ANNEX A

Republic of the Philippines

COMMISSION ON ELECTIONS
Barangay and Sangguniang Kabataan Elections

October 30, 2023

DEED OF CONTRIBUTION
(for Domestic Corporation)

KNOW ALL MEN BY THESE PRESENTS:

This Deed of Contribution, made and executed by into and between:

_NA a corporation duly organized and existing under the laws of the Republic of the Philippines
with office address at _________NA_____________________, represented by _NA____, who is
the ____NA____, hereinafter called the CONTRIBUTOR,

- and -

NA who is running for NA of NA, represented by ______NA___, with address at

_____NA___, hereinafter called the DONEE.

WITNESSETH

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That for and in consideration of a desire to support the electoral campaign of the DONEE
for the 2023 Barangay and Sangguniang Elections, the CONTRIBUTOR has freely and
voluntarily given, transferred and conveyed by way of contribution to the DONEE,

Details of the Contribution Amount/Fair Market Value (for in-kind

donations)
___________________________ _____________________________
___________________________ _____________________________

IN WITNESS WHEREOF, the CONTRIBUTOR has hereto subscribed this ____ day of
____________, 2023.

______________________________
SIGNATURE OF THE AUTHORIZED
REPRESENTATIVE
(Signature over Printed Name)

ACCEPTANCE

For and in behalf of the ( Name of the Candidate) , the DONEE expresses his/her most
sincere appreciation for the generosity shown by the CONTRIBUTOR. The DONEE, hereby accepts and
acknowledges the above Contribution/s.

IN WITNESS WHEREOF, the DONEE has hereto subscribed this ____ day of ____________,
202_.

______________________________
DONEE
(Signature over Printed Name)

SIGNED IN THE PRESENCE OF:

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 ________________________ ________________________
(Signature over Printed Name) (Signature over Printed Name)

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES)

____________________________) Ss.

BEFORE ME this ________ (date) __________, personally appeared:

NAME Identification Card and No. Date of Issue or Validity

__________________ _______________________ _______________________
___________________ ________________________ _______________________

Known to me to be the same persons who executed the foregoing instrument, and they acknowledged to
me that the same is free and voluntary act and deed, including that of the entities that they represent.

This instrument refers to a Deed of Contribution and Acceptance that consists of 2 pages, including this
page whereon this acknowledgement is written, and which is signed by the parties concerned on each and
every page thereof.

WITNESS MY HAND AND SEAL, this ___________ day of ______ 202__ in the
____________________, Philippines.

NOTARY PUBLIC

Doc. No. ______

Page No.______
Book No. _____
Series 2023.

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