TIZA REFORM MOVEMENT HOMEOWERS ASSOCIATION INC.

Barangay Tiza, Roxas City

Name of HOA: _______________________________________________________________________________________

Address: _____________________________________________________________________________________________
BOD Election
Date: ____________________________________________

ELECTION RETURNS
Total Number of HOA Members: __________________
Total Numbers of Members Qualified to Vote: _____________________
Total Number of Votes Cast: __________________
Total Number of Qualified Voters ( Who did not Vote ): ____________________
Number of Protests ( If any ): ____________________

21. _________________________________
Name of Candidates ________________________________
Tally of Votes ______________________________
Total Number of Votes _________________
Obtained
( In Words ) ( In Figures )
22. _________________________________________________________________ ______________________________ _________________
1.
23._________________________________ ________________________________ ______________________________
_________________________________________________________________ _________________
______________________________ _________________
2.
24._________________________________ ________________________________ ______________________________
_________________________________________________________________ _________________
______________________________ _________________
3.
25._________________________________ ________________________________ ______________________________
_________________________________________________________________ _________________
______________________________ _________________
4. _________________________________ ________________________________ ______________________________ _________________
5. _________________________________ ________________________________ ______________________________ _________________
6. _________________________________ ________________________________ ______________________________ _________________
7. _________________________________ ________________________________ ______________________________ _________________
8. _________________________________ ________________________________ ______________________________ _________________
9. _________________________________
We hereby certify that ________________________________ ______________________________
all the entries recorded herein are true and correct. In _________________
witness
hereof, we affix our signature________________________________
10. _________________________________ this document this _________________________________________ _________________
day of _______________________________.
11. _________________________________ ________________________________ ______________________________ _________________
12. _________________________________ ________________________________ ______________________________ _________________
13. _________________________________ ________________________________ ______________________________ _________________
ELECOM CHAIRMAN______________________________ _________________
14. _________________________________ ________________________________
15. _________________________________ ________________________________ ______________________________ _________________
16. _________________________________ ________________________________ ______________________________ _________________
_________________________________ _________________________________ _________________________________
17. _________________________________ ________________________________ ______________________________ _________________
MEMBER MEMBER MEMBER
18. _________________________________ ________________________________ ______________________________ _________________
19. _________________________________ ________________________________ ______________________________ _________________
20. _________________________________ ________________________________ ______________________________ _________________
__ ______

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 Subscribed and sworn to be me in the City of Roxas, Philippines this __________________
day of ____________ 2022.

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