Annex “K-1 CERTIFICATE OF CANDIDACY FOR MEMBER, SANGGUNIANG... ‘ TRICT BARANGAY ?&fciy:) ee ae TE aa im Fut the Rens completely We N/A an Rem nt sppeal. Pant the COc Ferm an BOTH SIDES (Font and back) of a FOLIO (8.5%13") or LEGAL (85%4") sam copy paper. 7 = Ties sich 25 Br, Atty, Don, Gino, Ser, Datu, Sultan, Bal, Sera, Kapitan or other similar titles are expressly prohibited. ‘Ths carteate shal be sworn Before a notary public or any oficial authorized to administer oath, The Election Oler may administer the oath on the COCs {led within thelr ares of jurisdiction, free of charge. Js. Fletis in THREE (3) LEGIBLE coples vith the COMELEC Ofceconcemed on any day fom August 28, 2023 (Monday) to September 2, 2023 (Saturday), from 18:00 AM to 5:00 PM ONLY. Js. No fing fee shall be imposed. 2 CHISBRHARPOUES my ancaac fore postin of MEMBER, SANGGUNIANG BARANGAY of BARANGAY “city/ Municipality of rovines of PIETRO, AABALLA, tn the October 30,2023 Barangay and Sangguniang Rabson (BE) Eecton; and afer aving been sworn In accordance with law, Thereby state the following: 1, NAME: a 14, SEX: _|15. AGE ON ELECTION DA\ ti tastname [7] 00 AWD AO saretnine [Ria Fla ere] | U 32 Male) Must be at least eighteen (18) years od on election day Female 16, DATE OF BIRTH: a “Month Day ~ i9ia4g 117. PLACE OF BIRTH: cryin. —CALDB CAN 2% sane clalzioiolclew| | | | my T Pop) | Province AMHTED, oadality aC EEEEET 3.4 House No, Street / Subdivision o 118, CIVIL STATUS: Ae, wlyig ti eo Katumay ar raReaco ec. | ||| Des Chwmw Rio manirical e : Married 4, ADDRESS FOR ELECTION PURPOSES: (Cold be the seme as No.3) ann Spy ma A723 TINO <7. _AmpaRO suboIVIGoN ORY 179 Nfs —Hdocrd cry No pro esstON oR OCCUPATION: ZRINER 5, PERIOD OF RESIDENCE IN THE PHILIPPINES UP TO THE DAY BEFORE OCT. 30, 2023: 20. AM A REGISTERED VOTER OF: 51. fe pes: vocfveas BIZ) ve-ethenns (OT) t Ho | Precinct N4e6 52. inthe shove ste Ban roorvers FZ) na otnenns OM |= 9 cityyMun, CALOOCAN & Tatanupne crn Prone AE abadli 5 {etinen Stow Rlwncion of ronete cme. (era, MAGA com) &Llsror peter Ret ox ot mca «een SOO fa. OFFICIAL E-MAIL ADDRESS: 2 Ii tue ron te oreee ceo ertece9 To ‘TRUE AND ITEMIZED STATEMENT OF CONTRIBUTIONS AND EXPENDITURES (SOCE) IN CONNECTION {WITH THE Ragen Have you ever Been found lable for an 114, TWILL SUPPORT AND DEFEND THE CONSTITUTION OF THE REPUBLIC OF THE PHILIPPINES AND WILL Mauna | 22.Have YOU ev obs ‘TRUE FAITH AND ALLEGIANCE THERETO. [WILL OBEY THE LAWS, LEGAL ORDERS, AID DECREES PROMULGATED By| Offense which caries with it the accessory THE DULY CONSTITUTED AUTHORITIES. I IMPOSE THIS OBLIGATION UPON MYSELF VOLUNTARILY, WITHOUT | Penalty of perpetual disqualification to MENTAL RESERVATION OR PURPOSE OF EVASION. hold public offee, which has become frat 112, 'SHALL NOT ADVOCATE VIOLENCE OR UNLANPUL MEANS TO ACHIEVE MY GOALS, and executory? 43. 1.GIVE CONSENT TO THE COMMISSION ON ELECTIONS TO COLLECT, DISCLOSE OR SHARE, AND PROCESS THE S PERSONAL DATA I PROVIDED HEREIN FOR ELECTION AND OTHER LAVIFUL PURPOSES IN ACCORDANCE WITH THE PRIVACY NOTICE AT-THE BACK OF THIS FORM, AND AS MAY BE AUTHORIZED BY EXISTING LAWS (Pease provide deals tthe back) Ar true and arrec to the . eS ‘Signature of Candidate over Printed Name a A eres OF cvs Wy nary cy ons rene wee Ob ori Thereby cory that the facts stated herein are ‘OATH SUBSCRIBED AND SWORN to before me this day of ATTY. io ria affiant exhibiting to me an