Downloaded from: http://www.comelec.gov.

ph
CEF-1A
Republic of the Philippines
COMMISSION ON ELECTIONS
APPLICATION FOR REGISTRATION
(Voters Registration Record upon approval by the ERB)

Application No. Precinct No.

Instructions : (1) Accomplish separately in three copies; (2) print legibly; (3) check the appropriate box.

Part 1 PERSONAL INFORMATION (To be filled out by Applicant)

Name Illiterate Person with Disability

Last M A L A B A N A N Assisted by:

(Please fill-up Assistor's Oath)
First E M M A N U E L
Middle C A S A B A L Gender
Male Female

RESIDENCE/ADDRESS Province B A T A N G A S 62Kgs Height 158cm Weight

City/Municipality Barangay DATE OF BIRTH

T A N A U A N A M B U L O N G 0 1 - 2 5 - 1 9 7 8

House No. / Street Month Day Year

1 3 4 7 S I T I O L U D L O D PLACE OF BIRTH

CITIZENSHIP FILIPINO By Birth Naturalized Reacquired City/Mun TANAUAN

(If naturalized/reacquired, state date of naturalization/reacquisition and Certificate number of naturalization/order of approval of reacquisition) Province BATANGAS

Date of Naturalization/ Month Day Year Certificate No./Order of Approval CIVIL STATUS
Reacquisition Single Widow/er
COPY FOR THE ELECTION OFFICER

PERIOD OF RESIDENCE Married Legally

No. of Years No. of Months No. of Years Separated
In the City / Mun 3 0 0 8 in the Philippines 4 0 Name of Spouse, if married

PROFESSION / OCCUPATION none TIN 2 0 7 - 3 8 9 - 8 3 8 Rachelle Beverly S. Malabanan

NAME OF FATHER NAME OF MOTHER

Last M A L A B A N A N Last M A L A B A N A N

First N U M E R I A N O First C L A R I T A

Middle R O B L E S Middle C A S A B A L

Part 2 OATH ROLLED THUMBPRINTS / SPECIMEN SIGNATURES

I do solemnly swear that the above statements regarding my person are
true and correct; that I possess all the qualifications and none of the
disqualification of a voter; that I have no pending application for registration in
any city/municipality; and that I am not registered in any precinct in the
Philippines.

DATE 0 9 - 2 9 - 2 0 1 8 Emmanuel C. Malabanan

Month Day Year Signature of Applicant
Above Printed Name Left Thumb Right Thumb

EO / Administering Officer 1. 2. 3.
(Signature above Printed Name)
Part 3 ACTION BY THE ELECTION REGISTRATION BOARD
Month Day Year

Approved - - With precinct assignment No.

Disapproved Date Reason for disapproval

Member Chairman of the Board Member

(Signature above Printed Name) (Signature above Printed Name) (Signature above Printed Name)

Part 4 VOTER IDENTIFICATION NUMBER (To be filled out by Election Officer)

CITY/MUN/
DISTRICT CODE

Prov Code PRECINCT NO. Month Day Year

DATE OF BIRTH

ACKNOWLEDGEMENT RECEIPT Application No.

This is to acknowledge receipt of your Application for

Application for Registration registration. You are not yet registered unless approved by the
Election Registration Board (ERB). You need not appear in the
Last M A L A B A N A N ERB hearing unless required through a written notice.

First E M M A N U E L
EO/Interviewer Signature above Printed Name
Middle C A S A B A L
Downloaded from: http://www.comelec.gov.ph CEF1-A: COPY FOR THE ELECTION OFFICER (BACK)
VOTING RECORD

Voter's
DATE Ballot No. Chairman's Signature
Thumbmark Signature
 Downloaded from: http://www.comelec.gov.ph
CEF-1A
Republic of the Philippines
COMMISSION ON ELECTIONS
APPLICATION FOR REGISTRATION
(Voters Registration Record upon approval by the ERB)

Application No. Precinct No.

Instructions : (1) Accomplish separately in three copies; (2) print legibly; (3) check the appropriate box.

Part 1 PERSONAL INFORMATION (To be filled out by Applicant)

Name Illiterate Person with Disability

Last M A L A B A N A N Assisted by:

(Please fill-up Assistor's Oath)
First E M M A N U E L

Middle C A S A B A L Gender
Male Female

RESIDENCE/ADDRESS Province B A T A N G A S Height Weight

City/Municipality Barangay DATE OF BIRTH

T A N A U A N C I T Y A M B U L O N G 0 1 - 2 5 - 1 9 7 8

House No. / Street Month Day Year

1 3 4 7 S I T I O L U D L O D PLACE OF BIRTH

CITIZENSHIP FILIPINO By Birth Naturalized Reacquired City/Mun TANAUAN

(If naturalized/reacquired, state date of naturalization/reacquisition and Certificate number of naturalization/order of approval of reacquisition) Province BATANGAS

Date of Naturalization/ Month Day Year Certificate No./Order of Approval CIVIL STATUS
Reacquisition Single Widow/er

PERIOD OF RESIDENCE Married Legally

COPY FOR THE PROVINCIAL FILE

No. of Years No. of Months No. of Years Separated

In the City / Mun in the Philippines Name of Spouse, if married

PROFESSION / OCCUPATION TIN - -

NAME OF FATHER NAME OF MOTHER

Last Last

First First

Middle Middle

Part 2 OATH ROLLED THUMBPRINTS / SPECIMEN SIGNATURES

I do solemnly swear that the above statements regarding my person are
true and correct; that I possess all the qualifications and none of the
disqualification of a voter; that I have no pending application for registration in
any city/municipality; and that I am not registered in any precinct in the
Philippines.

DATE - -
Month Day Year Signature of Applicant
Above Printed Name Left Thumb Right Thumb

EO / Administering Officer 1. 2. 3.
(Signature above Printed Name)
Part 3 ACTION BY THE ELECTION REGISTRATION BOARD
Month Day Year

Approved - - With precinct assignment No.

Disapproved Date Reason for disapproval

Member Chairman of the Board Member

(Signature above Printed Name) (Signature above Printed Name) (Signature above Printed Name)

Part 4 VOTER IDENTIFICATION NUMBER (To be filled out by Election Officer)

CITY/MUN/
DISTRICT CODE

Prov Code PRECINCT NO. Month Day Year

DATE OF BIRTH
 Downloaded from: http://www.comelec.gov.ph
CEF-1A
Republic of the Philippines
COMMISSION ON ELECTIONS
APPLICATION FOR REGISTRATION
(Voters Registration Record upon approval by the ERB)

Application No. Precinct No.

Instructions : (1) Accomplish separately in three copies; (2) print legibly; (3) check the appropriate box.

Part 1 PERSONAL INFORMATION (To be filled out by Applicant)

Name Illiterate Person with Disability

Last Assisted by:

(Please fill-up Assistor's Oath)
First

Middle Gender
Male Female

RESIDENCE/ADDRESS Province Height Weight

City/Municipality Barangay DATE OF BIRTH

- -
House No. / Street Month Day Year

PLACE OF BIRTH

CITIZENSHIP By Birth Naturalized Reacquired City/Mun

(If naturalized/reacquired, state date of naturalization/reacquisition and Certificate number of naturalization/order of approval of reacquisition) Province

Date of Naturalization/ Month Day Year Certificate No./Order of Approval CIVIL STATUS
Reacquisition Single Widow/er

PERIOD OF RESIDENCE Married Legally

COPY FOR THE CENTRAL FILE

No. of Years No. of Months No. of Years Separated

In the City / Mun in the Philippines Name of Spouse, if married

PROFESSION / OCCUPATION TIN - -

NAME OF FATHER NAME OF MOTHER

Last Last

First First

Middle Middle

Part 2 OATH ROLLED THUMBPRINTS / SPECIMEN SIGNATURES

I do solemnly swear that the above statements regarding my person are
true and correct; that I possess all the qualifications and none of the
disqualification of a voter; that I have no pending application for registration in
any city/municipality; and that I am not registered in any precinct in the
Philippines.

DATE - -
Month Day Year Signature of Applicant
Above Printed Name Left Thumb Right Thumb

EO / Administering Officer 1. 2. 3.
(Signature above Printed Name)
Part 3 ACTION BY THE ELECTION REGISTRATION BOARD
Month Day Year

Approved - - With precinct assignment No.

Disapproved Date Reason for disapproval

Member Chairman of the Board Member

(Signature above Printed Name) (Signature above Printed Name) (Signature above Printed Name)

Part 4 VOTER IDENTIFICATION NUMBER (To be filled out by Election Officer)

CITY/MUN/
DISTRICT CODE

Prov Code PRECINCT NO. Month Day Year

DATE OF BIRTH