1’ x 1’

APPOINTMENT OF WATCHER
Photo of
30 October 2023 Barangay And Sangguniang Kabataan Elections
Watcher

______________
Signature of Watcher

I, _______________________________ (Name of Candidate), of legal age, Filipino

and resident of __________________________, Barcelona, Sorsogon, after having
been duly sworn to in accordance with law, state as follows:

1. On ___________________________, I have filed my Certificate of Candidacy for

the position of _______________________________, of Barangay
__________________________, Barcelona, Sorsogon;

2. I hereby appoint ________________________________________ (Name of

watcher) whose photo and signature appears above, as my WATCHER;

3. As such he/she is assigned to : (Check the applicable box)

Cluster/Group No. _______

Barangay Canvassing Center

4. The above-named WATCHER possesses all the qualifications and none of the
disqualifications as a watcher. As such, I certify that he/she is:

a. Is a registered voter of the barangay or a member of the Katipunan ng

Kabataan, as the case may be, in the assigned barangay;
b. Is of good reputation;
c. Has not been convicted by final judgment of any election offense or
any other crime;
d. Know how to read and write Filipino, English, or any of the prevailing
local dialect; and
e. Is not related within the fourth (4 th) civil degree of consanguinity or
affinity to the Chairperson or any EB Members in the polling
place/canvassing center where the watcher seeks appointment.

IN WITNESS WHEREOF, I hereunto affix my signature this ____ of October

2023, in Barcelona, Sorsogon, Philippines.

_______________________________
Name and Signature of Candidate

SUBSCRIBED AND SWORN TO before me this , day of October, 2023, at

__________________, Sorsogon, Philippines, affiant exhibiting to me his/her
Identification document/card which contains a photograph and signature bearing No.
____________________ issued by ____________________ on
_____________________.

Officer Authorized to Administer Oath

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2023