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Republic of (lie Philip Jines

COMMISSION ON ELECTlONS
Manila .

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INSTRUCTIOHS: (Read well before filling up this rorrn.)
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:, 1.. Ale this in Fl)!E (5) LEGIBLE copies.
2; File this certificate of candidac r \..-itn thp. Law D~partment, COl-1ElEC r-1ain ,Office, tntrarnuros. l-4anila, staiting NO'i~n;tj;"~r 20, 2009 up to·
midnight of November 30, 2009.
3. Attac.h to 'thiS certificate the Cert mcete of PeTty Nomtnatton unless vou :?r:~~~.n,~::~~~:;P~.n.~~.nt
.candi~ate. After midnight or NO·/~ml.lcr 30, 2009, no
certificate of nomination shall De ucceneo. .' ")" . :", .. ' .
;,'.4. "TItles such as 'Dr., Atl;f., Don, Ginoo, 5'~fl~';, ~.I.
::..... h~dji. Sultan, Ba\, Senora, KiJpitan or 5imBar.titles are expressly prohlblted,
·;s:.'·~ This ccrtlf1ca:te shaJI be. sworn ~"'t~R.':l~.~.'~;;dry:a~'r1i.~ter:.o~th.
)€dt.;~ OJ ~'Jr:.i)ry public 0" i)ny. Ofr;Cii\I.";~.vn1?~ ..•. COHELEC officials e ee not authorized to
administer oath. . . ....••....... -- . _. .

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1.1 Last N~me

1.2 First Name

1.:3 t·jidd18 Name

7J NDgfENDENT.~:.
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~~t~.~'.'e:ti"c:te
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:J_On1inal:O:~......•.......•....•..• _ ..••..•..•. _ .•
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9. MY RESIDENCE!
ADDRESS IS:

·i~:~~·\,;;;!.1[~~~:
:"F·'··
14. I AI'1 A NATURAL BORN FILIPINO Cm:~Er'~:'" .
15, I M'! NOT A PERMANENT H,ESIDENT 01', .GR WtI'lIGR;\NTTO, A FOREIGN'
COUNTRY. . .
16. T A~1ELIGIBLE FOR'THE OFFICE I SEE'~ TO 8E C:LECTED TO.
l?: I WILL SUPPORT AND DEFEND T,·i::; .COi'iSTlTUTION OF THE REPUB,LIC OF THE
PHTLIPPINESAND WI.Ll·r~}\IN."IAIN TRUE F/IlTH AND ALLEGIANCE THERETO. I
1 WILL OBEY THE LAWS, LEGA1.·ORO{RS 'AND DECREES PROlvlULGATED BY THE
.~.pULY CONSTITUTED AUTHORITIES. j HIPOSE THIS OBLIGATION UPON rWSELF
\! VOLUNTARILY, WITHOUT r"lENTAL RI,SEiWAT10N OIy~lf?;f'OSF\JFEVA5

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• /.' OATH

crq
.SUBSCRIBED
Id"lndfication
CardNoa3.3~~~
AND SWORN to b~rO·~·;n~:1.I~i~E:~.J.
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Doc. No, .
Page Ho.
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. .. ' (~~I;gr\iEliro.r,W~W:tW~
Series of 2001"' Ip,riix (lo('lImentar/~amB1Iss:On tXplres 12131109
L • '. . rap Roll No, 39876; 4126/95
" . :." TIN 173·020·318
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