CEF-1B

Republic of the Philippines

COMMISSION ON ELECTIONS

APPLICATION FOR TRANSFER/

TRANSFER WITH REACTIVATION

A P P L I C A T I O N FOR T R A N S F E R OF R E G I S T R A T I O N R E C O R D
DUE T O C H A N G E OF R E S I D E N C E

to another city/municipality/district

J within the same city/municipality/district

, Filipino, born on

First name Middle name/Last name

a duly registered voter in Precinct No.

City/Municipality of
separated/married to
record due to transfer of my residence to:
House No./Street.
Sitio
City/Municipality:

month/day/year

of
, Province of

Barangay

, single/widow/er/legally
. do hereby apply for the transfer of my registration

.
Barangay:
Province:

That I have resided in my new residence for

years and

months.

(To be filled out by applicant applying for transfer with reactivation.)

UJ

Further, I do hereby apply for the reactivation of my registration record which was deactivated due to (please
check appropriate box):

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1. Sentence by final judgment to suffer imprisonment for not less than one (1) year;

_;

[ ]

2. Conviction, by final judgment, of crime involving disloyalty to the duly constituted government, etc;

UJ

..

<J

jE

U.

| |

3. Declaration of insanity or incompetence by a competent authority;

4. Failure to vote in two (2) successive preceding regular elections;
5. Loss of Filipino. Citizenship; or

>.

L_J

6. Exclusion by a court order.

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That said ground no longer exists, as evidenced by the attached certification/order of the court (in case of
1,2,3, 5 and 6).
IN WITNESS WHEREOF, I have hereunto affix my signature this
day of
, 20
at
,
Province of
, Philippines.

(Signature above Printed Name)

SUBSCRIBED A N D S W O R N to before me on the above date.

EO/Chairman of the Election Registration Board

(Signature above Printed Name)

Notice to the applicant: Please accomplish the form at the back and have your blometric data i.e., your photograph, signature and fingerprints
captured digitally if: l.) transfer is within the same city/municipality and you have not previously undergone validation procedure; or 2.) transfer is
to another city/munidpality.

Application No.

Precinct No.

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

P E R S O N A L I N F O R M A T I O N (To be filled out by Applicant)

NAME
Last

First

i l l !

Disabled/

Assisted by

i l l !

(Please fill up Assistor's Oath)

GENDER

Middle j
RESIDENCE/ADDRESS

[^Male
Height

Province

City/Municipality

Barangay
I

Month

Birth

Naturalized

Month

Day

Year

Day

Year

PLACE OF BIRTH
Reacquired

City/Mun
Province

(If naturaiized/reacquired, state date of naturalization/reacquisltlon and Certificate Number of naturalization/order of approval of reacqulsltiuri)

Date of Naturalization/
Reacquisition

Weight

House No./ Street

L_>

[Female

DATE OF BIRTH
I

CITIZENSHIP

CIVIL STATUS

Certificate No./Order of Approval

^Single

jjwidow/er

PERIOD OF RESIDENCE
No. of Years

In the City /Mun

No. of Months

MamuiJ

No. of Years

In the Philippines j

PROFESSION/OCCUPATION

Separated
Name of Spouse, if married

TIN

N A M E O F FATHER

NAME O F M O T H E R

Last

Last

First

Legally

f
|f|

First

Middle;

Middle i

OATH

PART 2

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 disqualifications of a voter;
that I have no pending application for registration in any city/municipality; and that I
am not registered in anyprecinct in the Philippines.
DATE
Month

Day

Signature of Applicant
Above Printed Name

Year

Left Thumb

Right Thumb

EO / Administering Officer
(Signature above Printed Name)
A C T I O N BY T H E E L E C T I O N R E G I S T R A T I O N B O A R D

PART 3

3.

Approved

With precinct assignment No.

Date

[Disapproved

Member
Signature above Printed Name
PART 4

Reason for disapproval

Chairman of the Board

Signature above Printed Name

Member
Signature above Printed Name

V O T E R IDENTIFICATION NUMBER (To be filled out by Election Officer)

CITY/MUN
DISTRICT CODE

PRECINCT N(

YEAR
DATE OF BIRTH

Republic of the Philippines

COMMISSION ON ELECTIONS

APPLICATION FOR TRANSFER/

TRANSFER WITH REACTIVATION

A P P L I C A T I O N FOR T R A N S F E R OF R E G I S T R A T I O N R E C O R D
DUE T O C H A N G E OF R E S I D E N C E

J within the same city/municipality/district

J to another city/municipality/district

I,

, Filipino, born on
First name Middle name/Last name

a duly registered voter in Precinct No.

City/Municipality of
separated/married to
record due to transfer of my residence to:
House No./Street.
Sitio
City/Municipality:

, Province of

Barangay

, single/widow/er/legally
, do hereby apply for the transfer of my registration

Barangay:
Province:

That I have resided in my new residence for

Bt

month/day/year

of

years and

months.

(To be filled out by applicant applying for transfer with reactivation.)

UJ

Further, I do hereby apply for the reactivation of my registration record which was deactivated due to (please
check appropriate box):
[ ]

2. Conviction, by final judgment, of crime involving disloyalty to the duly constituted government, etc;

UJ
m

UJ

1. Sentence by final judgment to suffer imprisonment for not less than one (1) year;

__

3. Declaration of insanity or incompetence by a competent authority;

4. Failure to vote in two (2) successive preceding regular elections;

o
u

5. Loss of Filipino Citizenship; or

6. Exclusion by a court order.
That said ground no longer exists, as evidenced by the attached certification/order of the court (in case of
1,2,3, 5 a n d 6).
IN WITNESS WHEREOF, I have hereunto affix my signature this
Province of
, Philippines.

day of

, 20

at

(Signature above Printed Name)

SUBSCRIBED A N D S W O R N to before me on the above date.

EO/Chairman of the Election Registration Board

(Signature above Printed Name)

Notice to the applicant: Please accomplish the form at the back and have your biometric data i.e., your photograph, signature and fingerprints
captured digitally if: 1.) transfer is within the same city/municipality and you have not previously undergone validation procedure; or 2.) transfer is
to another city/munidpality.

Application No.

Precinct No.

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

First

P E R S O N A L I N F O R M A T I O N (To be filled out by Applicant)

!..

City/Municipality
f
1
i
1 f
!
|
|
| |

Province
1

'

'

I i
Barangay
f
! i f
j | : |
1

!H_.VoA n
i

'

'

J_?...

,.J? L.,
a

.-

~j Naturalized

,- . .
Ye

ar

PERIOD OF RESIDENCE
No. of Years
In the City/Mun i
| I

^Reacquired

No. of Months

N A M E OF MOTHER

Last

First

First

Middle I

Married

. T I N i.

I I

^Jwidow/er

Legally
Separated
Name of Spouse, if married

No. of Years
In the Philippines

Year

CIVIL STATUS
^Single

Last

7 1 T

Day

Province

Certificate No./Order of Approval

N A M E OF FATHER
I

Weight

City/Mun

PROFESSION/OCCUPATION

Fema|0

PLACE OF BIRTH

(If naturallzed/reacquired, state date o f naturalization/ieacquisitlon a n d Certificate Number of naturalization/order of a p p r o v a l o f reacquisition)

Date of Naturalization/
Reacquisition

j-|

j ^ i j l

^ J B y Birth

CITIZENSHIP

Ma|e

Height
DATE OF BIRTH

J....

Month
i

Oath)

I
I

House No./ Street

<

( P l e a s e fill up A s s i s t o r ' s

GENDER

RESIDENCE/ADDRESS

Assisted by
1

Middle i

r-[Disabled/
ff&nnto>*>

Illiterate

PART 2

Middle

ROLLED THUMBPRINTS / SPECIMEN SIGNATURES

O A T H

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 disqualifications 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
Day

Month

Signature of Applicant
Above Printed Name

Year

Left Thumb

Right Thumb

EO / Administering Officer
(Signature above Printed Name)

3.

A C T I O N BY T H E E L E C T I O N R E G I S T R A T I O N B O A R D

PART 3
r
I

[Approved

Day

.
;

With precinct assignment No.

Date

[Disapproved

Member
Signature above Printed Name
PART 4

j.

Reason for disapproval

Chairman of the Board

Signature above Printed Name

Member
Signature above Printed Name

VOTER I D E N T I F I C A T I O N NUMBER (To be filled out by Election Officer)

CITY/MUN
DISTRICT CODE

PRECINCT NO.

YEAR
DATE OF BIRTH

ACKNOWLEDGEMENT RECEIPT
Application No.
Application for Registration
Last

First

Middle |

This is to acknowledge receipt of your Application for

registration. You are not yet registered unless approved by
the Election Registration Board/(ERB). You need not appear
in the ERB hearing unless required through a written notice.
i

[ [ i l l

L...L.
EO/Interviewer Signature Above Printed Name

CEF-1B
Republic of the Philippines

COMMISSION ON ELECTIONS

APPLICATION FOR TRANSFER/

TRANSFER WITH REACTIVATION

APPLICATION FOR TRANSFER OF REGISTRATION RECORD

DUE TO CHANGE OF RESIDENCE

j to another city/municipality/district

within the same city/munidpality/district

, Filipino, born on

I,

month/day/year

First name Middle name/Last name

a duly registered voter in Precinct No.

City/Municipality of
separated/married to
record due to transfer of my residence to:
House No./Street.^
Sitio
City/Municipality:

of
, Province of

Barangay

, single/widow/er/legally
_, do hereby apply for the transfer of my registration

Barangay:
Province:

That I have resided in my new residence for

years and

months.

(To be filled out by applicant applying for transfer with reactivation.)

UJ

Further, I do hereby apply for the reactivation of my registration record which was deactivated due to (please
check appropriate box):

Q.

DC

1. Sentence by final judgment to suffer imprisonment for not less than one (1) year;

Q_]

2. Conviction, by final judgment, of crime involving disloyalty to the duly constituted government, etc;

PI

3. Declaration of insanity or incompetence by a competent authority;

4. Failure to vote in two (2) successive preceding regular elections;

5. Loss of Filipino Citizenship; or

6. Exclusion by a court order.

That said ground no longer exists, as evidenced by the attached certification/order of the court (in case of
1,2,3, 5 and 6).
IN WITNESS WHEREOF, I have hereunto affix my signature this
Province of
, Philippines.

day of

, 20

at

(Signature above Printed Name)

SUBSCRIBED A N D S W O R N to before me on the above date.

EO/Chairman of the Election Registration Board

(Signature above Printed Name)

Notice to the applicant: Please accomplish the form at the back and have your blometric data i.e., your photograph, signature and fingerprints
captured digitally if: 1.) transfer is within the same city/municipality and you have not previously undergone validation procedure; or 2.) transfer is
to another city/munidpality.

Application No.

Precinct No.

Instructions : (1) A c c o m p l i s h separately in t h r e e copies; (2) print legibly; (3) c h e c k the a p p r o p r i a t e box.

PART 1

PERSONAL INFORMATION (To be filled out by Applicant)

Last

1 11 1 1 j 11 j1 11 1 I1

First

i j

Middle I

j i ; i i | ] i j

RESIDENCE/ADDRESS

Province

(Please fill-up Assistor's Oath)

11I 1 1

GENDER

Barangay

--I

f |"II
,.i 1 i I .

I J i L
^Naturalized

Birth

Month

Day

Year

^Reacquired

Certificate No./Order of Approval

In the Philippines j

. TIN [

"jLegaliy
Separated
Name of Spouse, if married
I-i

NAME OF MOTHER

Last

Last

First

Middle j

First

Middle

OATH

PART 2

jjwidow/er

^Married

N A M E O F FATHER
j

Year

CIVIL STATUS

No. of Years

No. of Months

Day

Province

^Single

PROFESSION/OCCUPATION

Weight

City/Mun

PERIOD OF RESIDENCE
No. of Years
In the City /Mun i
i

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 disqualifications 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

Signature of Applicant
Above Printed Name

Year

Left Thumb

Right Thumb

EO / Administering Officer
(Signature above Printed Name)

ACTION BY THE ELECTION REGISTRATION BOARD

PART 3
^Approved

With precinct assignment No.

Date

^Disapproved

Member
Signature above Printed Name

PART 4

|Female

PLACE O F BIRTH

(If naturalized/reacqulred, state date o f naturalization/reacquisition and Certificate Number of naturalization/order of approval of reacquisition)

Month

DATE OF BIRTH

House No./ Street

Date of Naturalization/
Reacquisition

^Male
Height

City/Municipality

CITIZENSHIP

[Disabled/

Assisted by:

|[""'I'""]jJ|

! | | j |

ill

illiterate

I I I I I I I

Reason for disapproval

Chairman of the Board

Signature above Printed Name

Member
Signature above Printed Name

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

DISTRICT CODE

YEAR
DATE OF BIRTH