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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, 2015
(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: ORDOÑEZ DELIA O. POSITION: MASTER TEACHER II
(Family Name) (First Name) (M.I.) AGENCY/OFFICE: DEPARTMENT OF EDUCATION
ADDRESS: OFFICE ADDRESS: STA. MARIA ELEMENTARY SCHOOL
Binalonan, Pangasinan
SPOUSE: NONE POSITION: NONE
(Family Name) (First Name) (M.I.) AGENCY/OFFICE: NONE
OFFICE ADDRESS: NONE
UNMARRIED CHILDREN BELOW EIGHTEEN (18) YEARS OF AGE LIVING IN DECLARANT’S HOUSEHOLD
NAME DATE OF BIRTH AGE
NONE NONE NONE
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
(e.g. lot, house and
lot, condominium
and improvements)
KIND
(e.g. residential,
commercial, industrial,
agricultural and mixed
use)
EXACT
LOCATION
ASSESSED
VALUE
CURRENT FAIR
MARKET VALUE
ACQUISITION ACQUISITION
COST
(As found in the Tax Declaration of
Real Property)
YEAR MODE
LOT RESIDENTIAL CILI, BINALONAN,
PANGASINAN
10,680.00₱ 26,700.00₱ 2003 PURCHASED
46.700.00₱
HOUSE RESIDENTIAL CILI, BINALONAN,
PANGASINAN
67,200.00₱ 336,000.00₱ 2011 IMPROVED 403,200.00₱
Subtotal: 449,900.00₱
b. Personal Properties*
DESCRIPTION YEAR ACQUIRED ACQUISITION
COST/AMOUNT
APPLIANCES, LAPTOP, CELLPHONE VARIOUS YEARS 77,440.00₱
FURNITURES VARIOUS YEARS 30,190.00₱
CLOTHING, SHOES VARIOUS YEARS 15,000.00₱
JEWELRIES VARIOUS YEARS 5,000.00₱
Subtotal : 127,630.00₱
TOTAL ASSETS (a+b):
* Additional sheet/s may be used, if necessary.
Page 1 of ___
#07 CILI, BINALONAN, PANGASINAN
577,530.00₱
2. LIABILITIES*
NATURE NAME OF CREDITORS OUTSTANDING BALANCE
CONSOLIDATED GSIS 83,125.00₱
SALARY LOAN MTMAS 40,800.00₱
TOTAL LIABILITIES: ₱123,925.30
NET WORTH : Total Assets less Total Liabilities = 453,604.2₱ 0
* 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
NONE NONE NONE NONE
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
IMELDA O. BOMBARDA NIECE TEACHER III DEPARTEMEN OF EDICATION
STA. MARIA NATIONAL HIGH SCHOOL
BINALONAN, PANGASINAN
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: JANUARY 21, 2016
DELIA O. ORDOÑEZ
(Signature of Declarant) (Signature of Co-Declarant/Spouse)
Government Issued ID: PRC Government Issued ID: NONE
ID No.: 0121040 ID No.: NONE
Date Issued: 09/06/1997 Date Issued: NONE
SUBSCRIBED AND SWORN to before me this 21st
day of January 2016, affiant exhibiting to me the above-
stated government issued identification card.
JESSIC S. BAUTISTA
(Person Administering Oath)
Principal II
Page 2 of ___

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2015 saln

  • 1. 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, 2015 (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: ORDOÑEZ DELIA O. POSITION: MASTER TEACHER II (Family Name) (First Name) (M.I.) AGENCY/OFFICE: DEPARTMENT OF EDUCATION ADDRESS: OFFICE ADDRESS: STA. MARIA ELEMENTARY SCHOOL Binalonan, Pangasinan SPOUSE: NONE POSITION: NONE (Family Name) (First Name) (M.I.) AGENCY/OFFICE: NONE OFFICE ADDRESS: NONE UNMARRIED CHILDREN BELOW EIGHTEEN (18) YEARS OF AGE LIVING IN DECLARANT’S HOUSEHOLD NAME DATE OF BIRTH AGE NONE NONE NONE 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 (e.g. lot, house and lot, condominium and improvements) KIND (e.g. residential, commercial, industrial, agricultural and mixed use) EXACT LOCATION ASSESSED VALUE CURRENT FAIR MARKET VALUE ACQUISITION ACQUISITION COST (As found in the Tax Declaration of Real Property) YEAR MODE LOT RESIDENTIAL CILI, BINALONAN, PANGASINAN 10,680.00₱ 26,700.00₱ 2003 PURCHASED 46.700.00₱ HOUSE RESIDENTIAL CILI, BINALONAN, PANGASINAN 67,200.00₱ 336,000.00₱ 2011 IMPROVED 403,200.00₱ Subtotal: 449,900.00₱ b. Personal Properties* DESCRIPTION YEAR ACQUIRED ACQUISITION COST/AMOUNT APPLIANCES, LAPTOP, CELLPHONE VARIOUS YEARS 77,440.00₱ FURNITURES VARIOUS YEARS 30,190.00₱ CLOTHING, SHOES VARIOUS YEARS 15,000.00₱ JEWELRIES VARIOUS YEARS 5,000.00₱ Subtotal : 127,630.00₱ TOTAL ASSETS (a+b): * Additional sheet/s may be used, if necessary. Page 1 of ___ #07 CILI, BINALONAN, PANGASINAN 577,530.00₱
  • 2. 2. LIABILITIES* NATURE NAME OF CREDITORS OUTSTANDING BALANCE CONSOLIDATED GSIS 83,125.00₱ SALARY LOAN MTMAS 40,800.00₱ TOTAL LIABILITIES: ₱123,925.30 NET WORTH : Total Assets less Total Liabilities = 453,604.2₱ 0 * 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 NONE NONE NONE NONE 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 IMELDA O. BOMBARDA NIECE TEACHER III DEPARTEMEN OF EDICATION STA. MARIA NATIONAL HIGH SCHOOL BINALONAN, PANGASINAN 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: JANUARY 21, 2016 DELIA O. ORDOÑEZ (Signature of Declarant) (Signature of Co-Declarant/Spouse) Government Issued ID: PRC Government Issued ID: NONE ID No.: 0121040 ID No.: NONE Date Issued: 09/06/1997 Date Issued: NONE SUBSCRIBED AND SWORN to before me this 21st day of January 2016, affiant exhibiting to me the above- stated government issued identification card. JESSIC S. BAUTISTA (Person Administering Oath) Principal II Page 2 of ___