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Republic of the PhilippinesDEPARTMENT OF LABOR AND EMPLOYMENT

lntramuros, Manila

B@Corrifi caio |lor AJAl t0048

MEMORANDUM

FOR

SUBJECT SUBMISSION OF SWORN STATEMENT OF ASSETS,LIABILITIES AND NET WORTH (SALN) FORM FOR CY 2020

DATE 29 JANUARY 2021

ln compliance with Section 93 of the General Appropriations Act of 20't 3 onTransparency Seal provision, may we provide your office, for posting in the DOLEwebsite, the attached memorandum relative to the submission of the Sworn Statementof Assets, Liabilities and Net Worth Disclosure of Business lnterest and FinancialConnections and ldentification of Relatives in the Government Service for CY 2O2O.

Electronic copy of the same will be sent to your office's official e-mail address atps@dole.gov.ph.

Thank you

Y PDire rlV

Human esource lopment Service

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DIRECTOR ADELINE T. DE CASTROPlanning Service

A Republic of the PhilippinesDEPARTMENT OF LABOR AND EMPLOYMENT

Muralla St., lntramuros, ManilaB

n*y\elf,**ditb cldmc{e ilo.: AJA15-0048

TO

MEMORANDUM

ALL HEADS OF OFFICES, SERVICES, BUREAUS, REGIONALOFFICES, ATTACHED AGENCIES AND PHILIPPINE OVERSEASLABOR OFFICES (POLOS)

SUBJECT : SUBMISSION OF SWORN STATETENT OF ASSETS, LIABILITIESAND NETWORTH (SALN) FORir FOR CY 2O2A

DATE :19January2021

Section 8-A (Statements of Assets and Liabilities and Financial Disclosure) ofRepublic Act 6713, provides that "All public ofiicials and employees, except those whoserve in an honorary capacity, laborers and casual or temporary workers, shall fileunder oath their Statement of Assets, Labilities, and Net Worth and a Disclosure ofBusiness lnterests and Financial Connections and those of their spouses and unmarriedchildren under eighteen (18) years of age living in their households.

Further. Section 11-a (Penalties) of the same law states that "Any public officialor employee regardless of whether or not he holds office or employment in a casual,temporary, holdover, permanent or regular capacrty, committing any violation of this Actshall be punished with a fine not exceeding the equivalent of six (6) months' salary orsuspension not exceeding one (1) year, or removal depending on the gravity of theoffense after due notice and hearing by the appropriate body or agency.

ln this connec{ian, all officials and employe€,s are advised lo slafl thepreparation of their SALJtls in thr* (3) original copies as reguired by law. Thebasic guidelines in filling-out the SALN form for CY 2O2O are attached for yourreference. Electronic copies of the SALN Forms can be downloaded from the CSCWebsite at ,. , Form.

The Heads of Offices and the Human Resource Management Ofiicer (HRMO)designates of the bureaus and services are reminded to check whether the SALNs oftheir respective employees are properly, conectly, completely filled-up and dulynotarized before submission to HRDS not Iater than 31 ilarch 2021.

For further information, you may contact Ms. Donna Salve M. Cordova, HRDS-PAD at telephone no. (02) 8527-3000 loc 5O4.

Secretary

Mx

For compliance.

Revised as ofJanuary 2Ol5Per CSC Resolution No. 1500088Promulgated on January 23, 20 1 5

DECLARANT:

ADDRE.SS:

SPOUSE:

swoRN STATEMENT OF ASSETS, LIABILITIES AND NET WORTHAs of

(Required by R.A. 6713)

Note: Husband and uife tuLw are both pttblic offrcials and emplogees mag file the required stotements jointlg or separatelg.

Q Joint Filing Q Separate Filing tr lVof Applicable

(Family Name) (First Name) (M.r.)FOSITION:AGEI|CY/OFFICE:OFFICE ADDRESS:

POSITION:AGEITCY/OFFICE:OFFICE ADDRBSS:

UNMARRIED CHILDREN BELOW EIGHTEEN (18I YEARS OF AGE LIVING IN DECLARANT'S HOUSEHOLD

NAME DATEOFBIRTH AGE

ASSETS. LIABILITIES AIID NETtrIORTH(Including those of the spouse dnd unmarried children belout eighteen (18)

Aears of age liuing in declarant's household)

1. ASSETS

a. Real Properties*

Subtotal:b. Personal Properties*

Subtotal

* Ad.ditional sheet/ s mag be used, if necessary'

Page I of

-

TOTALASSEIE (a+bf:

(Famtl

DESCRIPTIOT{(e.g.lot,

md

lot, hou$ andcondominiumimprovements)

KIND(e.g. residential,

commercial, industrial,agricultural md mhed

rtsel

EXACT

LOCATION

ASSESSED

IIALI'ECI'NREITT FAIR

UARITEf,VALI'E

acQrrrsrTrox Acaw!ff#,cosT 'i

(As lound ln the Tar Dcclaration ofRed Propcrtyl IEAR MODE

DESICRIPIION YEARACQT'IREI) rcaulsrlrcI{cosf,/Auotrr

2. LIABILITIES*

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

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

BUSINESIS INTERESTS Ar{D TINANCIAL CONNECTIONS(of Declarant / Declarant's spouse/ [Jnmarried Children Bebut Eighteen (18) gears of Age Liuing in Declarant's Household)

Q I/We do not haue ang business interest orfinancial connection.

RELATTVES IN THE GOVERNMENT SERVICE(Within the Fourih Degree of Consanguinitg or Affinitg. Include also Bilas, Balae and Inso)

Q I/ We do not knout of ang relatiue/ s in the gouerrlment seruice)

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 beloweighteen (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 oraffinity.

I hereby authorize the Ombudsman or his/her duly authorized representative to obtain andsecure from all appropriate government agencies, including the Bureau of Internal Revenue suchdocuments 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 myhousehold covering previous years to include the year I first assumed office in government.

Date

( Signature of D eclor ant) (Signature of Co-Declarant/ Spouse)

Govemment Issued ID:ID No.:Date Issued:

Government Issued ID:ID No.:Date Issued:

SUBSCRIBED AND SWORN to before me this

-day

of

-,

affiant exhibiting to me the above-statedgwernment issued identification card.

(Person Administeing O ath)Page 2 of _

NATT'RE I{AME OF CREDTTORS OIyI TAITDIITG BAJ,NTqE

MUEoF EilflTY/BUSIITESS- EIITERPRISE

BUSINISS ADDRESS I|ATURE OF BUSIITESSINTERESf, &/ OR FII{ANCIAL

CONITECTION

DATE OF ACQITTSITION OrNTTEREST OR CONUECTION

RELATIOII$IIP FOSITIOI{ ITAUE Oi AGEI{CY/OFFICE Ar{D ADDRESSXAUE OF RELAT{IIE

.

GUIDELINES IN THE FILLING OUT OF THE SWORN STATEMENT OF ASSETS,LlAgLrnEs AND NETWORTH (SALN) FORM FOR CY 2019

. Spouses \rvho are both public officers and employees shall have theoption to file their SALN eith€r iointly or separately. The.ioint statementsflall be signed by both spouses;

. ln case the declarant is single or married but whose spouse is not inthe govemment seMce, he/shall tick the box marked as "NotAppllcable":

. Declarant must provide the information requrred for all his/herunmamed children below eighteen (18) years of age and living inhis/her household, whether legitimate or illegitimate;

. The SALN form should be filled as is. Additional sheels shall be usedfor information needing additional spaces. (For exa mple, if in casa thedeclarant has t ree (3) unmafiid childrcn, he/she may attach theadditional sr,eel that would lisl the thittl unmanied child. The s,meshould apfly tor the declaration of real propedies, assets ard /iahrrit esand o(hea)

II. ASSETS, LIABILTIES AND NET WORTH

. The SALN shall contain a true and compl€te declaration of assets,liabilities and net \,vorth, including a disclosure of business interestsand financial connections of the declarant, hislher spouse andunmanied children below eighteen (18) years of age living in his/herhousehold.

. Daclaration of real properties shallinclude rn ats d€scription, kind, exadlocauon, year and mode d acquisition, assessed value, fair markelvalue, acquisition cost of land, building, and others, includingimprovements thereon;

. Real propertres refer to properties which are immovable by nature. Forpurposes of SALN, the kind of real properties are classified accordingto thoir use, that rs, rBsidenlial, crmmercial, agricultural, industrial ormix use and the like:

. T.he declarant shall indacate e description of the real propgrties,

whether it is a land only or land with building, a house and lotcondominium unat, or en improvement such as an elcenslon or garage'

and tho like;

I. BASIC INFORMATION

REAL PROPERTIES

FINANC]AL CONNECTIONS AND BUSINESS INTERESTS

. The dedarent, including that of his/her spouse end unmanied childrenbelo\f, eighteen (18) years of age living in dedarant's household, shalldeclare th€irexisting interest or connection in any business enterpriseor entity, aside from income from the govemment. They shall alsoindicate the business address, nature of business interest and/orfinancial conn€ction, and date of acquisition of interest or connection.

RELATIVES IN THE GOVERNMENT

. The dedarant shall disclose his/her relatives in the govemment withinthe 4s civil degree of relationship, either by consanguinity or affinity.The disclosur€ shall also slate his/her relationship with the relative,the position of the relative as well as the name of the office/ag€ncyand address: and

. Relatives in the government refer to the declarant's relatives up to the4th civil degr€€ of r€lationship, eith€r by consanguinity or affinaty,including bilas. inso and balae.

. The declarant is strictly required to fill all applicable information in the$ALN form. Otherwise, such item should be marked with " NA' ot"Ootaoofrcahle",

. All fficials and employees in the DOLE Central Office are required tohavo their resp€ctive accomplished SALN Forms not,rized be aNotery Public.

III. FILING OF SALN

Pursuant to CSC Momorandum Circular (MC) No. 03, series of 2015,otficials and employees are to use the revlsed SALN prescribed bythe CSC in 2015 and must be accomplished in TRIPUCATEOR'GINALCOPIES,

Third Level Officials specifically the Secr?tary Undersecretarlesand Assistant Secr€taries shall submit their accomplished SALN tothe Human Resource Development Servrce on or before 3{ Marchm20.

OTHER MATTERS

. ln order to prevent unauthorized insertions or pullang out of pages,pagination shall resd as page 1 of number of pages, page 2 of numberof pages, and so on,

. The d€clarant shall indicate those real properties which are alrBadytitled or r€gistered under his/her name, the name of his/her spouse orunder the name of his,her unmanied children below 18 years of ageand living in the declarant's household. However. real properliesalready covered by a deed of sale, inherited or subject of an extra-judicial settlement of estate but not yet titled under declarant's nameshall be disclosed:

ln case of properties received grafuitously, e.g. donation orinheritancr. no acquisition cost shall be declared. However, the fairmarket value and the assess€d value if said properties as found in thetax declaration thoreof must be declared

P-EBSONAL!8oEEEJIEI

. Declaration of personal properties shall include mode, year and costof acquisition, or lhe value or amount of said personal properties;

r Personal properties refer to jewelry, appliances, fumiture, motorvehicles and other tangible/movable properties. This shall also includeinvestment or other assets, such as cash on hand or in bank,negotiable instruments, secunties, stocks, bonds and the like:

o Personal properties colleclively acquired or are of minimal value maybe declared generally or collectiv€ly. ln which case. the declaranl maywrite/indicate "various years" under the column required,

. The amount of money/cash in bank to be declared should be the lastbalanco as of Docember 31 of the preceding year.

Ltaerunes

. Under liabilities, the nature of liability, name of ffeditors and theoutstancling balance shall be indicated. The outstanding balanceshall refer to the amount of money that is still due as of December31 of the preceding calendar yeac

. Nature of liability refors to the type of loan obtained from banks,financial institutions, GSIS, PAG-|B|G and others, such as personal,multi-purpose, salary, calamity loans and the like.

COMPUTATION OF NET WORTH

e Net worth is the sum of all assets (real and personal) less totalliabilities.

All officials and employees of the Central Office (including Directors,whether regular or under temporary status (coterminous) shall submittheir accomplishod SALN to the Human Resource DevelopmentService on or beforc 31 llarch 2020. HRMOS shall submit the SALNto tho ffice of the Ombudsman of their respective regions.

R€gional Offices and Attached Agencres are required to lumlrh acopy of the 2019 SALN of 3'd level position incumberlts (Directorlll and lV for Rogional Ofllces lncludlng OlCs and Agency Headsand Deputy Executiv. Directoit or equivalent lavel for AttachedAganciesl to the HRDS duly received by the Clvll ServiceCommisslon/Ofllce of the Ombudeman on or before 30 June2020. These submissions will be the bases for the net worths ofofficials to be posted in the DOLE website.

Regional Offices are required to update and maintein theTransparency Seal section relative to the posting of SALN in theirresp€cliv€ official websites. Net worths of the Regional Directors andAssistant Regional Directors are required to be posted.

:D Ii.1:LOYtlENl

etary

Document ID: Republic of the PhilippinesDepartment of Labor and Employment

ROUTE SLIP

DATE:

[;i'" -l ''(Subject:

MEMO - SUBMISSION OF SWORN STATEMENT OF ASSETS, L|ABILITIES A ID NET WORTH (SALNIFORM FOR CY 2O2O

Descri ption of Documents :

With reference to CSC MC. No. 09 s. 202O Filing and Submission of the Revised Statement of Assets, Liabilities and Net

Worth (SALI.D Form for the Year 2021, all officials and employees are required to file their 2020 SALN. Deadline ofsubmission to the Human Resource Development Service on of before 3 I March 202 I .

DEPARTMENT OF LABOR ANO TM PrOVMtrtOFFICE OF THE ASSISTANT SECRETARI

,* ATTY. PHlr rD A. PAREOES

0t--os 40/JAN 20 2021

g.'d(Time Rec-., -Received by:.Control No.:

rIII ll'.Lhow'fhnir*

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66rxi';odbi: -Ciai,rf.mJ : -FillU J ax-

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OrieinDatc/TimcReceived

From To Action Required/Remarks

,bJanuaryz02l

Human ("*i."ROVELINDA A. DELA ROSA

Director IV, DOLE-IAS

For the Director'sconsideration /endorsementto thc OlC-Undersecretary,

please. Thank you.

A. DELA ROSA ATTY. PHILIPA. PAREDESOlC-Undersecret ry

Concurrent Head DOLE-LS

For the OIC-Undersecretary's

consideration /endorsementto the Undesecretary, please.

Thank you.

A. PAREDESOIC-Undersecretary

Concurrent Head DOLE-LS

RENATO L. EBARLEUndersecretary

For the Undersecretary'sconsideration/endorsem ent

to the Secretary, please.

Thank you.

TO L.Undersecretary

SILVESTRE H. BELLO IIISecretary

For the Secretary'sconsideration, please.

Thank you.

IV, DOLE.IAS