LIABILITIES: 550,000.00
NET WORTH : Total Assets less Total Liabilities = 159,000.00
* 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 BUSINESS ADDRESS NATURE OF BUSINESS DATE OF ACQUISITION OF

ENTERPRISE INTEREST &/OR FINANCIAL INTEREST OR CONNECTION
CONNECTION
N/A N/A N/A N/A

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
TERESITA M. LAZAGA SISTER HTIII DEPED/CUYAPO DISTRICT
SHIERLY M. MALIG SISTER TIII DEPED/QUEZON DISTRICT
ANGEBIRTH A.MALUBAG BROTHER PO1 PNP AVSEG.

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 above-
enumerated 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 28, 2018

(Signature of Declarant) (Signature of Co-Declarant/Spouse)

Government Issued ID: PRC ID Government Issued ID:

ID No.: 0919422 ID No.:
Date Issued: FEBRUARY 2, 2017 Date Issued:

SUBSCRIBED AND SWORN to before me this day of , affiant exhibiting to me the above-stated
government issued identification card.

_______________________________________

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 (Person Administering Oath)

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