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SWORN STATEMENT OF ASSETS, LIABILITIES AND NET WORTH

As of December 31, 2015

(Required by R.A. 6713)

DECLARANT: FURIGAY , RENANTE LAVADIA POSITION: SPO4 - PLATOON SER

(Family Name) (First Name) (M.I.) AGENY/OFFICE: 1MC, RPSB2, PRO2,

ADDRESS: # 14-A MAGUIGAD STREET , ATULAYAN SUR OFFICE ADDRESS: BARANGAY MALAPAT,

TUGUEGARAO CITY, CAGAYAN - 3500 CORDON, ISABELA

SPOUSE: FURIGAY SUSAN MONTEREY POSITION: OVERSEAS FILI

(Family Name) (First Name) (M.I.) AGENY/OFFICE: EMRY'S

OFFICE ADDRESS: HONG

UNMARRIED CHILDREN BELOW EIGHTEEN (18) YEARS OF AGE LIVING IN DECLARANT'S HOUSEHONAME DATE OF BIRTH AGE

KATHLEEN RACHEL M. FURIGAY March 26, 1993 23

KATHLEEN JOY M. FURIGAY April 25, 1994 22

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

KIND LOCATION ASSESSED VALUE ACQUISITION

(e.g. lot, house and (e.g. residential, (As found in the Tax Declaration of YEAR MODE

lot, condominium commercial, industrial, Real Property)

and improvements)

House & Lot ResidentialTug City CagayanP 1,200,000.00 P 1,000,000.00 2002 Installment

Subtotal:

DESCRIPTION YEAR ACQUIRED ACQUISITION C

Tricycle CY-2009 P 100,0

Jewelry CY-1992 50,00

Furniture and Appliances CY - 1992 115,0

Clothings CY- 1992 TO PRESENT 120,0

Subtotal:

TOTAL ASSETS (a+b):

2. LIABILITIES*NATURE NAME OF CREDITORS OUTSTANDIN

Salary Loan AFPSLAI P 175,

P 173,TOTAL LIABILITIES:

Note:Husband and wife who are both public officials and employees may file the required statements jointly or sep

qJoint Filing qSeparate Filing qNot Applicable

a. Real Properties*

DESCRIPTION CURRENT FAIRMARKET VALUE

agricultural & mixed

use)

b. Personal Properties*


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NET WORTH : Total Assets less Total Liabilities =


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EANT

INO WORKER

GENCY

ONG

D

ACQUISITION COST

P 800, 000.00

1,200,000.00

ST/AMOUNT

00.00

.00

0.00

0.00

P 385,000.00

P 1,585,000.00

BALANCE

14.00

97.00P 349,311.00

arately.


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P 1,235,689.00


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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'

NAME OF ENTITY/BUSINESSBUSINESS ADDRESS

NATURE OF BUSINESS

ENTERPRISE INTEREST AND/OR

FINANCIAL CONNECTION

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)

NAME OF RELATIVE RELATIONSHIP POSITION NAME OF AGENCY/OF

JOSE C. FURIGAY UNCLE SUPERVISOR/SG BSP-TUGUEGARAO CITY CAGAY

JOSHUA C. FURIGAY COUSIN POLICE OFFICER 3 ROPD, PRO2. TUGUEGARAO CI

BONG- BONG F. LOPEZ COUSIN SERGEANT MARINES, TAGUIG, METR

I hereby certify that these are true and correct statements of my assets, liabilit

business interests and financial connections, including those of my spouse and unmarried child

eighteen (18) years of age living in my household, and that to the best of my knowledge, the abov

enumerated are names of my relatives in the government within the fourth civil degree of consan

affinity.

I hereby authorize the Ombudsman or his/her duly authorized representative to obtain

secure from all appropriate government agencies, including the Bureau of Internal Revenue suc

documents that may show my assets, liabilities, net worth, business interests and financial con

to include those of my spouse and unmarried children below 18 years of age living with me in m

household covering previous years to include the year I first assumed office in government.

(Signature of Declarant) (Signature of Co-D

Government Issued ID : PNP Government Issued ID :

ID No. : 15B10029 ID No. :

Date Issued : February 10, 2015 Date Issued :

to me the above-stated government issued identification card.

(Person Admini

qI/We do not have any business interest or financial connection.

qI/We do not know of any relative/s in the government service)

Date:March 01, 2016

SUBSCRIBED AND SWORNto before me this _______ day of __________________, affiant ex


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Household)

DATE OF ACQUISITION

OF INTEREST OR

CONNECTION

N/A

ICE AND ADDRESS

AN

Y CAGAYAN

MANILA

es, net worth,

en below

e-

guinity or

and

ections,

clarant/Spouse)

stering Oath)

ibiting

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