STATEMENT OF ASSESTS, LIABILITIES AND NET WORTH AND DSICLOSURE OF BUSINESS INTERESTS, FINANCIAL CONNECTIONS AND RELATIVE/S IN THE

GOVERNEMENT SERVICE As of December 31, _2011_ (Required by R.A. Nos. 3019 and 6713) (Note: Husband and Wife who are both public officials or employees may file the require statement jointly or separately) Jointly filed. Separately filed. Name_________Morales_________Mark Anthony______________S.____ (Surname) (First Name) (Middle Initial) Address _____B-7 Buenavista, Agusan del Norte______________________ _____________________________________________________ I am married I am not married. Spouse _______________________Not Applicable___________________ (Surname) (First Name) (Middle Initial) Position _______Secondary School Teacher II_______________ Office Address ______Buenavista SPED-ISS_________________ ____________________________________

Position ________________ Not Applicable ________________ Office _______________________________________________ Office Address ________________________________________ Unmarried Children below 18 years of age living in his/her household: (use additional sheets/s, if necessary) Name Date of Birth 1. _______________________________________________ ___________________________________________________ 2. _________________ Not Applicable_________________ ___________________ Not Applicable___________________ 3. _______________________________________________ ___________________________________________________ I have no children below 18 years of age living in my household. ASSETS, LIABILITIES AND NET WORTH I. ASSETS (Including that declarants spouse and unmarried children below 18 years of age living in his/her household) A. REAL PROPERTY/IES (Use additional sheet/s, if necessary) NATURE OF LOCATION ACQUISITION (Res./Comm./Ag PROPERTY ri., etc.) MODE YEAR (Paraphernal, KIND
conjugal or community)

ASSESSED VALUE

FAIR MARKET VALUE

ACQUISITION COST
Land Building, others

Improvement/s

Not

Applicable

Not

Applicable

TOTAL: ___________________ B. PERSONAL PROPERTY/IES AND OTHER ASSETS (Use additional sheet/s, if necessary) TANGIBLE ACQUISITION MODE YEAR Computer Clone CPU only Cash 2011 INTANGIBLE TOTAL: ____ P 11, 800.00_______ *For computation purposes, use acquisition cost. Properties of unmarried children below 18 years of age living in his/her household shall be excluded as well as the paraphernal/exclusive properties of spouse, in case of separate filing. Total: Assets (A+B)= ____ P 11, 800.00_____ II. LIABILITIES (Including that declarants spouse and unmarried children below 18 years of age living in his/her household) NATURE NAME OF CREDITOR/S *OUTSTANDING BALANCE Policy Loan GSIS P 13,000.00 Consolidated Loan GSIS P 36,000.00 ACQUISITION COST P 11, 800.00

Use additional sheet/s, if necessary)

Total: ________P 49,000.00__________

*In the computation of outstanding balances, properties of unmarried children below 18 years of age living in his/her household shall be excluded as well as the paraphernal/exclusive properties of spouse, in case of separate filing.

III. NET WORTH (TOTAL ASSETS (I) LESS TOTAL LIABILITIES (II) = NET WORTH (III) TOTAL NET WORTH: ___________-__P 37, 200.00___________________

NATURE
(Salary/income, business, etc.)

AMOUNT AND SOURCES OF GROSS INCOME (ALL amount received from ALL sources for the preceding calendar year) SOURCES DEPED Friends/Co Teachers DEPED

AMOUNT

Salary Honorarium Bonuses Use additional sheet/s, if necessary)

P 219.996.00 P 5,000.00 P 29,000.00 TOTAL: __________P 253,996.00_________

AMOUNT OF PERSONAL, AND FAMILY EXPENSES

(For the preceding calendar year)

PERSONAL EXPENSES Clothing, food, transportation, Leisure and gadgets Use additional sheet/s, if necessary)

ESTIMATE AMOUNT P 35,000.00

FAMILY EXPENSES Food, Minor repairs and projects Transportation, clothing

ESTIMATED AMOUNT P 120,000.00

TOTAL: ______P 35,000.00_____________ AMOUNT OF INCOME TAXES PAID

(For the preceding calendar year)

TOTAL: __P 120,000.00_________

NATURE Compensation Salary Business Income Other Income Use additional sheet/s, if necessary) BUSINESS INTERESTS AND FINANCIAL CONNECTIONS

AMOUNT P 24269.28

TOTAL: ____P 24,269.28.00_____________

(Declarant/Spouse/Unmarried Children below 18 years of age living in the household of declarant) (Use additional sheets/s if necessary) I/ We dont have any business interests and financial connections.

Name of Entity/Business Enterprise None

Business Address None

Nature of Business Interest and/or Financial Connection None

Date of Acquisition Interest or Connection None

RELATIVE/S IN THE GOVERNMENT

(Up to the 4th civil degree of relationship. Either by consanguinity or affinity, including bilas, inso and balae) (Use additional sheets/s if necessary) I/ We dont have any relative/s in Government.

Name of Relative Osea S. Makiling Alex A. Gamolo

Relationship
Auntie Uncle

Position
COMELEC Officer DAR Officer

Name of Office & Address

Butuan City Province/ Agusan del Norte

I /We hereby certify that these are my/our true and detailed assets and liabilities, net worth amount and resources of income., personal and family expenses amount of income taxes paid, business interests, and financial connections, including those of my spouse and my/our children below 18 years of age living in my household, and the name/s of my relative/s in the Government, as of December 31, ______ as required by and in accordance with Republic Act No. 3019 and 6713. I/We hereby authorize the Ombudsman or his duly authorized representative to obtain and secure from all appropriate agencies, including the Bureau of Internal Revenue, such documents that may show such assets, liabilities, net worth, business interests, and financial connections, including those of my spouse and my/our children below 18 years of age living in my household, covering previous years, and if possible, including the year I/We first assumed in Government. I/We further undertake to produce all supporting document of each of the entries herein made when required. Declarants Signature: _______________________________________ Date:___________________________1-25-2012_________________ (For Separate Filing) Spouse Signature: ___________________________________________ N.A. Date:_______________________________________________________________________

SUBSCRIBED AND SWORN TO before me on this ___25th_ day of ___January____, 20__12___ affiant(s) exhibiting his/her their tax identification number/s _927-433692____________and employee number/s_____2020020___________________________.

FRANCISCO Y. CHAN JR.

(Municipal Mayor of Buenavista Agusan del Norte)