COMMISSION ON ELECTIONS

October 30, 2023 RCF

Barangay and Sangguniang Kabataan Elections
Report of Contractor and Business Firms
PART A: INFORMATION OF THE CONTRACTOR OR BUSINESS FIRM

NAME of CONTRACTOR/
BUSINESS FIRM
SJ - PRINTING SERVICES

CONTACT DETAILS: Contact Numbers

E-Mail Address:
OFFICE / BUSINESS
ADDRESS: CABALUNA STREET NCM COMMERCIAL BUILDING
(STREET NO.) (STREET NAME) (BUILDING/SUBDIVISION)

BRGY. GREDU PANABO CITY DAVAO DEL NORTE

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

PART B: LIST OF ELECTION-RELATED BUSINESS TRANSACTIONS

DESCRIPTION OF SERVICES
NAME OF DATE OF RECEIPT AMOUNT OF GOODS PURCHASED /
RENDERED/GOODS
CANDIDATE TRANSACTION NUMBER VALUE OF SERVICES RENDERED
PURCHASED
NOLI B. RELAMPAGOS
JR. SEPTEMBER 2, 2023 No. 000008 TARPAULIN PRINTING ₱9,400.00

PART D: CERTIFICATION, CONSENT AND ACKNOWLEDGMENT

The undersigned, after being duly sworn, do hereby certify that : (1)the foregoing transactions for goods/services were made for the purpose of the
elections; (2)that all the information provided and stated in this report are true and correct; (3) the candidate complied with the duty to require every agent of
a candidate to present written authority to incur electoral expenditures on behalf of such candidate as mandated by Section 112 of the Omnibus Election
Code; and (6) consents on the general use and sharing of information obtained in this disclosure and its attachments for legitimate and authorized purposes.

LENALEN T. MACAN NOVEMBER 28, 2023

(SIGNATURE OVER PRINTED NAME) (DATE SIGNED)
(PROPRIETOR)

SUBSCRIBED AND SWORN TO BEFORE ME this , affiant exhibiting his/her

issued by , with expiry date on
[Identification (ID) Type] [Serial No. of ID] [Government Agency issuing the ID]
.
[Expiry date of ID]

AUTHORIZED PERSON TO ADMINISTER OATH