Saln Form JL

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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 31 December 2022
(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: Valencia Jesel Love P. POSITION: CG P/ENS


(Family Name) (First Name) (M.I.) AGENCY/OFFICE: DOTR-PCG/Head Quarter
CGETDC/OT5
ADDRESS: DBBI Campus, Iloilo City, Iloilo OFFICE ADDRESS: Coast Guard Base Farola Muelle Dela
Industria, Binondo Manila

SPOUSE: Valencia Agape Lovelle N POSITION: N/A


(Family Name) (First Name) (M.I.) AGENCY/OFFICE: N/A
OFFICE ADDRESS: InN/A

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

NAME DATE OF BIRTH AGE


Jesham Love P. Valencia March 4, 2018 4
Jezekiel Love P. Valencia January 2, 2020 3

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 LOCATION ASSESSED CURRENT FAIR ACQUISITION ACQUISITION COST


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

N/A N/A N/A N/A N/A N/A N/A N/A


Subtotal: N/A
b. Personal Properties*

DESCRIPTION YEAR ACQUIRED ACQUISITION COST/AMOUNT

Cellphone 2022 Php 29,000.00


Clothing & Accessories 2022 - 2023 Php 69,000.00
Kia Sportage 2022 Php 250,000
Subtotal : Php 348,000.00
TOTAL ASSETS (a+b): Php 348,000.00
2. LIABILITIES*

NATURE NAME OF CREDITORS OUTSTANDING BALANCE

N/A N/A N/A


TOTAL LIABILITIES: N/A

NET WORTH : Total Assets less Total Liabilities = N/A


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

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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

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 POSITIO NAME OF AGENCY/OFFICE AND ADDRESS


N
Jeryle Hope P. Valencia Brother T! DepEd Sagay

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: 24 January 2023

Jesel Love P Valencia N/A


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

Government Issued ID: PRC I.D Government Issued ID: N/A


ID No.: 1466673 ID No.: N/A
Date Issued: 22-6-2019 Date Issued: N/A

SUBSCRIBED AND SWORN to before me this 24th day of J a n u a r y 2 0 2 3 , affiant exhibiting to me


the above-stated government issued identification card.

(Person Administering Oath)

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