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 OCCENO CLAIROL JOY D. POSITION: TEACHER I
:
(Family Name) (First Name) (M.I.) AGENCY/OFFICE: DEPED
ADDRESS: POBLACION DUMARAO CAPIZ OFFICE ADDRESS: DUMARAO
ILAYA
󠇟 I am married 󠇟 I am not married
SPOUSE: OCCENO LORENZO H. POSITION: OILER
(Family Name) (First Name) (M.I.) AGENCY/OFFICE: ASIAN SHIPPING CORPORATION
OFFICE ADDRESS: CBU CITY
UNMARRIED CHILDREN BELOW EIGHTEEN (18) YEARS OF AGE LIVING IN DECLARANT’S HOUSEHOLD
NAME DATE OF BIRTH AGE
LORENZ KYSLER OCCENO 12-12-21 2
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 VALUE COST
commercial,
(e.g. lot, house and industrial, agricultural (As found in the Tax Declaration of YEAR MODE
lot, condominium and mixed use) Real Property)
and improvements)
Subtotal:
b. Personal Properties*
DESCRIPTION YEAR ACQUIRED ACQUISITION
COST/AMOUNT
CELLPHONE 2020 7,000.00
MOTORCYCLE 2023 82,500.00
LAPTOP 2023 23,000.00
Subtotal: ₱105,507.00
TOTAL ASSETS (a+b): ₱105,507.00
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* Additional sheet/s may be used, if necessary.
2. LIABILITIES*
NATURE NAME OF CREDITORS OUTSTANDING
BALANCE
SALARY LOAN FCB ₱50,000.00
SALARY LOAN CITY SAVINGS BANK(CSB) ₱300,000.00
TOTAL LIABILITIES: P 350,000.00
NET WORTH: Total Assets less Total Liabilities =
* 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 NONE NONE 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
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, 2023
CLAIROL JOY D. OCCENO LORENZO OCCENO
H.
(Signature of Declarant) (Signature of Co-Declarant/Spouse)
Government Issued ID: TIN Government Issued ID: DRIVERS LICENSE
ID No.: 762-002-203 ID No.: LO9-22-307 130
Date Issued: 01/28/2020 Date Issued: 06/28/2022
SUBSCRIBED AND SWORN to before me this day of , affiant exhibiting to me the above-stated
government issued identification card.
_______________________________________
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(Person Administering Oath)
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