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 . ANNEX "B'

AUTHORIry TO RECEIVE ELECTOML CONTRIBUTIONS

AND/OR INCUR ELECTORAL EXPENDITURES

TO WHOM IT MAY CqNCERN:

This is io certiry that of

is dLrly authorized by the Undersigned to receive electoral contributions and/or incur

electoral expenses in my behalf as a candidate of the political party herein below indlcated
ir connection with the eledions on 20-.

( sisnature abave printed fuil nane af candidate/treasurer)

Authorized amount of
Expenditures
(In words and in figures)
Camplete Address/E-ma il Address/Tet. No

(Ph p
office ( and canstituency) to which candklate seeks
to be elected or palitical party treasure
 ANNEX "C"

STATEMENT OF ELECTION CONTRIBUTIONS AND EXPENDITURES

Date of Election

FULL NAME OF CANDIDATE/PARTY TREASURER FILING THE STATEMENT:

COMPLETE OFFICE/RESIDENTIAL ADDRESS/E-MAIL ADDRESS/TEL' NO. OF

CANDIDATE/ TREASURERI

OFFICE FORWHICH THE FILER IS A CANDIDATE OR POLTTICAL

PARW/ORGANIZATION
OF TREASTJRER-FILER:

PERIOD COVERED: TO

CONTRIBUTIONS RECEIVEDT
( Attach schedule l or it€mized contributlons)

Tota contributions from p;liticalparty organizalions - -

T06l rtion5 ron orhe oer:ors
Lonu io
_- --' P
TOI^L CON-D BUTIO\5 A,-CC'VEDI

EXPENDITURES INCURRED:
( Attach schedule 2 for,itemiz€d expenditures)

. For.andidater
Total expenditures paid by candidate oLrl of personal lunds ' - - P
Total expenditurcs pajd out of cont butions received
_''----- P
TOTAL EXPEN'ITURESiINCURRED - - - - - ' ' ' P

i
' For PartyTreaslrer:
Totdl expendjtures paid bv national office
_ P
Totalexpendiiurespaidbybranches/chaplerc/comrniitees-__'-- P
TOTAL EXPENDITURES INCURRED - - - - - - - - ' ' P

Republic of th€ Phit'ppines

I, after being duly sworn to, herebY depose and state thar:
1: The fo.eqojng staternenl and sLlppoiling docurnents ( Schedule 1 and 2) are supported by
,..einis. vouchers and other documents refleciinq the full, true, accu.ate and complete eleciion cont butions
recei;e; .id e/pendiiures inclrrcd by me and/or bv mv dllv authorized representaiive durins the period
indjcated; i
2, The expenditures incurred ar€ lor laMul purposes- and the conLributions wer€ nol received
lrom persons or entitjes p;ohibited by law to give contribuiions
IN WITNESS WHEREoF, I have her€unto alJixed my signature this of
201_.
-
( signature of ca ndldate/treaslred

SUBSCRIBED AND SWoRN io befor€ nre this day of 20-, afflant eYhibiiinq
to me his ]deniificaflon Card No.
l sred o/_ w .e oadae
- Noiary P!bLic

Page No, :
- -
Book No, r_
Series ol20l_
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l,ax,lirl llxpenditrues of n Caudidnte or Political Partl'

in connection with the l\{ay :10, 2010 National and Local Elcctious

NAI'IE OF CANDII]ATII/PAIITY TRI]ASURER TlLING TIID STATllMENT:

PLACI]:
(]OT,IPLETE OFFICE/tIES ID ONTIAL ADDRESS OF CANIIIDAT E/TREA!iURERJ

(:ONTA(]T NT]I\'IBIIR,/S:

FI-A.TURI]] AN{OfINT
-A.. Travelling Expenses {rlthe candi.lates
aDd c.mpaicr personncl iD thc
corlsc ofthe campnign and fo).
Dersonal exnenses incident thcteto
B. ComFensation of campxigners,
clerks, sienographe.si nessetrgcrs,
an{l olher pcrsons acttrally €mployed
In the cimDaicn
C. Telegraph and teleFhone todls,
postlg€s, freight and express
delivery.harscs
D. St.tionery, printing.rnd dhtribntion
ofprinted nat€rirh relative to tIe

E. Enplold.nt ofwnlchets at lhe polls

F. Rent, hnintennncc lnd fi'rnishing
of cxhpaign headqtrartcrs, office or
Dlace ofmeetinqs
G. Polilicxl hcctings and r.llics .nd ihe
se ofso nd systcnr, .nd
ligh ts
dccoralions during s.id n)cetings an.l
 REPORT ON CONTRACTORS BUSINESS FIRMS

(Date of Elecuon)

rll Nahe and address/E-Mail Address/Tel. No, ofCandi.late/Partv Treasurer:

ryor ofEle€tion Expenditures Full Name and Address of Candidate/ Partv Treaslirer/Agent'
'aqe_ . ir/ are cara.oare/parv'e -eo-F'elbl:

(Nam€)

.fic€ (and elecied or politica

3asureri

TOTAL EXPENDITURES.. P

CERTIFICATION

I her€by ceftlfy that ihe faregoi.g eection expendillres llerc mdde bY the candidate/pa y t.easurer mennoned
rove/ or through authorized representaiive who slbm;tted to me his authoriiy; that all the data stated in this reporl are
re and coffecl; ihat they are supported by invoices/ receipts, coniFcts or documents presser ed in rny offce or place of
rsin€ss, slbjeci io jnsp€cijon by the Commhslon on Elections or its duly authorized rcpresentatjves; and that the
ipendltures Were in accordance wjth the omnibls Eleciion Code,

Signature of conkacior/ slrpplier or

person to r{hom elecloral expenditurc
is made. (Pr€sident or seneralmanaq€r
in case of business flrnrs)

SUBSCRIBED AND s!'/ORN to before me ihis day of 200 in

Fiant exhibitinq Idenufication Card No 20r:r at
-

ries of 20

rti0ction:F e tndupridatdwllh the Et.clion oitcer @ncehed wthLd 7wo ing day3 aner the public meel nq or €liy (Sec 33, Omnbts ELecton Code)
ro rad a copyrD lhd commiss on on E eclions. Manila
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 "ANNEX'F"

NOTICE BY CANDIDATE OR POLITICAL PARTYIORGANIZATION

COALITION ON HOLDING OF PUBLIC POLITICAL MEETING/RALLY

(Date)

TO: THE ELECNON OFFICER

Sir/lvla da m i

Please be advised that the undersigned candidate/representative of candidate or

authorlzed officer of Paity intends to organize

and hold a public meetirg/rally at
on in connection with the May 10,20i0 National and
Local Elections, and the corresponding perrnit therefore has been lssued by the
city/munjcipal offcial concerned, copy of which is attached. The undersigned will submit
the repoft on expenses incurred in connection with the holding of said rally within seven
(7) wolkinq days after the holding thereot as rdquired by Section BB of the Omnibus
Election Code.

Yours truly,

(Signaiure over printed name of candidate/authortzed

r€presenlative or authorized olTicer of po itjcat parly)

(Full name ofCandidat€/ iifiled by his r€presenta|ve)

(otrice and constilu€ncy souqhi by candidate)

(Posi office address/E-llail Address/

T€1. No. of person flling notice)