COMMISSION ON ELECTIONS

May 13, 2019 FORM

National and Local Elections

1
SOCE
Statement of Contributions and Expenditures
PART A: PERSONAL INFORMATION OF THE CANDIDATE

NAME OF CANDIDATE:
A.1.
(SURNAME) (FIRST NAME) (MIDDLE NAME)

A.2. TYPE CANDIDATE: INDEPENDENT CANDIDATE (Indicate "N/A" for Part A.3.)
(Use "X" in appropriate box)
CANDIDATE WITH POLITICAL PARTY
NAME of POLITICAL PARTY:
A.3.
(COMPLETE NAME OF THE PARTY) (ACRONYM)

ELECTIVE POSITION:
A.4. (Skip Part A.5. if national position)
A.5. CONSTITUENCY OF THE ELECTIVE POSITION:

(DISTRICT) Indicate "LONE" if only 1 (CITY/MUNICIPALITY) (PROVINCE/REGION)

CONTACT DETAILS: MOBILE/PHONE NOS.:

A.6.

E-MAIL ADDRESS:

PERMANENT ADDRESS:
A.7.
(HOUSE NO./UNIT) (NAME OF BUILDING/SUBDIVISION) (STREET NAME)

(BARANGAY) (DISTRICT/AREA) (CITY/MUNICIPALITY) (PROVINCE)

PART B: CONTRIBUTIONS RECEIVED (Itemized entries in the schedule of contributions, indicate "N/A" if none received)
B.1. CASH CONTRIBUTIONS RECEIVED FROM OTHER SOURCES:
B.2. IN-KIND CONTRIBUTIONS RECEIVED FROM OTHER SOURCES:
B.3. CASH CONTRIBUTIONS RECEIVED FROM POLITICAL PARTY: (for candidates with parties only)
B.4. IN-KIND CONTRIBUTIONS RECEIVED FROM POLITICAL PARTY: (for candidates with parties only)
TOTAL CONTRIBUTIONS RECEIVED

PART C: EXPENDITURES INCURRED (Itemized entries in the schedule of expenditures, indicate "N/A" 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

PART D: CERTIFICATION AND ACKNOWLEDGMENT

The undersigned candidate, after being duly sworn to, hereby depose and state that:
(1) This disclosure and its attachments, are supported by receipts, vouchers, and other documents reflecting the full, true, accurate, and
complete contributions received and expenditures incurred by the undersigned and his/her duly authorized representative;
(2) The expenditures incurred are for lawful purposes and the contributions were not received from persons or entities prohibited by law to
give contributions.
(3) The undersigned consents on the general use and sharing of information obtained in this disclosure and its attachments for legitimate
and authorized purposes.
IN WITNESS WHEREOF, the undersigned hereunto affix his/her signature on [date signed].

AFFIX SIGNATURE HERE

NAME AND SIGNATURE

SUBSCRIBED AND SWORN TO before me on date notarized , affiant exhibiting his/her

issued by expiring on [date of expiry].
(Type of identification document) (ID Number) (Government Agency issuing the ID)

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. Remarks:
☐ 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)
 COMMISSION ON ELECTIONS
May 13, 2019
National and Local Elections
Schedule of Contributions Received

NAME OF CANDIDATE: CONTRIBUTION

(SURNAME) (FIRST NAME) (MIDDLE NAME)

DATE RECEIPT FULL NAME OF DESCRIPTION

ADDRESS OF CONTRIBUTOR
RECEIVED NUMBER CONTRIBUTOR (for in-kind contributions)

(Type
and Source)

TOTAL CONTRIBUTIONS RECEIVED

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]
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
 FORM

nal and Local Elections 2

SCR

(MIDDLE NAME)

AMOUNT/VALUE OF CONTRIBUTION

OWLEDGMENT

[date of expiry].

NOTARY PUBLIC
 COMMISSION ON ELECTIONS
May 13, 2019
National and Local Elections
Schedule of Expenditures

NAME OF CANDIDATE:
(SURNAME) (FIRST NAME) (MIDDLE NAME)

RECEIPT/ FULL NAME OF

ADDRESS OF BUSINESS FIRM TIN OF CONTRACTOR or Exp Type
DATE INCURRED INVOICE BUSINESS FIRM OR DESCRIPTION OF EXPENSE
OR CONTRACTOR BUSINESS FIRM (A-K)
NUMBER CONTRACTOR

TOTAL EXPENDITURES INCURRED

CERTIFICATION ACKNOWLEDGMENT
I hereby certify that: (1) the expenses listed above were incurred by me as a candidate or by my SUBSCRIBED AND SWORN TO BEFORE ME this [date of oath]
duly authorized representative/s; (2) all entries specified above are true and correct; (3) they are affiant exhibiting his/her
supported by the official receipts, invoices or other similar documents; (4) the expenses comply issued by the [issuing office] expiring on
with Section 102 of the 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
 FORM

al Elections 3
SCE

(MIDDLE NAME)

AMOUNT/VALUE OF EXPENDITURE

₱0.00

NOWLEDGMENT
[date of oath]

[date of expiry].

NOTARY PUBLIC
 COMMISSION ON ELECTIONS
May 16, 2019

National and Local Elections

FORM

4
Summary Report of Lawful Expenditures SLE

PART A: PERSONAL INFORMATION OF THE CANDIDATE

A.1. NAME OF CANDIDATE:

(SURNAME) (FIRST NAME) (MIDDLE NAME)

A.2. INDEPENDENT CANDIDATE (Indicate "N/A" for Part A.3.)

CANDIDATE TYPE:
(Use "X" in appropriate box) CANDIDATE WITH POLITICAL PARTY
A.3. NAME of POLITICAL PARTY:
(COMPLETE NAME OF THE PARTY) (ACRONYM)

A.4. ELECTIVE POSITION: (Skip Part A.5. if national position)

A.5. CONSTITUENCY OF THE ELECTIVE POSITION:

(DISTRICT) Indicate "LONE" if only 1 (CITY/MUNICIPALITY) (PROVINCE/REGION)

PART B: SUBTOTAL OF LAWFUL EXPENDITURES PER EXPENSE TYPE/CATEGORY

Travel expenses of candidate and campaign personnel during the campaign and incidental personal expenses
A
Compensation of campaigners, clerks, stenographers, messengers, and other persons employed in the
B campaign
Telephone, mobile phone usage fees, prepaid phone load, internet access, postages, freight and courier
C charges
Stationery, printing and distribution of printed materials relative to candidacy;
D
Employment of watchers at the polls
E
Rent, maintenance and furnishing of campaign headquarters, office or place of meetings
F
Political meetings and rallies & the use of sound systems, lights and decorations during said meetings and
G rallies
Newspaper, radio, TV and other advertisements to promote the candidacy, including website/internet ad
H placements
SUBTOTAL

PART C: EXPENDITURES INCURRED (Itemized entries in Schedule of Expenditures)

Employment of counsel
I
Copying and classifying lists of voters, investigating and challenging the right to vote of persons registered in
J the lists
Printing of sample ballots in such color, size and maximum number as may be authorized by the Commission
K
TOTAL EXPENDITURES INCURRED

PART D: CERTIFICATION AND ACKNOWLEDGMENT

The undersigned candidate, after being duly sworn to, hereby depose and state that:
(1) This disclosure and its attachments, are supported by receipts, vouchers, and other documents reflecting the full, true, accurate, and complete

contributions received and expenditures incurred by the undersigned candidate and his/her duly authorized representative;
(2) The expenditures incurred are for lawful purposes and the contributions were not received from persons or entities prohibited by law to give
contributions.
(3) The undersigned consents on the general use and sharing of information obtained in this disclosure and its attachments for legitimate and
authorized purposes.
IN WITNESS WHEREOF, the undersigned hereunto affix his/her signature on [date signed].

AFFIX SIGNATURE HERE

NAME AND SIGNATURE

SUBSCRIBED AND SWORN TO before me on date notarized , affiant exhibiting his/her

issued by expiring on [date of expiry].
(Type of identification document) (ID Number) (Government Agency issuing the ID)

Doc. No.:
Page No.:
Book No.:
Series of (Place Notarial Seal & Signature here)
 COMMISSION ON ELECTIONS
May 13, 2019
National and Local Election
Schedule of Unpaid Obligations

NAME OF CANDIDATE: REMAINING

PURPOSE
DESCRIPTION OF THE OBLIGATION
(SURNAME) (FIRSTOBLIGATION
NAME) (MIDDLE NAME)

DATE CONTRACT / LOAN

NAME OF CREDITOR ADDRESS OF CREDITOR
INCURRED NO.

(i.e. loan, etc.) (Partial

(for incurring obligation)
Payments were made)

TOTAL UNPAID OBLIGATIONS

CERTIFICATION ACKNOWLEDGMENT
I hereby certify that: (1) the obligations listed above were incurred by me as a SUBSCRIBED AND SWORN TO BEFORE ME this [date of oath]

candidate or with my authority by my duly authorized representative; (2) all entries affiant exhibiting his/her
issued by the [issuing office] expiring on
specified above are true & correct ; (3) they are supported by contracts,
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
 FORM

al and Local Election

5
SUO

(MIDDLE NAME)

AMOUNT/VALUE OF OBLIGATION

[date of oath]

[date of expiry].