Repub lic or the Philippines

COMMISSION ON ELECTIONS
Manila

CERTIFICATE OF CANDI
SENATOR
INSTRUCTIONS:(Readwellbeforefilling up this form.)
1. Filethisin AVE(5) LEGIBLE copies.
2. File this certificate of candidacy with the Law Department, COMELECMain Office, Jntramuros, Manila, starting November 20, 2009 up to
,. midnightof NovemberJO, 2009.
3. Attach to this certificate the Certificate of Party Nomination unless you are an independent candidate. After midnight of November 30, 2009. no
certificateof nominationshaITbe accepted.
4. Titles such as 'Dr .• Atty., Don, Ginoo, Senor, Datu, Hadjl, Sultan, Bal, Senora, K?,Jpltan
or similar utles are expressly prohibited.
5. This certificate sball be sworn before a notary Dublic or any official authorized to administer oath. COMELECofficials are not authorized to
admini,teroath.

t.t~~~~'y ~nnQullcemy.tandidacy
~~·::..r,~
~Ol' the Positl()n"~~~~~NATOR,
,I. '.1._ ' .
Repllblh: of th~ Philippines, in the May lOt 2Ql~ • e1k'iti[)ns;
~.,~ ~

l;:g~~~~~t~
t ~ •

flaVlngbeen ~wQrnto in accordill1ce with law, heretit.~~e the following: : . :;;.:f'~.\.

:,\,l>·I."·-I'~' . ,I' "'<"'.t.~.,.••. , . ~~~!

1. MY NAME IS : 3. MY GENDER IS : 4. MY AGE IS:

1.1 last Name

o Male 0Female at
5. MY DATE OF BIRTH-IS:
1.2 first Name
[p/H.?o ..:-[t .:~:W:i.:
1.3 r~iddle Name Month Day Year

6. MY PLACE OF BIRTH IS :
2. I AM GENERALLY OR POPULARLY I{NOWN BY THE NICKNAME OR STAGENAME
Oty/Mun N flf:. U fP!3 (j
(Indicateonly onenicknameor stagename)
•• -., - • ',' • - •. - - , - - ',' - -r- • - r - - r - - •• - .••• - r - -., - - -,-' -,. - -, - - ',"', - - r' - •. - -. - - ....•
- - -,- - -,- - -,
~.- - . - . - - . - . - - - - - - -- .
Province If,Irtrt1'l6/(S
't' - ',' - •

:..~:.t<:.:.~.:.(}.:~!..
.;
1--------~----~----~~--~--~--~~--~~----~~~~~~~~~~~~~~8.MYCIVllSTATUSIS:
~.. :.. : ': : : ~..: ; ,..;.. : .
7. I AM OFFICIALLY NOMINATED BY, (AttochCertiAcateof Nomination)
............................. AN'='.. !=·/J/!I117f!.fW. f,/!~7Y. .
o Single 0 Widow/er

Polltlca!Par Q Married 0 LegallySeparated

9. MY RESIDENCE!
ADDRESSIS:
9.1 Province : '"v.~ .:~.:. _ .•..
: .. : :
, .• ~ ;•.. ;•.. : .. : ... ;... ;... : .. : .. ~... ;... ;....
: ;;;
D AnnulledI Divorced
I 9.2Ci~"Nunicipality 9.3 ·B~~n~:~~· - Full Nameof Spouse,if married
..... . .....•........•.............. , .. : : .. ~ : :": ;.. ';'.".': .. ;.. ~ : : .. : : . l!OJ?d.l:t:P.. F.:. r.~Il.~ .
: tJ.:U:.<~.:O.. d.:.. ~C:;/!.:.( :.!\n/I!:~.;O.:.t-.: _ : : : : c ....•• :.: 10.MYPROFESSlONOR
9A ~ous7.N?! .So;eetL~~~~v~s!on
.•.....•.... ' . ' ........•.. , .. , .. OCCUPATION IS :
:6:~: ~ irT.! fu:ti:n-i:t: :,4 V~· : ~l(t·: ~oq~~n
'r •. ,' •••••.••••••••• '.

:6ivrWb··~V!;J~;·:···.tltW'I-'f~Jftjf!(7-'~V(tJ(Yl~.j}f!;;f~
11. MY POST OfFICE ADDRESS FOR ELECTION PURPOSES IS : (Couldbe the sameasNo.9) 12. I AM A REGISTERED VOTER OF •

Precinct .... 'f?:l.CJ.. ~ .

13. MY PERIOD OF RESIDENCE IN THE PHILIPPINES BEFORE MAY 10, 2010 IS:
Bgy Prrn6ol- _--
----- .. _'.-.- ...

City!Mun ... /~.NP.. f?!~~Cr. .

: (J: J : No.of Months NO. of Years
Province
r-'-~--
.... -'1.~
-- --- ----.--------
._
14. I Af'1 A NA1lJRAL BORN FILIPINO CITIZEN. : iHHtlMIIPRiNt .. :::{,~~.::
--',< '"•• "::

15. I AM NOT A PERMANENT RESIDENT OF, OR I~lMIGRANT TO, A FOREIGN I •• ,- !~l'E'~ '
COUNTRY.
16. I AM ELIGIBLE FOR 'THE OFFICE I SEEK TO BE ELECTED TO.
17. I WILL SUPPORT AND DEFEND THE CONSTITUTION OF THE REPUBLIC OF THE
PHJLIPPINES AND WILL MAINTAIN TRUE FAITH AND ALLEGIANCE THERETO. I
WILL OBEY THE LAWS, LEGAL ORDERS AND DECREES PROMULGATED BY THE
DULY CONSTITUTED AUTHORITIES. I Ifv1POSE THIS OBLIGATION UPON MYSELF
VOLUNTARILY, WITHOUT MENTAL RESERVATION OR PURPOSE (?F EVASION.

I he~~~~'C~~i~ .; ., .; ~;~t~~·
.; •.••.; ~::; :~~: ~:;~~:~~;~~;~~
. Thumbprint

Signature of Candidate Over Printed Name

. ~ nV "0 . OATH
SUBSCRIBED AND SWORN to befate Me this,_i_ da7Qrl~ember, 200fny OF SAN V~nt exhibiting to m~/her • ~ .
~Identification Card NoN04 -·'bt-05CXXt8 Issued by :-ISO rxy,ru1on: 10 IAtlY' to Ui • L\t(;>~

Doc. NO. 3'Z'D

Page No. -=J-L..qo!-. __
Book No. :IT. (Officer Authorized to Administer Oath) ATTV. BENlO ~ UDD C .ONG
Seriesof 20051 (A.ffiv r:I~,,,,,,pnr.tvA~mol. - NOT'! :~yPU8U
COM~,..jfSS!ONEiJUNTil 31 tEl" {(jO£!

!BP LRN No. 07232 +t!.!\L.-::-\N ..JUAN

PTR No. OOl61:~O - (lJA6ilJS, - SQNJlu\N
Po:!!! I !\l~") C;l"f~ 4 7