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Statement of Contributions and Expenditures: May 13, 2019 National and Local Elections
Statement of Contributions and Expenditures: May 13, 2019 National and Local Elections
A.2. CANDIDATE TYPE: X INDEPENDENT CANDIDATE (Indicate "N/A" for Part A.3.)
(Use "X" in appropriate box)
CANDIDATE WITH SUPPORT OF A POLITICAL PARTY
ELECTIVE POSITION:
A.4. (Skip Part A.5. if national position)
A.5. CONSTITUENCY OF THE ELECTIVE POSITION:
PART B: CONTRIBUTIONS RECEIVED (Itemized entries in the schedule of contributions, indicate "0.00" if none received)
B.1. CASH CONTRIBUTIONS RECEIVED FROM OTHER SOURCES: ₱0.00
B.2. IN-KIND CONTRIBUTIONS RECEIVED FROM OTHER SOURCES: ₱0.00
B.3. CASH CONTRIBUTIONS RECEIVED FROM POLITICAL PARTY: (for candidates with parties only) ₱0.00
B.4. IN-KIND CONTRIBUTIONS RECEIVED FROM POLITICAL PARTY: (for candidates with parties only) ₱0.00
TOTAL CONTRIBUTIONS RECEIVED ₱0.00
PART C: EXPENDITURES INCURRED (Itemized entries in the schedule of expenditures, indicate "0.00" if none received)
C.1. EXPENDITURES PAID OUT OF PERSONAL FUNDS / RESOURCES:
C.2. EXPENDITURES PAID OUT OF CASH CONTRIBUTIONS:
C.3. EXPENDITURES INCURRED USING IN-KIND CONTRIBUTIONS:
TOTAL EXPENDITURES INCURRED ₱0.00
Doc. No.:
Page No.:
Book No.:
Series of (Place Notarial Seal & Signature here)
THIS SECTION IS FOR COMELEC USE ONLY - DO NOT ENCODE / WRITING ANYTHING BEYOND THIS LINE
Indicate "✓" beside form code/document name if submitted, " ✗" if not.
☐ SCR (Sched of Contributions Rcvd) ☐ Contribution Receipts
☐ SOE (Sched of Expenditures) ☐ Expenditure Receipts
☐ SUO (Sched of Unpaid Obligations) ☐ Obligations Payable
☐ SLE (Sum. Report of Lawful Exp.) NO. OF PAGES: _________
☐ Others: pls. specify: (This space is for the receiving date/time stamp of the receiving office)
FORM
COMMISSION ON ELECTIONS
May 13, 2019
Schedule of Contributions Received
2
National and Local Elections
SCR
(Cash or
In-kind)
CERTIFICATION ACKNOWLEDGMENT
I hereby certify that:(1) the contributions listed above were made to me as a candidate; (2) all SUBSCRIBED AND SWORN TO BEFORE ME this
entries specified above are true & correct; (3) they are supported by the official receipts issued affiant exhibiting his/her
by me upon acceptance; (4) the contributions are from sources not prohibited by the Omnibus issued by the [issuing office] [date of expiry].
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.
Doc. No. ________;
Page No. ________;
Book No. ________;
NAME AND SIGNATURE DATE SIGNED Series of ________. NOTARY PUBLIC
COMMISSION ON ELECTION FORM
May 13, 2019
National and Local Elections 3
Schedule of Expenditures SCE
NAME OF CANDIDATE:
(SURNAME) (FIRST NAME) (MIDDLE NAME)
RECEIPT/ INVOICE FULL NAME OF BUSINESS FIRM ADDRESS OF BUSINESS FIRM TIN OF CONTRACTOR or BUSINESS Exp Type AMOUNT/VALUE OF
DATE INCURRED DESCRIPTION OF EXPENSE
NUMBER OR CONTRACTOR OR CONTRACTOR FIRM (A-K) EXPENDITURE
CERTIFICATION ACKNOWLEDGMENT
I hereby certify that: (1) the expenses listed above were incurred by me as a candidate or by my duly SUBSCRIBED AND SWORN TO BEFORE ME this [date of oath]
authorized representative/s; (2) all entries specified above are true and correct; (3) they are supported by the affiant exhibiting his/her
official receipts, invoices or other similar documents; (4) the expenses comply with Section 102 of the issued by the [issuing office] expiring on [date of expiry].
Omnibus Election Code.
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.
Doc. No. ________;
Page No. ________;
Book No. ________;
Series of ________.
NAME AND SIGNATURE DATE SIGNED NOTARY PUBLIC
COMMISSION ON ELEC
May 13, 2019
Local Elections
Summary Report of Lawful E
PART A: PERSONAL INFORMATION OF
A.1. NAME OF CANDIDATE: MELENDREZ
(SURNAME)
A.2.
CANDIDATE TYPE:
(Use "X" in appropriate box)
0 0
(DISTRICT) Indicate "LONE" if only 1 (CITY/MUNICIPALITY
Printing of sample ballots in such color, size and maximum number as may be authoriz
K
TOTAL EXPEN
contributions received and expenditures incurred by the undersigned candidate and his
(2) The expenditures incurred are for lawful purposes and the contributions were
contributions.
(3) The undersigned consents on the general use and sharing of information obtained i
purposes.
IN WITNESS WHEREOF, the undersigned hereunto a
Doc. No.:
Page No.:
Book No.:
Series of
ISSION ON ELECTIONS FORM
Local Elections
4National and
SLE
Report of Lawful Expenditures
AL INFORMATION OF THE CANDIDATE
RUFILINO BARONGGO
(FIRST NAME) (MIDDLE NAME)
0 0
(COMPLETE NAME OF THE PARTY) (ACRONYM)
0 0
(CITY/MUNICIPALITY) (PROVINCE/REGION)
ative to candidacy;
₱0.00
₱0.00
₱0.00
allenging the right to vote of persons registered in the
₱0.00
g of information obtained in this disclosure and its attachments for legitimate and authorized
Err:511
PURPOSE REMAINING
DATE CONTRACT / LOAN ADDRESS OF AMOUNT/VALUE OF
NAME OF CREDITOR (for incurring OBLIGATION (Partial
INCURRED NO. CREDITOR OBLIGATION
obligation) Payments were made)
(i.e.
loan, etc.)
CERTIFICATION ACKNOWLEDGMENT
SUBSCRIBED AND SWORN TO BEFORE ME this [date of oath]
I hereby certify that: (1) the obligations listed above were incurred by me as a
candidate or with my authority by my duly authorized representative; (2) all entries affiant exhibiting his/her
specified above are true & correct ; (3) they are supported by contracts, issued by the [issuing office] expiring on [date of expiry].
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.
Doc. No. ________;
Page No. ________;
Book No. ________;
NAME AND SIGNATURE DATE SIGNED Series of ________. NOTARY PUBLIC