Professional Documents
Culture Documents
COMMISSION ON ELECTIONS
Date filed:
The undersigned candidate/party treasurer hereby grants the authority to incur election expenses to
his/her agent
(Surname)
(First Name)
(Middle Name)
Said person is authorized to incur expenses for/on behalf of the candidate or party for the upcoming
2016 NLE elections. He/she is only authorized to incur expenses with a maximum limit of
(Amount in words)
(Amount in figures)
Date signed:
PARTY INFORMATION: Accomplish this part only if you are the party treasurer
NAME of PARTY
TREASURER:
NAME OF
PARTY:
PARTY
TYPE:
(SURNAME)
(FIRST NAME)
Political Party
Party-List Group
Contact information:
(Phone no. & e-mail
address)
(MIDDLE NAME)
(ACRONYM)
N/A
(SURNAME)
(FIRST NAME)
(MIDDLE NAME)
District,
Municipality/city/province
of elective office:
Contact information:
(Phone no. & e-mail
address)
AGENT INFORMATION: (Person authorized to incur expenditures, whose name appears in main body)
Home/Office
Address:
Telephone &
Mobile No.:
E-mail Address:
ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES
)
City/Municipality of Tuguegarao )
Before me, on ___________ and in _________________, personally appeared
the following persons with competent evidence of their identity:
Name
Doc. Type
ID No.
Expiry
Issuing
Date
Authority
Said persons acknowledged under oath to me under penalty of law, that the whole
contents of this document are true and the same are their free and voluntary acts and
deeds.
WITNESS MY HAND AND NOTARIAL SEAL.
Doc. No.:
Page No.:
Book.:
NOTARY PUBLIC
Series of