Annex "A"

Date, Time, and Month: ____ ___.AM/PM

Location Day: ___ Location: _____

Name of the
Candidate/ Authorized
Representative (please Signature
attach SPA

SPECIFIC INFORMATION
ACTMTY (Pls. check REQUIRED
the desired activity) (Please attach on a
se arate sheet
□ In-Person Campaign □ Proof of identity of the Date: _____
companions Time: _____
Names of the companions:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10. ___________
11. ___________,
12. -----------
13. -----------
14. _ ____________,
15. -----------

lPlease attach the names of

additional campaign support
staff on a separate sheet, as
needed.
□ Motorcade o Permit duly issued b y the Date: ______
□ Caravan Local Government Unit Time: ______
concerned Starting Point: _______
Intended Route/s: _____

End Point: _________

o Caucus □ Proof of reservation and Date: ______

o Meeting Department of Tourism Time: ______
o Convention (DOT) accreditation of the Venue: ____________
o Indoor Rally venue where the activity Maximum Capacity: ______
o Other Election will be held.
Campaign Activities
held indoors
(Please specify: ___,

D Rally o Permit duly issued by the Date: _____

□ Miting De Avance held Local Government Unit Time: _____
outdoors or in an concerned. Venue: _____ _______
enclosed outdoor space Maximum Capaci ty/ measures taken
to enclose an outdoor space, when
necessary: __________

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 Annex "B"
Republic of the Philippines)
___________, S.s.

AFFIDAVIT OF COMPLIANCE

I, ________________ , of legal age, Filipino, and a

resident of _______________________ ,
after being duly sworn to, under oath and in accordance with law,
do hereby depose and state that:

1. I applied for the conduct of _______ (activity) as part of

my/ 's (name of candidate) election
campaign activity; and

2. I attest to the full compliance with all the requirements and

procedure for such applications, pursuant to the provisions of
the Guidelines for the Conduct of' (1) In-Person Campaign, (2)
Rallies, (3) Caucuses, Meetings, and Conventions, (4) Motorcades
and Caravans, and (5) Miting De Avance Under the New Normal
in Connection with the 09 May 2022 National and Local
Elections.

IN WITNESS WHEREOF, I hereunto affix my signature this __

day of _____ 20__, at _______________

Affiant

SUBSCRIBED AND SWORN TO before me this ____ day of

___ _____, 20_ at
affiant having exhibited to me his/her _______ with nos.

Doc. No. ___

Page No. ___
Book No. ___
Series of 20_
 Annex "C"

MONITORING REPORT

Date
Candidate/ s involved
1. '
2. ,
3. '
4. '
5.
(Please attach a separate sheet for additional names of
candidates, as needed.)

Activity
Venue/Location
Time Started
Time Finished

Report/ Observations

Prepared by
Position/ Designation
Barangay
City
Signature
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