Beruflich Dokumente
Kultur Dokumente
Joint Filing
DECLARANT
:
ADDRESS:
Separate Filing
CALULOT
ALEXANDER
D.
(Family Name)
(First Name)
(M.I.)
Homestead,
Bambang,
Not Applicable
Sangguniang Bayan Member
POSITION:
AGENCY/OFFICE:
OFFICE ADDRESS:
Nueva Vizcaya
SPOUSE:
CALULOT
IMEE ANDRE
R.
(Family Name)
(First Name)
(M.I.)
POSITION:
AGENCY/OFFICE:
OFFICE ADDRESS:
UNMARRIED CHILDREN BELOW EIGHTEEN (18) YEARS OF AGE LIVING IN DECLARANTS HOUSEHOLD
NAME
DATE OF BIRTH
AGE
9
7
Real Properties*
DESCRIPTION
KIND
(e.g. residential,
commercial, industrial,
agricultural and mixed
use)
LOCATION
ASSESSED
CURRENT FAIR
VALUE
MARKET VALUE
ACQUISITION
YEAR
ACQUISITION COST
MODE
Subtotal:
b. Personal Properties*
DESCRIPTION
YEAR ACQUIRED
Isuzu Trooper
Appliances
Personal Belongings
2012
2011-2014
2010-2014
ACQUISITION COST/AMOUNT
P450, 000.00
P100, 000.00
P55, 000.00
Subtotal :
TOTAL ASSETS (a+b): P605,000.00
2. LIABILITIES*
NATURE
Consolidated/Policy/Emergency/
Educational Loan
Multi-purpose/Calamity Loan
NAME OF CREDITORS
OUTSTANDING BALANCE
GSIS
P145,000.00
HDMF
P78, 000.00
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BUSINESS ADDRESS
NATURE OF BUSINESS
INTEREST &/OR FINANCIAL
CONNECTION
DATE OF ACQUISITION OF
INTEREST OR CONNECTION
Homestead, Bambang, N. V.
2010
RELATIONSHIP
POSITION
Father
Register of Deeds
MARINELLE M. CALULOT
Sister-in-Law
Clerk of Court
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 aboveenumerated 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:
(Signature of Declarant)
Government Issued ID:
ID No.:
Date Issued:
(Signature of Co-Declarant/Spouse)
BIR - TIN
943-650-024
day of
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BIR - TIN
263-054-099
_______________________________________
(Person Administering Oath)
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