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INSTRUCTIONS: (Read well before filling up this form.)


1. File this in FIVE (5) LEGIBLE copies.
2. File this certificate of candidacy with the Law Department, COMELEC Main Office, Jntramuros, Manila, startIng November 20, 2009 up to
midnight of November 30, 2009.
3. Attach to this certificate the Certificate of Party Nomination unless you are an independent candidate. After midnight of November 30, 2009, no
certifICate of nomination shall be accepted.
4. Titles such as 'Dr., Atty., Don, Ginoo, Seiior, Datu, Had)i, Sultan, Bai, Seiiora,.Kapitan.or similar titles are expressly prohibited.
5. This certificate shall be sworn before a notary public or any official authorized to eomrntster oath. COMELEC offiCials are not authorized to
administer oath. . '

t It~reby announce my candidacy for the position of SENATOR, Republic of the Philippines, in the May 10, 2010 ~Iett~ons:
and-aftet having bee., sworn to in aCl::ordance with law, he~ebv statE! the:! following~ J
l
1. MY NAME IS : 3. MY GENDER IS : 4. MY AGE IS :

4.3_
1.1 Last Name
B; A :/?':A
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L: - ....... 5. MY
DMal~

DATE OF BIRTH IS :
Female

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L 2 First Name
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j/O:N; t i ,V: fRo; D:(:-- --;-
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1.3 Middle Name Month Day Year

6. MY PLACE OF BIRTH IS :
'2.. I AM GENERALLY OR POPULARLY KNOWN BY THE NICKNAME OR STAGfNAME
dicate only one nickname or stagename) Oty/Mun _ UP1. PF_.fvtA-.lV.ft..-1J
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---";"-+8. MY CIVIL STATUS IS :
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Province - -- Neff.
7. I AM OFFICIALLY NOMINATED BY: (Attach Certificate of Nomination)
o Single I2(l Widow/er
L-IBFr<l+L
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PAf<.TLf _. _
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.... . '. .,
o Married D Legally Separated

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9. MY RESIDENCE
AOORESSIS:
9.1 Province
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11:
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,, :D:I :S:T:rz/c;r Annulled / Divorced

9.2 City/Municipality Full Name of Spouse, If married


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. 9.3Bar,ang~y'
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. . .' ,. 10. MY PROFESSION OR
9.4 ~ouse No:! street / Subdivision OCCUPATION IS I
:1: :N;A: e:rT/(A j{:{IL CO fJ~/C.r;S{ W_ OM 4rV
11. MY POST OFFICE ADDRESS FOR ELECTION PURPOSES IS : (Could be the same as No.9) 12. I AM A REGISTERE~ VOTER OF

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. ....;,. .;..;,;A,;;;..:\...;...;,;.,.,N.;...,;o....:.,- . ..;;;,.q.;....;._ ...;....;.,;,.;...;.;..;........;..;...;.;..;..;.....;,....;....;.,;,....;.;..;..;,.;.....;.;...-t-Precinct Cf-3g0 Ii
1. [\1Y PERIOD OF RESIDENCE IN THE PHIUPPINES BEFORE MAY 10, 2010 IS : Bgy !vtl4:TA-/Ii DI+f\J{~_ 6ft LA- t<.A .
, 'It ' City/Mun . 'R tA.f?};OI\J (.- t.N
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secon» __pIS-----
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No_ of Months ' No. of Years

provinceN{Al",. -

14. : 1) fHUMIlPRINT
I AM A NA1URAL BORN FILIPINO CrnZEN. I
• I
15. I AM NOT A PERMANENT RESIDENT OF, OR IMMIGRANT TO, A FOREIGN
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
PHILIPPINES AND WILL MAINTAIN TRUE FAITH AND ALLEGIANCE THERETO. I
WILL OBEY THE LAWS, LEGAL ORDERS AND DECREES PROMULGATED BY THE
DULY CONSTITUTED AUTHORITIES. I IMPOSE THIS OBLIGATION UPON MYSELF
VOLUNTARILY, WITHOUT MENTAL RESERVATION OR PURPOSE OF EVASION .

. I hereby certify that the facts stated herein are true a.;~~~n~
AMA 71ifKfOA /toAl V' - QUa
Signature of candidate Over Prtnted Name

OATH
SUBSCRIBED AND SWORN to b~fore me
ere/IdentIfication Card No. /1 I ,f3 ft? 3D
l~iP_V_2 Zf ~l!
Issued by:
~b~1Q~r, y 2009, at __
On:
,.- __
,/u,n
,' affiant exhibiting to me his/her
R} (tlY()q
Doc No. nM ( .dJ G _L- --..~L ~