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, 2023
(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 ADRIANO P POSITION:

TEACHER I
: JEROME ALDWIN
(Family Name) (First Name) (M.I.) AGENCY/OFFICE: DEPED DIVISION OF BULACAN
-
ADDRESS: OFFICE ADDRESS: STA. CATALINA BATA
1115 SAN JUAN, SAN MIGUEL, BULACAN NATIONAL HIGH SCHOOL,
STA CATALINA BATA, SAN
ILDEFONSO, BULACAN

SPOUSE: ADRIANO CHARLIN M POSITION: TEACHER I

(Family Name) (First Name) (M.I.) AGENCY/OFFICE: DEPED DIVISION OF BULACAN
-
OFFICE ADDRESS: SAN MIGUEL CENTRAL
DISTRICT
BANTOG ELEMENTARY
SCHOOL, BANTOG SMB.

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

HOUSEHOLD

NAME DATE OF BIRTH AGE

LUNA STELLA M. ADRIANO MARCH 20, 2023 1 YR. OLD
N/A N/A N/A
N/A N/A N/A
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*

DESCRIPTION KIND EXACT ASSESSED CURRENT FAIR ACQUISITION ACQUISITION

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

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 N/A N/A
Subtotal: 0.00
b. Personal Properties*

DESCRIPTION YEAR ACQUIRED ACQUISITION

COST/AMOUNT

GADGETS 2018-2020 P 55, 500.00

VEHICLE 2021-2023 P 83, 000.00
APPLIANCES 2021-2023 P 44, 000.00
N/A N/A N/A

Subtotal : P 182, 500.00

TOTAL ASSETS (a+b): P 182, 500.00

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

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2. LIABILITIES*

NATURE NAME OF CREDITORS OUTSTANDING BALANCE

N/A N/A N/A

N/A N/A N/A
N/A N/A N/A
N/A N/A N/A
TOTAL LIABILITIES: 0.00
NET WORTH: Total Assets less Total Liabilities = P 182, 500.00
* 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 BUSINESS ADDRESS NATURE OF BUSINESS DATE OF ACQUISITION OF

ENTITY/BUSINESS INTEREST &/OR FINANCIAL INTEREST OR CONNECTION
ENTERPRISE CONNECTION
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

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
DOMINGO PANGILINAN UNCLE TEACHER I DEPED DIVISION OF BULACAN, SAN MIGUEL
NATIONAL HIGH SCHOOL
MAURICE DEAN PANGILINAN COUSIN TEACHER II DEPED DIVISION OF BULACAN, SAN MIGUEL
NATIONAL HIGH SCHOOL
CLARISSA P. MANZO COUSIN TEACHER I DEPED DIVISION OF BULACAN, SAN MIGUEL
NATIONAL HIGH SCHOOL

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: ___________________________

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

Government Issued ID: PRC Government Issued ID: N/A

ID No.: 2142479 ID No.: N/A
Date Issued: 02/08/2024 Date Issued: N/A

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

_______________________________________
(Person Administering Oath)

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