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    TSC Wealth Declaration

    Uploaded by

    Mutai Kiprotich
    This document is a declaration of income, assets, and liabilities form required by the Public Officer Ethics Act of Kenya. It requires a public officer to disclose personal information including name, birth details, employment, marital status, dependents, and a financial statement listing income, assets, and liabilities for the officer and their spouse and dependents. The financial statement must include descriptive details and approximate monetary amounts and covers the period from the previous declaration to the current statement date.

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    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    TSC Wealth Declaration

    Uploaded by

    Mutai Kiprotich
    4K views4 pages
    This document is a declaration of income, assets, and liabilities form required by the Public Officer Ethics Act of Kenya. It requires a public officer to disclose personal information including name, birth details, employment, marital status, dependents, and a financial statement listing income, assets, and liabilities for the officer and their spouse and dependents. The financial statement must include descriptive details and approximate monetary amounts and covers the period from the previous declaration to the current statement date.

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    tsc wealth declaration form

    Original Title

    Tsc Wealth Declaration

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    © Attribution Non-Commercial (BY-NC)

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    This document is a declaration of income, assets, and liabilities form required by the Public Officer Ethics Act of Kenya. It requires a public officer to disclose personal information including name, birth details, employment, marital status, dependents, and a financial statement listing income, assets, and liabilities for the officer and their spouse and dependents. The financial statement must include descriptive details and approximate monetary amounts and covers the period from the previous declaration to the current statement date.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    4K views4 pages

    TSC Wealth Declaration

    Uploaded by

    Mutai Kiprotich
    This document is a declaration of income, assets, and liabilities form required by the Public Officer Ethics Act of Kenya. It requires a public officer to disclose personal information including name, birth details, employment, marital status, dependents, and a financial statement listing income, assets, and liabilities for the officer and their spouse and dependents. The financial statement must include descriptive details and approximate monetary amounts and covers the period from the previous declaration to the current statement date.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    The document outlines the requirements for public officers in Kenya to declare their income, assets and liabilities on an annual basis as required by law.

    The declaration form requires public officers to provide personal details like name, address and employment information as well as disclose sources of income, descriptions and values of assets and liabilities for the reporting period.

    Public officers are required to declare their income, assets and liabilities to promote transparency and accountability. It helps determine if there are any conflicts of interest between private financial interests and public duties and prevents corruption and abuse of office for private gain.

    POEA.

    REPUBLIC OF KENYA
    THE PUBLIC OFFICER ETIHCS ACT, 2003
    (No. 4 of 2003)
    Declaration of Income, Assets & Liabilities (section 26)
    1.

    Name of the Public Officer

    (Surname)

    (First name)

    (Other names)

    _________________________________________________________________________________
    2.

    Birth Information
    a.

    Date of birth __________________________________________________________

    b.

    Place of birth _________________________________________________________

    3.

    Marital Status _______________________________________________________________

    4.

    Address

    5.

    a.

    Postal address ________________________________________________________

    b.

    Physical address _______________________________________________________

    Employment Information
    a.

    Designation __________________________________________________________

    b.

    Name of Employer ____________________________________________________

    c.

    Nature of employment (permanent, temporary, contract, etc)


    ____________________________________________________________________

    6.
    (i)

    d.

    T.S.C. No. ___________________________________________________________

    e.

    School/Institution ______________________________________________________

    f.

    District ______________________________________________________________

    Name of spouse of spouses


    (Surname)

    (First name)

    (Other names)

    ___________________________________________________________________________
    (ii)

    (Surname)

    (First name)

    (Other names)

    ___________________________________________________________________________

    iii)

    (Surname)

    (First name)

    (Other names)

    ___________________________________________________________________________
    (iv)

    (Surname)

    (First name)

    (Other names)

    ___________________________________________________________________________
    (v)

    (Surname)

    (First name)

    (Other names)

    ___________________________________________________________________________
    (vi)

    (Surname)

    (First name)

    (Other names)

    ___________________________________________________________________________
    (vii)

    (Surname)

    (First name)

    (Other names)

    ___________________________________________________________________________
    7.

    Name of dependent children under the ages of 18 years

    (i)

    (Surname)

    (First name)

    (Other names)

    ___________________________________________________________________________
    (ii)

    (Surname)

    (First name)

    (Other names)

    ___________________________________________________________________________
    (iii)

    (Surname)

    (First name)

    (Other names)

    ___________________________________________________________________________
    (iv)

    (Surname)

    (First name)

    (Other names)

    ___________________________________________________________________________
    (v)

    (Surname)

    (First name)

    (Other names)

    ___________________________________________________________________________
    (vi)

    (Surname)

    (First name)

    (Other names)

    ___________________________________________________________________________
    (vii)

    (Surname)

    (First name)

    (Other names)

    ___________________________________________________________________________
    (viii)

    (Surname)

    (First name)

    (Other names)

    ___________________________________________________________________________
    (ix)

    (Surname)

    (First name)

    (Other names)

    ___________________________________________________________________________
    8.

    Financial statement for ________________________________________________________

    (A separate statement is required for the officer and each spouse and dependent child under the age
    of 18 years. Additional sheets should be added as required)

    a.

    Statement date

    (Statement date is the first day of the month preceding the month in which the declaration is due.)
    b. Income, including emoluments, for the period from
    _____________________________________to________________________________________
    (Including, but not limited to, salary and emoluments and income from investments, the period is
    from the previous statement date to the current statement date. For an initial declaration, the period is
    the year ending on the statement date.)

    Description

    c.

    Approximate amount

    Assets (as of the statement date)

    (Including, but not limited to land, buildings, vehicles, investments and financial obligations owed to
    the person for whom the statement is made)
    Description
    (Including the location of asset where
    applicable)

    Approximate amount

    d.

    Liabilities (as of the statement date)

    Description

    9.

    Approximate amount

    Other information that may be useful or relevant

    I solemnly declare that the information I have given in this declaration is, to the best of
    my knowledge, true and complete.

    Signature of Officer: ________________________________________________________________


    Date: ____________________________________________________________________________
    Witness:
    Signature: ____________________________________________________________
    Name: _______________________________________________________________
    Address: ________________________________________________________

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