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Republic of the Philippines

COMMISSION ON ELECTIONS
Manila

CERTIFICATE OF CAN
SENATOR
INSTRUCTIONS: (Readwell before filling up this form.)
1. Filethis in FIVE(5) LEGIBLEcopies.
2. File this cernncare of candidacy with the Law Department, COMELEC Main Office, Jntramuros, Manila, starting November 20, 2009 up to
midnight of 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
certificate of nomination shall be accepted.
4. Titles such as 'Dr., Atty., Don, Ginoo,Seiior, Datu, Hadji, Sultan, Bai, Senora,Kapitanor similar ti~es are expresslyprohibited.
5. This certificate shall be SWOrn before a notary public or any o.Fficial authorized to administer oath. COMELEC orncrets are not authorized to
administer oath.

J.l Last Name

1. 2 First Name

1.3 r'liddle Name Month Day Year

6. MY PLACE OF BIRTH IS :
2. lAM GENERALLY OR POPULARLY KNOWN BY THE NICKNAME OR STAGENAME
(Indicate anty one nickname or stagename) Oty/Mun .M!l-Nl~/L .
:'IJi ':ifC;:" .:..""':";":":-' r: --r":" ':"
~------~'-"~'-'-"~'~".-.-.~,.-.~:~ •.~:~.~
.. ~.•-.~:'.~.-.'~
.. ~.-:~.. ~:~..-.~'.-..-~'.-.~.:-.~.~
T':" ':"r'~'-f":"~" T ":"'; Province
...-.~..-.-.~:.-'~:-··~'·-'-"-·'~'·-'-'~':-'-'~:'-'-·-"-'-'-"~8.MYCIVIL
~ .• riel{
STATUS IS:
_ _..
.7. I"AM OFFICIALLY

...............
NOMINATED BY: (Attach Certificateof Nomination)

ANfa .. K/teltTltiJtJ .. Plttr! _ .

o Single 0 Widow/er

Political Par [6] Married 0 LegallySeparated

9. MY RESIDENCE
ADDRESS IS:
I
9.1 Province
[~j~::~::.::[:::::~:::::::;:::~::::::::::::::::::::•• :::.:: tJ Annulled/ Divorced

9.2 Cilyi~lunicipality Full Name of Spouse, if married

::'.:~::::.'.: [~J:~::~:i::::::~:~:~:
~j~I: :::::[: I::: . /'Yl~.~.?!i/llI1 ..C~.MIIIP.
9.3 Barangay

:M:~><[~Erj::::: :r~:ij::~:-: 10. MY PROFESSION OR

.

i:" ':'C"[A:~..:,;\':R:~':'
9.4 House No.1Street f Subdivision OCCUPATION IS :

'1"~TR::" ':-c:r~\]v1"A'r~' :~.:~. r":~: i' \Ti':s':" :'~TI':~.:.. Jrlt!w~pmL I-b.NJlJhtA.JJr .

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

~}.LI. .1.ft.o t...6£N.·MP.\NPlN.~. SAN.l\N.1D~~O

.. 1/.IJ.Ml-~~.P.ft'h~.ClT.'l){.,t?~. Precinct .~S~.~>1 .
1.3. MY PERIOD OF RESIDENCE IN THE PHILIPPINES BEFORE MAY 10, 2010 IS : Bgy ~ .. kJYI8.o. '.
; ..•... , ;" "". OtyfMun mlJxf1:7l.cJJ!1. .
t------------: _P_.:_:)_. '_: __ NO_._Of_r"_on_t_hs :_~_.
,_:,~_.
.: : N_O._O_fY_ea_,_s -1 Province Ncfl. :-:.I.fttl. p!QR;/cT .
1.4. I AM A NATURAL BORN FILIPINO CrnZEN.
15. I AM NOT A PERMANENT RESIDENT OF, OR IMMIGRANT TO, A FOREIGN
COUNTRY.
16. I AM ELIGIBLE FOR 'THE OFFICE I SEEK TO BE ELECfED TO.
17. I WILL SUPPORT AND DEFEND THE CONSTITUTION OF THE REPUB.LIC 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 MYSELF
VOLUNTARILY, WITHOUT MENTAL RESERVATION OR PURPOSE,SlF EVASION.

Thumbprint

Signature of candidate Over Printed Name

- N0\/ 1 6 ,)MO OATH

SUBSCRIBED AND SWORN to before me this __ Jay of Novem~l.J.tib9, at CiTY OF S~~AJ~W~Jbitlng to me his/her
CTC/ldentification Card No. JiJ~ -~'1-M·1:2(O
Issued by: LTo .iilfi: [2. JO.\1 20\1
. t..p il';"3
. 3'-t.
Doc No
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Page No. _-,--::(,:--g_~-,
Book No. _.,.-"'lrc-- __ (Officer Authorized to Administer Oath)
Series of 2003. (Affix documentary stamp)