Escolar Documentos
Profissional Documentos
Cultura Documentos
NAME OF CANDIDATE:
A.1.
(SURNAME)
ELECTIVE POSITION:
A.4.
A.5. CONSTITUENCY OF THE ELECTIVE POSITION:
E-MAIL ADDRESS:
PERMANENT ADDRESS:
A.7.
(HOUSE NO./UNIT)
(BARANGAY) (DISTRICT/AREA)
Doc. No.:
Page No.:
Book No.:
Series of
(CITY/MUNICIPALITY) (PROVINCE/REGION)
(CITY/MUNICIPALITY) (PROVINCE)
RCES:
TY: (for candidates with parties only)
sharing of information obtained in this disclosure and its attachments for legitimate and
(This space is for the receiving date/time stamp of the receiving office)
COMMISSION ON ELECTIONS
May 13, 2019
Nati
Schedule of Contributions Received
(Type and
Source)
TOTAL CONTRIBUT
CERTIFICATION A
I hereby certify that:(1) the contributions listed above were made to me as a candidate; (2) all SUBSCRIBED AND SWORN
entries specified above are true & correct; (3) they are supported by the official receipts issued by
me upon acceptance; (4) the contributions are from sources not prohibited by the Omnibus
Election Code and other pertinent laws.
I hereby certify that:(1) the contributions listed above were made to me as a candidate; (2) all
entries specified above are true & correct; (3) they are supported by the official receipts issued by affiant exhibiting his/her
me upon acceptance; (4) the contributions are from sources not prohibited by the Omnibus issued by the
Election Code and other pertinent laws.
DATA PRIVACY ACT
The undersigned consents on the general use and sharing of information obtained in this disclosure and
its attachments for legitimate and authorized purposes.
(MIDDLE NAME)
DESCRIPTION
AMOUNT/VALUE OF CONTRIBUTION
(for in-kind contributions)
NOTARY PUBLIC
COMMISSION ON ELECTION
May 13, 2019
N
Schedule of Expenditures
NAME OF CANDIDATE:
(SURNAME)
3
SCE
(MIDDLE NAME)
AMOUNT/VALUE OF EXPENDITURE
₱0.00
GMENT
[date of oath]
[date of expiry].
NOTARY PUBLIC
COMMISSION ON ELECTIONS
May 16, 2019
Na
A.2.
CANDIDATE TYPE:
(Use "X" in appropriate box)
Doc. No.:
Page No.:
Book No.:
Series of
ON ELECTIONS
4
Summary
SLE
(CITY/MUNICIPALITY) (PROVINCE/REGION)
lative to candidacy;
aring of information obtained in this disclosure and its attachments for legitimate and
NAME OF CANDIDATE:
candidate or with my authority by my duly authorized representative; (2) all entries affiant exhibiting his/her
issued by the
specified above are true & correct ; (3) they are supported by contracts,
promissory notes & other similar documents.
DATA PRIVACY ACT
The undersigned consents on the general use and sharing of information obtained in this
disclosure and its attachments for legitimate and authorized purposes.
REMAINING
PURPOSE
DESCRIPTION OF THE OBLIGATION
(FIRSTOBLIGATION
NAME) (MIDDLE NAME)
AMOUNT/VALUE OF OBLIGATION
(for
(i.e. loan, etc.) (Partial Payments
incurring obligation)
were made)
TOTAL UNPAID OBLIGATIONS
ACKNOWLEDGMENT
CRIBED AND SWORN TO BEFORE ME this [date of oath]
NOTARY PUBLIC