SALN-DONNA As of 2023

Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 4

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 LUNA DONNA B. POSITION:


: NURSE II
(Family Name) (First Name) (M.I.) AGENCY/OFFICE: DEPARTMENT OF HEALTH BICOL
CENTER FOR HEALTH
DEVELOPMENT
ADDRESS: PUROK 5 BINODEGAHAN, OFFICE ADDRESS: LEGAZPI CITY ALBAY
PIODURAN ALBAY

SPOUSE: POSITION:

(Family Name) (First Name) (M.I.) AGENCY/OFFICE:


OFFICE ADDRESS:

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


HOUSEHOLD

NAME DATE OF BIRTH AGE


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*

DESCRIPTIO KIND EXACT ASSESSED CURRENT FAIR ACQUISITION ACQUISITION


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

NONE

Subtotal: 0.00
b. Personal Properties*

DESCRIPTION YEAR ACQUIRED ACQUISITION


COST/AMOUNT

ELECTRONIC GADGETS 2021 Php 62,000.00


APPLIANCES 2020 Php 34,000.00
CLOTHING AND ACCESSORIES 2021 Php 50,000.00
MOTORCYCLE 2018 Php71,000.00
Subtotal : Php
217,000.00

TOTAL ASSETS (a+b): Php217,000.0


Page 1 of 2
0
* Additional sheet/s may be used, if necessary.

Page 2 of 2
2. LIABILITIES*

NATURE NAME OF CREDITORS OUTSTANDING


BALANCE

NONE

TOTAL LIABILITIES: 0.00


NET WORTH : Total Assets less Total Liabilities = Php217,000.00
* 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 BUSINESS ADDRESS NATURE OF BUSINESS DATE OF ACQUISITION OF


ENTITY/BUSINESS INTEREST &/OR FINANCIAL INTEREST OR CONNECTION
ENTERPRISE CONNECTION
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
ALFRANCIS LUNA BROHER STAFF PNP/ PIO DURAN ALBAY
SARGEANT
MARCO LUNA BROTHER TECHNICAL PHILIPPINE COAS TGUARD/QUEZON CITY
SARGEANT

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: December 31, 2022

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

Government Issued ID: PRC LICENSE Government Issued ID:


ID No.: 0830529 ID No.:
Date Issued: 2/242014 Date Issued:

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

_______________________________________
Page 3 of 2
(Person Administering Oath)

Page 4 of 2

You might also like