TIN Number and - BFP

MEMORANDUM

TO:

ATTN:

SUBJEGT:

DATE

Republic of the philippines

Department of the lnterior and Local GovernmentBUREAU OF FIRE PROTECTION

NATIONAL HEADQUARTERSAgham Road, Sitio San Roque, Brgy. Bagong pag-asa, euezon City

Tetefax Number: (02) 8426 _ 4399Email: ofc(Obfp. gov. ph

ALL REGIONAL DIRECTORS

Regional SALN Review and Compliance Commiftee

statement of Assets, Liabilities and Networth (SALN) calendarYear 2A21

03 January 2022

1. Referencesa. Section 8, RA 6713.b. CSC MC# 03, s. 2015 dated 17 February 2015.c. OMB MC# 2, dated 02 August 2017.d. CSC MC# 06, s. 2021 dated 24 May 2021.e.2017 Rules on Administrative cases in the civir service (RACCS).t. BFP Memorandum circular No. 2020-001 dated 14 January 2a2o.g. Guidelines in the filling out of SALN Form.h. Sample SALN Form 2019.

2. ln compliance with the mandate of RA 6713, othenruise known as the "Code ofConduct and Ethical Standards for Public Officials and Employees" requiring publicofficials and employees to submit their Sworn Statement of Assets, Liabilities andNetworth (SALN), you are hereby directed to require your personnel within your area ofresponsibilities to submiufile their respective sALNs for cy 2021.

3. ln this connection, all officers/personnel of the BFP-Regional Office/s and thosewho are on detail service at Department of the lnterior and Local Government (DILG) and911 as support personnel shall submit oriqinal copies of dulv accomolished SALNForm to the Regional SALN Review and Compliance Committee Secretanat forevaluation and consolidation prior to submission to the Office of the Ombudsman.Likewise, officers/personnel who are undergoing mandatory training at National FireTraining lnstitute (NFTI) or other training facilities shall submit their SALN to theirrespective mother units.

4. The Regional Compliance and Review Committee shall evaluate/consolidate thesubmitted SALN and prepare SALN Matrix together with the Electronic/Scanned Copyand subsequently submit directly to the Deputv Ombudsman in their respectivereqions (Luzon, Visayas & Mindanao) toqether with electronic copies tfiereof incompact discs (CD) or Universal Serial Bus (USB) flash drive as prescriOeO Oetow:

Ombudsman/CSC Template PBB Tem(Last Name, First Name and Middle Name) and. All capital for officers and small caps for non-

a. Complete the name of personnelrank as of declared Calendar Yearofficers.

b. Complete theNetworth.

TIN Number and

c. n umS m ist noof n-fiary lers, the ilsdeta of rthei nspecify from eth SEseparatio rvtcee. res or thfrom( g igned, rollse withdropped AU) correspondin g hority

edattach onal( Regi Order)d. lnsert numbers in the tem to avoid il out and insertion of6 Complete the

non-uniformedsalarv qrade including

f. Com the ition.report should be signed prepared bv the Chairman. SALN Review

andg. The template

h

the remarks column, indicateioint filinq if spouses who are bothoersonnel assiqned in vour reqionfiled their SALN iointly, the exactabsorotion date for those who werenewly absorbed and effectivitv dateof separation from the service (e.q.dismissal. dropped from the rolls.resiqnation. retirement andtermination) of personnel who filedtheir SALN.

Under

i. The Certification as oer OMB MC#2 dtd02 Auqust 2017 should be included in the

j. The last page of the CSC/OMB Templateis the Certification. The certification shouldbe signed by the members and chairman ofRegional SALN Review and ComplianceCommittee.k. The Template of SALN Non-Filers shall also be accomplished othenrise indicatesnone.L For newly absorbed personnel(December 2021) and separated personnelfor the entire CY 2021 who are filers shallbe in the separate sheets of the sametemplate respectively.

All newly absorbed personnel andseparated personnelwho are filers shallbe included in PBB Template withremarks of effectivity of absorption andseparation date whichever isa licable.

5. Electronic Copy of duly accomplished SALN

5.1 The electronic/scanned copy of duly accomplished SALN of every personnelshould be named per individual folder and document title following the format:SALN of (Last name of personnel) (comma) (space) (First name of personnel)(space) (Middle lnitial). For example, SALN of Dalisav. Cardo T and stored incd/dvd/usb.

5.2 The SALN Matrix with stamp received by the Office of the Ombudsman andthe copy of the PBB Template shall be scanned and emailed atrecords. [email protected]. ph.

6. Further, the Regional Compliance and Review Committee shall submit to theSecretariat, BFP-NHQ (Attn: Records Section/PRMD) NLT 29 April 2022 the foilowingreports in prescribed form and in alphabetical order region wide, failure to comply on thesaid deadline shall attached an explanation for non-submission on time;

a. Matrix of Filers and Non-Filers (Transmittal Received by the Office of theOmbudsman)b. One ('1) Electronic/Scanned copy of duly accomplished SALN of everypersonnel

dismissed,

c. 2 sets of PBB Matrix of Firer and Non-Filer (Hard and soft copy)d. Soft copy of the Transmittal Received by the Office of the Ombudsman and

PBB Matrix email to [email protected]

7. Furthermore, be reminded of some significant details in filing sALN:

a. The date must be completely written (as of 31 December 202{).

b. Personnel who were absorbed on December 202{ shall declare their SALNas of absorption date while retired officers/personnel shall declare their SALNas of their retirement date.

c. ln case of joint filing of spouses who are both qovernment emplovees, thesignatures of both spouses are required.

d. lf the spouse is not a public official or emplovee (eg. self-employed,privately employed and housewife), the declarant shall tick the (r')

-Not

Applicable and the spouse shall sign the SALN. Otherwise, an exnlanationlefter shall be attached to the SALN form for non-comptiance of spousesignature.

e. The declarant is strictly required to fill all applicable information in the SALNform. otherwise, such items should be marked with "N/A" or,,not apolicable,,.

f. Declaration of real properties shall include its description, kind and mostimportantly the exact location shall be the complete address of the property(no., street, sitio/purok, brgy, city/town, and province), year and mode ofacquisition, assessed value, current fair market value, acquisition cost of tand,building, etc. including improvements thereon. lf there is no tax declaration, thedeclarant may indicate "N/A" or "not applicable" in the assessed value andcurrent fair market of the property.

g. ln case of properties received gratuitously, e.g. donation or inheritance, .reacquisition cost shall be declared. However, the cunent fair market valueand the assessed value of said properties as found in the tax declarationthereof must be declared.

h. Additional sheets may be used if necessary. The additional sheets mustindicate the name of the declarant, his/her position, agency name, the yearcovered, the page number and sion on each page to prevent unauthorizedinsertion or pulling out of pages.

i. Filling up of the form may be computer generated or typewritten provided thesiqnature of the declarant is oriqinal. The declarant is required to writelegibly if he/she chooses to fill up the form by handwriting.

j. lf the declarant is the spouse of a BFP officer/personnel, who submitted theirSALN at the declarant's agency, the BFP officer/personnel shall still submitoriginal copies of SALN with the BFP. Othenrvise a certification from thereceiving agency shall be submitted as proof of filing. Same shall be applied tothose BFP personnel whose spouse is also a BFP officer/personnel butassigned to other regions.

k. A comprehensive Guidelines in the filling out of SALN form can bedownloaded at unrrrw.csc.oov.ph for your ready reference.

l. Use the revised 2015 sALN Form, the same can be downloaded in the cscwebsite. (Attached is a sample of accomplished SALN Form marked as.AnnexA',.)

. 8. Section 50 (DX8), Rule 10 ol the 2O17 RACCS state that the faiture to fite SALN isa-less grave offense punishable by suspension of one (1) month and one 1t; oay to six(6) months for the first offense; and dismissal from the service for the second'offense.

9. For your guidance and strict compliance.

CESEBFP(DSc)

Directorial Staff

lmgm/tcuors/desklop/saln cy 2021lmemo saln 2021

,R.Yi3ed as ofJanuary i]0lSPer (SC RHolution No. ISO00EBftomulgated 6n January 2J" 20rS

swoRrt STATEMEIIT or AssETs, LrABrtITrEs aItD ltET woRrHAs ofDecember 3O.20lQ

{Requircd by R.A. 6?lJ}

f,ot* I{as}and and wife who are bath pubtic oflicids andemplaqe*i mag ffu the requbed statefieni-silmtly o, separatelA.fi JaintFiling il Separcte Frting Q Not Applicnbtn

DECIl{I.IIffl Dela Cruz Juan Clerk VName) (First Name| {M.r.}

FOEr?Iot{;AGEilC{/OPFICE:O]rFICE ADDI'ESS:

CiYilAI'DRSg83 I Risal $1.,

Batasan

SBOUSE: Dela Cruz Jua.tra M. ITOSITIO!{:ACETCYIoFTICE:OfFICSADDR"ASA:

Director Ii

xor,nI{IIITE

Gabriel M. dela CrtraMichael M. dela Crue 9Angelica M dela Cruz i 7 2

N N/A

Manila csc

DATE OT BIn?'Ir/2/2OA3

AGE

13

0I

tsEr& I,Ii8JfmIe8 AI{l} SplWOnTrr{lnctuding thase af the spouse and unmarried- iiitaren aetow eighteen (I g}

Wars of age liuirE in deelarant,s hausehald.)

1. ASsET8

&. Reel Prolrcttlor*

b. Pereonal Prcpeilles*Subtotel: P7,B(Xtr0q_O.OO

Srbtotet! pBJlSe,Ofn.OO

TOTAL ASSETGI {a+b}: pt 1,OS0,(X)O.(X)

House andL,ot {mort.l

Residential I Riual 31.,Sampaloc. Manila

PSOO,OOO.OS P1,500,(}$0.oo 2003 Sale withmortgage

P5,OO0,000.oo

Building{).13 co-owncd}

Cornmercial I Quezon Ave.,Tandang Sora,

Cavite

Pr,200,o0s"$0 P2,000,000.00 2000 Deed ofSale

P1,500,000.oo

Farm lot Agricultural Brgr" Kaligayahan,Cavite

P90$,O00.co P1,200,O00.00 2010 Inherited o

Lot Mixed use Santa Fe Subd.,Brgr. Ana, Queaon

City

1600,o00.00 P80S,000.0* 2008 Deed ofSale

P1,300,0O0.00

2015 P500,000.00Fumifiirr 2LlO$present P150,000.00

2000-prcsent P200,000.c0$hares ofstock 2013 P50,000.00

* Ad.d.itiofla,l sheet/ s mag be used, gt necessnry.

Page I al4

{Family

{Firsr Nanre} {M.r.}

i

I

Applianes

2. LIABILITIES*

T0TAL LLABILITIE$I !$$01@!{1_ltET YORTII : Totel Att tt lcra Total Llabllltles = P6"69O,(X)O.O0

E* Additional sheet/ s rnag be used, tf necessary.

BUSilTE$S IITTEnEATE AnD rIXAlrCIAL CQr{I{ECTI'o$Sld DecIarant l Declo:ant's spouse/ Unmarbd Childrea Belsw E$hteen (18j gears of Age Uuing in Dedcrantk Househatd.)

J I/We do nat hsve ang business intsrest or ftnnncial trtnneetran.

Ber"Afl_lrE$ rlt firp qo.wgiln0E[!_*E8l[eElWtlhifl lhe Faur*t D*gree af Consanguinig ar AffuiE- In*lude also Brlas, Sclae altd lasoi

A I/We da rwt krow af ang relatiuels in the gouemment seruice)

I hereby certr*/ that these ere true and cprrecl statemerrt$ of my a$sets, liabilities, net wrrrJh,

businese interests and financial ccnnections, including those of my spouse and un&arriecl children beloweighteen {18} years sf age living in r:ry hcusehold, and that to the best of my knowiedge. the above-

enurnerated are names of my relatives in the government within the fourth civil degree of eonsanguinily or

allinity"

I hereby authorize the Onnbudsrran 6r his/her duiy authorized representative to obtain and

$ecure from all appropriate governmerit egerrciee, includi*g the Bureau of lnternal Revenue sruch

documents that mey show my asseta, liabilities, net worth, bueiness intereste and Iinancial connections,

to include those of rny strouse and unmarried children below l8 years of age iiving with me in my

household coveriRg previous years to include the year I {irst assumed office in government,

Dater 03/1512019

Spousel

Cowmment le€ued ID:lD No.:Datc Issued:

csc lDI 23456.ar/02l2or8

Covemmffrt lssued ID; *g!gl&-.-.----_-_-ll-] No.: 987654$ate lssu*d: guqs#qi!

-affiant exhibiting to me the e-bcn e-BUBSCRIBEDAIID$fIOBII to before me this i5 day of

$tated gwernme.nt issued identification card.

Personal debr Fxidie dela Cruz P800,000.n0

P2.5il0.000.00Housing loan Pag"IBIG

Contmct to Se:l DMCI Pl,{}00,000.0o

CSIS Multipurpose loan csts P60,000.0o

Sea Travel and Tours Agapito $t., Sampaloc,Manila

Owner 20r 5

N/AN/A N/a N/AN/A N/A N/A N/ANIA N/A N14 NIA

Nadine Lustre sister Attornev Y DepBrtment of Educa.tian, Quezon Citr

James Reid cousln Prooert!'Oflicer III Depprtment of Prrblic Works and Highwav, Pasis

Anne Curtig au$t Health 0lficer Municipality of Bukid, Batangas

N/A N/A rc/A N/.{

il1.4 I{/A NIA HIA

Page 2 ot'4(Persan

EUSffSSA T.DDR&AS p*ra_.or lswrfirflof 0rITTEREST OB OomElgrrcr

1

tlAMpr Dcla Cruz

r. a88ET8&. Raal propertier

NIA

b. Pcreonel Propcrtes

2, LIABILITIES

Juan M, POSITIOIT:AGEilCY/OTFICE:firirst Na.!le)

AqqFTS. LTABILITIEE AI{D ilET \YORTII

Rerisrd as of ?O l B

Pcr CEC Rcsotution i{o. 130{Og8Promu.lgated dn Januaty 23, 2015

Clerk v

@--*

$ubtotalr Fhp o

Sr$totel : rftp ApE{),OOO.OO

TOTAL ASlSElg la*bf: rhp 2,35O,OOO,OOklE

slroRr{ srA?EMtHT or AssETs, LlABrtrrrs$ AND lrET TFORTHAs ofDecember il, ZQJ&

{Additional sheetls /or the d.eclarant)

N ATO?AI, LTABILI?IE$: A

Busnrpss il{TERESTS .A}rp rraAltcl&_" COm{ECTrOryQ

condorninium residential SM Prima Tovcrs, ED8A,

Mandaluyong CityP1,000.00{}.00 Pt,750,{}u,0.o0 2016 donation 0

NIA N/A NIA N/A N/A NIA N/r\

N/A N/A N/A N/A NIA N/A Nlrl N/rr

NIA N/A N/A Itl/.C l{lA N/A N/A N//\

P 00Mitsubishi MonteroP1201u

2012 pCash in bank

2{J{10 P 800,000.00Cash on hand 2018

NIA .N/ArryA A

NA

*ryL

NIA NIA N A, A$.{A A

N N/AN/A A NIA N/A

Page 3 of4

t

I

P 200,oo0.o0

I

N/A N/AN/A N/A

$rATE![E!5ToF&ssErf,LIABILIfiE$AIIDrBrgoRTIIAs of December 31. LO18

{Additio*st sheet/ s for the exclusiue praperties a! the decleranf 's spouse and unmaried child"ren

betaweEhteen{18}gearso!*gelivingindecl:arant,shau^sehold}

Clerk lll

R€vised As nf 20 1 a

FeTCSC Rgolution Ho l5O0O8$

I'rornulgated on Janua:1 ?3, 2t)15

Ciuil Scrvicc CnmmtssionI{ASD: Dela Cruz Juan M.

-lFffiName) (First NEme) lM.l.)

POSI?IO!{':AGBI{CYIOTFICD:

1 AS8ETS

r. ReelPrcperticr

b. Perroael Pro1rcrdts

2. LIASILITIES

assETs. TIABILITIE$ AnD flg-f $foRTH

BgsI@ rI!{A!{CLiL colrlTEcTIOI{S

donation 02018P2lO,OOO.O0Pl50,o$o.00tsrgr. Xaligayahan,Sto. Tomas,

lot agriculturai

N/,\N/A N/AN/ANIAN/ANIANIA

N/A N/r\N/AN/AN/AN/AI

N/AN/A

N/r\NIAN/AN/AN/AN/Ar'r/AN/A

N/ltN/AAN/ltAN AN/ltN/AN AN/ltN ANIA

N/AN/AAN/&_ _t\ ,{N/ANA

N

l\A

N/AN/AAN/AN AltN/AA

tl

NN/AN/A

-P*ge 4 aJ 4

I

I

II

1

NiANIAN/ANIA