Republic of the Philippines

COMMISSION ON ELECTIONS
Manila

INSTRUCTIONS: (Readwell beforefilling up this form.)

1. Filethis in FIVE (5) LEGIBLE copies.
2. File this certificate of candidacy with the Law Department, COMELEC r~ain Office, Intramuros, Manila, starting November 20, 2009 up to
midnightof November30, 2009. ~
3. Attach to this certificate the Certificate of Party Nomination unless you are an independent candidate. After midnight of November 30, 2009, no
certificateof nominationsha II be accepted.
4. Titles such as 'Dr., Atty., con, Ginoo, Senor, Datu, Hadji, Sultan, Bai, Senora, Kapitan or similar titles are expressly prohibited.
5. This certificate shall be sworn before a notary public or any official authorized to administer oath. CONELEC officials are not authorized to
administeroath.
;.1 .-l'·'~''..:' , .' ~ . \ M. ,I, \' .,,:;',' . :'\..' \ ~ ')"':'':.~:/4' \
.' ~ ~tiI~e"y·"9notinc:e my c:alldidacy fo\' the pqsition ·of· PRESII)~~T. RflP.l\blic of the Phili.,pines, in the MaY"10~;J010
';,elec;ti9ns; ,and afl;~rhaving be~n sworn win jlcc:ordance witlt law, hereby state the-following: .' :: ·:!·ii,';;!',
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1. MY NAME IS : 3. MY GENDER IS : 4.MYAGEIS:
r •• , •• ',' •••••• r •• ~ •• ~,' •••••• ,- •• r •• ., - • "I' " ., •• ., • - ",' •• " •• ., •• " .'. '," •• r • - •••••••.••• ',' • ''- • "
I2$] Male DFemale ,..?~,.."" ",
1.1 Last Name
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: •••••••.
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y ,:~(g,i:...
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r •• ' •• ..,· •• , ••• ,··.· •. ••••• •• ···,···,'·_.,··_,·· .,·.,.··,···,···"··r··T·· ..···,···,···, 5. MY DATE OF BIRTH IS:
1.2 First Name
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,:,(;~f\,l~,\.,:()~.::..t.,:., ,:,..:...~..:,.,:..,:..,:",:",j, ..:...:... : :0· .:~.:-: ·1·: Lr:_!·[·;'q· ·:~.-:O:
1.3 ~liddleName
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Month Day
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Year

6. MY PLACE OF BIRTH IS :
: ••• ", _.~ _.~._.:. - .:._.~ •• :. •• ~._: ••• ' ••• 0. _ .:' ••• ~ _ ~~o ••• ' ••• ~ •• : ••• "; _.' ••• ' ••• :' •• ~ _ •• _ ••• _.

2. I AM GENERALLY OR POPULARLY KNOWN BY HIE NICKNAME OR STAGENAME

City/Nun ,1'Y!~,f\lD,~\..J.i'/O,~f" .GIll4

',.,::.,::::J::~:.::::'~,:.:'::::,'::'::~'::'.: r:T " ..":

dicate only one nickname or stagename)

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r-------------~~~~--~~~----~--~~~~~~~~--~~--~~--~~~8.MYCIVILSTATUSIS:
Province ~ N C1t __

7. I AM OFFICIALLY NOMINATED BY: (Attach Certificateof Nomination)

.' .. ,"""".,," , .... ,. ,t'tN&,.Klt.P.ftllf\I.1:N., flt((r:/ ... , .. "",."" ". ,. ".".,., ..... , '.'
o Single 0 Widow/er

PoliticalPar lB Mcrried D legally Separated

9. MY RESIDENCE/
ADDRESS IS: 9.1 Province - :~::~:~: - 1~::i:i::::::::;::::::•. :::.::::::I::: D AnnulledI Divorced

::::::::;:~::~:~:i]::,:~I1.:~:~]t}i::i'~::::'
9.2 City/Municipality 9.3 Barangay Full Nameof Spouse,if m"",ed

;~J~Ir.-. I? ~':~:;j~kT~:~ 1--~'''''~~-'''~';''';~'''''~:':''''~''''~'-'~~''''1'''''~"'-~ ..-.'"""""''''-'-'-4

t,b&",-~.-.~••••.~...::"....;. ~~i:.'

i:' .':".;'.:..::'':~'':"':'":";.":'';'': ,.,,~,

9.4 HouseNoJ Street/ Subdivision OCCUPATIOJlj IS:

:'j :~'':';;:/1:.' ·:R':R';cf~':;V~',1':';;7<"~

ft.:W:A·: ~,.COVy)~~,.".",.", ,

11. MY POST OFFICE ADDRESS FOR ELECTION PURPOSES IS : (Couldbe the sameas No,9) 12. I AM A REGISTERED VOTER OF

:# 4... ~ fk.not,. ~ ~,C4W\.NP-'-N,ST,}. MtN., /I1l1OYH17. ..JIU;ft:bt, ,(J~/.b,. blW, .Ifd.ov. , Precinct ••. //f<p.::1-:A ... ' ., . , " , , , .
13. NY PERIOD OF RESIDENCE IN THE PHILIPPINES BEFORE NAY 10,2010 IS :
Bgy .w~t. ,W\\J1l~:-,~tk ..... ".
•• ()l,.P.~h,ftPQ...c-td.,." "."
: 0: t:
:.':".: City/Mun
No.of Months : 4:0: No.DfYears
1--------.,;....:....:..-----------------------1 Province •• ~Nl.BItL.~,,, ..... ,, .. ,,,,,,
14. I AM A NATURAL BORN FILIPINO CITIZEN.
15. 1 AM NOT A PERMANENT RESIDENT OF, OR Ifo1MIGRANT TO, A FOREIGN
COUNTRY.
16. I AM ELIGIBLE FOR THE OFFICEI'I SEEK TO BE ELECTED TO.
17. I WILL SUPPORT AND DEFEND THE CONSTITUTION OF THE REPUBLIC OF THE
PHILIPPINES AND WILL MAINTAIN TRUE FAITH AND ALLEGIANCE THERETO. I
WILL OBEY THE LAWS, LEGAL ORDERS AND DECREES PROMULGATED BY THE
DULY CONSTITUTED AUTHORITIES. I IMPOSE THIS OBLIGATION UPON MYSEi.F
VOLUNTARILY, WITHOUTMENTAL RESERVATION OR PURPOSE Of EVASION.

Thumbprint

I hereby certify that the facts stated herein are true and correct of my
'" -;--,;r.::-~-:c.......-.I'..:Z---::--:-=-

. IV OATH
SUBSCRIBED AND SWORN to before me this __ VaVof lJib211f)9, at CITY OF SAN,MUMhibiting to me his/her
CTC/ldentification Card No.!Jo!-'f;t-OSOc.OQ Issued by: LTo 9!'i: 14 teh ;201(
F-X:P;I";':5
Doc. No. ;'3)
Poge No. _-;:{,:::::i'-- __
Book No. _=",--"-:::./ _
Series of 200:\
(Officer Authorized to Administer Oath)
(Affix documentary stamp)
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