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The wealth declaration form; free download, pdf, and guide

Section 26 and 27 of the Public Officer Ethics Act (POEA) requires all public officers to declare their Income, Assets and Liabilities (IAL). Since 2003 when the law requiring Public Officers to declare their Income, Assets and Liabilities (IAL) was enacted, the mode of declaration has been manual. Nowadays, the declaration is done online via portals provided to Public and Civil Servants in Kenya.

The Declaration of Income, Assets and Liabilities form contains the following fields:

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:
a. Postal address
b. Physical address

5. Employment Information:
a. Designation
b. Name of Employer
c. Nature of employment; (permanent, temporary, contract, etc)
d. T.S.C. No.
e. School/Institution
f. District

6. Name of spouse of spouses:
(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)

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.)
c. 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).

d. Liabilities (as of the statement date)

9. Other information that may be useful or relevant.

Declaration;
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: ______________

Also read:

Here is the Wealth declaration form;

Wealth declaration form page 1
Wealth declaration form page 1
Wealth declaration form page 2
Wealth declaration form page 2
Wealth declaration form page 3
Wealth declaration form page 3
Wealth declaration form page 4
Wealth declaration form page 4

Click on the link below to download the form free, in PDF;

wealth_declaration_form

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