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COMMISSION ON ELECTIONS FORM

May 13, 2019


National and Local Elections 1
Statement of Contributions and Expenditures SOCE

PART A: PERSONAL INFORMATION OF THE CANDIDATE


A.1. NAME OF CANDIDATE:
(SURNAME) (FIRST NAME) (MIDDLE NAME)

A.2. CANDIDATE TYPE: INDEPENDENT CANDIDATE (Indicate "N/A" for Part A.3.)
(Use "X" in appropriate box)
CANDIDATE WITH SUPPORT OF A POLITICAL PARTY

A.3. NAME of POLITICAL PARTY:


(COMPLETE NAME OF THE PARTY) (ACRONYM)

ELECTIVE POSITION:
A.4. (Skip Part A.5. if national position)
A.5. CONSTITUENCY OF THE ELECTIVE POSITION:

(DISTRICT) Indicate "LONE" if only 1 (CITY/MUNICIPALITY) (PROVINCE/REGION)

CONTACT DETAILS: MOBILE/PHONE NOS.:


A.6.
E-MAIL ADDRESS:

A.7. PERMANENT ADDRESS:


(HOUSE NO./UNIT) (NAME OF BUILDING/SUBDIVISION) (STREET NAME)

(BARANGAY) (DISTRICT/AREA) (CITY/MUNICIPALITY) (PROVINCE)

PART B: CONTRIBUTIONS RECEIVED (Itemized entries in the schedule of contributions, indicate "0.00" if none received)
B.1. CASH CONTRIBUTIONS RECEIVED FROM OTHER SOURCES: ₱0.00
B.2. IN-KIND CONTRIBUTIONS RECEIVED FROM OTHER SOURCES: ₱0.00
B.3. CASH CONTRIBUTIONS RECEIVED FROM POLITICAL PARTY: (for candidates with parties only) ₱0.00
B.4. IN-KIND CONTRIBUTIONS RECEIVED FROM POLITICAL PARTY: (for candidates with parties only) ₱0.00
TOTAL CONTRIBUTIONS RECEIVED ₱0.00

PART C: EXPENDITURES INCURRED (Itemized entries in the schedule of expenditures, indicate "0.00" if none received)
C.1. EXPENDITURES PAID OUT OF PERSONAL FUNDS / RESOURCES:
C.2. EXPENDITURES PAID OUT OF CASH CONTRIBUTIONS:
C.3. EXPENDITURES INCURRED USING IN-KIND CONTRIBUTIONS:
TOTAL EXPENDITURES INCURRED ₱0.00

PART D: CERTIFICATION & ACKNOWLEDGMENT


The undersigned candidate, after being duly sworn to, hereby depose and state that:
(1) This disclosure and its attachments, are supported by receipts, vouchers, and other documents reflecting the full, true, accurate, and
complete contributions received and expenditures incurred by the undersigned candidate and his/her duly authorized representative;
(2) The expenditures incurred are for lawful purposes and the contributions were not received from persons or entities prohibited by law to
give contributions.
(3) The undersigned consents on the general use and sharing of information obtained in this disclosure and its attachments for legitimate and
authorized purposes.
IN WITNESS WHEREOF, the undersigned hereunto affix his/her signature on [date signed].

AFFIX SIGNATURE HERE



NAME AND SIGNATURE

SUBSCRIBED AND SWORN TO before me on date notarized , affiant exhibiting his/her


issued by expiring on [date of expiry].
(Type of identification document) (ID Number) (Government Agency issuing the ID)

Doc. No.:
Page No.:
Book No.:
Series of (Place Notarial Seal & Signature here)

THIS SECTION IS FOR COMELEC USE ONLY - DO NOT ENCODE / WRITING ANYTHING BEYOND THIS LINE
Indicate "✓" beside form code/document name if submitted, " ✗" if not.
☐ SCR (Sched of Contributions Rcvd) ☐ Contribution Receipts
☐ SOE (Sched of Expenditures) ☐ Expenditure Receipts
☐ SUO (Sched of Unpaid Obligations) ☐ Obligations Payable
☐ SLE (Sum. Report of Lawful Exp.) NO. OF PAGES: _________
☐ Others: pls. specify: (This space is for the receiving date/time stamp of the receiving office)
FORM
COMMISSION ON ELECTIONS
May 13, 2019
Schedule of Contributions Received
2
National and Local Elections

SCR

NAME OF CANDIDATE: Type of Contribution


(SURNAME) (FIRST NAME)

DATE RECEIPT FULL NAME OF DESCRIPTION


ADDRESS OF CONTRIBUTOR AMOUNT/VALUE OF CONTRIBUTION
RECEIVED NUMBER CONTRIBUTOR (for in-kind contributions)

(Cash or
In-kind)

TOTAL CONTRIBUTIONS RECEIVED ₱0.00

CERTIFICATION ACKNOWLEDGMENT
I hereby certify that:(1) the contributions listed above were made to me as a candidate; (2) all SUBSCRIBED AND SWORN TO BEFORE ME this
entries specified above are true & correct; (3) they are supported by the official receipts issued affiant exhibiting his/her
by me upon acceptance; (4) the contributions are from sources not prohibited by the Omnibus issued by the [issuing office] [date of expiry].
Election Code and other pertinent laws.
DATA PRIVACY ACT
The undersigned consents on the general use and sharing of information obtained in this disclosure
and its attachments for legitimate and authorized purposes.
Doc. No. ________;
Page No. ________;
Book No. ________;
NAME AND SIGNATURE DATE SIGNED Series of ________. NOTARY PUBLIC
COMMISSION ON ELECTION FORM
May 13, 2019
National and Local Elections 3
Schedule of Expenditures SCE

NAME OF CANDIDATE:
(SURNAME) (FIRST NAME) (MIDDLE NAME)

RECEIPT/ INVOICE FULL NAME OF BUSINESS FIRM ADDRESS OF BUSINESS FIRM TIN OF CONTRACTOR or BUSINESS Exp Type AMOUNT/VALUE OF
DATE INCURRED DESCRIPTION OF EXPENSE
NUMBER OR CONTRACTOR OR CONTRACTOR FIRM (A-K) EXPENDITURE

3/1/2019 48718 Señor Jose Panaderia, Inc. Señor Jose Panaderia, Inc. 004-261-344-020 Meals A ₱3,000.00
3/14/2019 491810 First Auto-LPG Gas Holding Corp. Gorordo Ave., Cor. Sanson Rd., Lahug, Cebu City 244-935-042-001 Gas A ₱ 1,956.00
3/16/2019 71796 Argao Petron Pump Station High, Poblacion, Argao, Cebu 212-871-618-001 Gas A ₱ 2,000.00
5/7/2019 407828 La Nueva Supermarket, Inc. M.C Briones St., Cebu City 000-312-822-003 Meals A ₱ 2,088.00
3/23/2019 1653498 A Cebu Port Authority Port of Danao, Danao City 004-269-886-004 Transportation A ₱ 5.00
3/26/2019 244996 Cebu Port Authority North Reclamation Area, Mabolo, Cebu City 004-269-886-00000 Transportation A ₱ 84.00
3/26/2019 320946 Cebu Port Authority North Reclamation Area, Mabolo, Cebu City 004-269-886-000 Transportation A ₱ 168.00
3/23/2019 332198 SANDS TICKETING LOUNGE Sands Poblacion, Danao City, Cebu 468-079-452-000 Transportation A ₱ 20.00
3/28/2019 4146521 A Cebu Port Authority Pier 3 Port Area, Tinago Cebu City 004-269-886-00019 Transportation A ₱ 25.00
3/7/2019 0001-01598134 Route Stop Ventures Corporation Archbishop Reyes Ave Lahug Cebu City 472-829-683-000 Meals A ₱ 522.00
5/8/2019 1012067 La Nueva Supermarket, Inc. Plaridel Street, Cebu City 000-312-822-000 Meals A ₱ 702.00
5/8/2019 5412 Parrt Ebelle Eatery Tungkop, Minglanilla, Cebu 236-802-968-002 Meals A ₱ 970.00
5/8/2019 5413 Parrt Ebelle Eatery Tungkop, Minglanilla, Cebu 236-802-968-002 Meals A ₱ 300.00
5/6/2019 40796 ASSI MART Mabolo, Cebu City 900-846-123-000 Meals A ₱ 510.00
5/4/2019 278616 FOODA SAVERSMART F. Cabahug St. Kasambagan Cebu City 218-479-030-0004 Meals A ₱ 562.00
5/4/2019 239020 FOODA SAVERSMART F. Cabahug St. Kasambagan Cebu City 218-479-030-0004 Meals A ₱ 580.00
5/4/2019 432907 RMG Management Corporation Talamban Cebu City 243-930-102-024 Meals A ₱ 505.00
5/7/2019 877595 La Nueva Supermarket, Inc. Plaridel Street, Cebu City 000-312-822-000 Meals A ₱ 1,000.00
4/24/2019 77327 Julies Bakeshop Corner Carlock, C. Padilla, Cebu 243-930-102-140 Meals A ₱ 150.00
5/9/2019 1175328 PETRON Escario St. Kamputhaw Cebu City 424-392-875-0000 Gas A ₱ 500.00
4/23/2019 913 New Ventures Shell Station General Maxilom Ave., Zapatera, Cebu City 200-206-114-011 Gas A ₱ 100.00
5/10/2019 2396 Genesis: Center for Mother and Child Health Inc. T. Padilla, Cebu City 475-189-186-000 Medicines A ₱ 2,500.00
4/23/2019 10289 FILLWISE FUEL SERVICE STATIONS INC Bogo City 461-393-937-000 Gas A ₱ 2,500.00
4/29/2019 001-114123 Leon Cakes and Pastries Juan Luna Ave. Cebu City 234-190-081-000 Meals A ₱ 385.00
4/22/2019 298251 Maayo Shipping, Inc. Poblacion, Sibulan, Negros Oriental 000-612-056-002 Transportation A ₱ 430.00
3/12/2019 79583 AA ISDA BABOY N' BBQ Inc. Pusok Lapulapu City 272-852-021-007 Meals A ₱ 895.00
4/29/2019 299785 Maayo Shipping, Inc. Poblacion, Sibulan, Negros Oriental 00-612-056-002 Transportation A ₱ 654.00
4/22/2019 1565250 Maayo Shipping, Inc. Poblacion, Sibulan, Negros Oriental 000-612-056-002 Transportation A ₱ 70.00
4/29/2019 1565251 Maayo Shipping, Inc. Poblacion, Sibulan, Negros Oriental 000-612-056-002 Transportation A ₱ 70.00
4/30/2019 22378 Vitagarian Commodities Inc. Plaridel St., Ermita, Cebu City 254-2288-256-1222 Meals A ₱ 2,300.00
4/25/2019 1801050 A Cebu Port Authority Port of Sta. Fe Bantayan Cebu 004-269-886-003 Transportation A ₱ 5.00
4/25/2019 1801053 A Cebu Port Authority Port of Sta. Fe Bantayan Cebu 004-269-886-003 Transportation A ₱ 5.00
4/25/2019 1801052 A Cebu Port Authority Port of Sta. Fe Bantayan Cebu 004-269-886-003 Transportation A ₱ 5.00
4/25/2019 1801051 A Cebu Port Authority Port of Sta. Fe Bantayan Cebu 004-269-886-003 Transportation A ₱ 5.00
4/25/2019 1801054 A Cebu Port Authority Port of Sta. Fe Bantayan Cebu 004-269-886-003 Transportation A ₱ 5.00
4/26/2019 3416339 A Cebu Port Authority North Reclamation Area, Mabolo, Cebu City 004-269-886-003 Transportation A ₱ 168.00
2/26/2019 17000 Cebu Andoks Corporation Salinas Drive, Lahug, Cebu City 238-820-073-006 Meals A ₱ 1,254.00
2/26/2019 621186 La Nueva Supermarket, Inc. Briones St. Cebu City 000-312-822-003 Meals A ₱ 160.00
2/26/2019 543548 La Nueva Supermarket, Inc. Briones St. Cebu City 000-312-822-003 Meals A ₱ 2,360.00
2/20/2019 412117 La Nueva Supermarket, Inc. Briones St. Cebu City 000-312-822-003 Meals A ₱ 1,865.00
2/26/2019 10359083 SM Supermarket Reclamation Area Mabolo Cebu City 000-144-976-00001 Meals A ₱ 369.00
2/26/2019 222222 JM UY and SONS TRADING Corp. Briones St. San Roque Cebu City 225-947-691-001 Meals A ₱ 210.00
5/11/2019 136168 JS' PUBLICATIOS (The Freeman) CO., Inc. V. Gullas cor. D. Jakosalem Sts., Cebu City 003-843-740-000 Newspaper H ₱ 13,418.00
4/26/2019 156233 MTM FUEL EXPRESS H. Abellana St., Canduman, Mandaue City 246-803-959-000 Gas A ₱ 60.00
4/26/2019 156273 MTM FUEL EXPRESS H. Abellana St., Canduman, Mandaue City 246-803-959-000 Gas A ₱ 70.00
4/4/2019 49912 Señor Jose Panaderia, Inc. Magallanes St. cor, Climaco st., Ermita Cebu City
004-261-344-020 Meals A ₱ 1,041.00
3/27/2019 3996 HES 4H ETERPRISES INC. M. Cuenco Avenue Banilad, Cebu City 472-994-765-000 Office Supplies D ₱ 160.00
3/2/2019 E-0000000000000875389 Philippines Airlines Terminal, NAIA Floor, International Cargo Pasay
City. 000-597-645-000 Transportation A ₱ 3,532.00
3/2/2019 E-020-1000000000323196 Philippines Airlines Terminal, NAIA Floor, International Cargo Pasay
City.
000-597-645-020 Transportation A ₱ 3,928.00
2/25/2019 E-000-000000000855666 Philippines Airlines Terminal, NAIA Floor, International Cargo Pasay
City. 000-597-645-000 Transportation A ₱ 1,779.00
Terminal, NAIA Floor, International Cargo Pasay
3/2/2019 E-000-000000000857226 Philippines Airlines City.
000-597-645-000 Transportation A ₱ 1,743.00
3/4/2019 E-000-0000000000857688 Philippines Airlines Terminal, NAIA Floor, International Cargo Pasay
City. 000-597-645-000 Transportation A ₱ 1,196.00
4/30/2019 615245 CDC Resources, Donna Angela Yatco South Luzon Expressway San Antonio
008-413-215-0001 Gas A ₱ 3.41
5/4/2019 107731 ANALIZA CANLAS PETROLEUM STATION Olongapo-Gapan Raod Dolores City of San Fernando 242-582-437-005 Gas A ₱ 900.00
5/5/2019 E-000-000000000876287 Philippines Airlines Terminal, NAIA Road, Pasay City 1300 000-597-645-000 Transportation A ₱ 399.00
2/28/219 E-000-00000000008566600 Philippines Airlines Terminal, NAIA Road, Pasay City 1300 000-597-645-000 Transportation A ₱ 50.00
2/27/2019 E-000-0000000000856125 Philippines Airlines Terminal, NAIA Road, Pasay City 1300 000-597-645-000 Transportation A ₱ 6,639.00
4/20/2019 406222 Pagpilao Petron Service Center Brgy. Bukal Pagbilao Quezon 148-467-127-0000 Gas A ₱ 1,500.00
5/5/2019 1124437 Neighborhood Fuel and Lubes Corp. Santo Nino NCR, Fourth District City of Paranaque 009-197-708-0000 Gas A ₱ 500.00
4/17/2019 723169 NAIA Road Services Station, Inc. MIA Road NAIA Complex Brgy 197 Pasat City 009-544-286-0000 Gas A ₱ 200.00
3/21/2019 947241 Lucy Stargazer Corp. EDSA cor., Connecticut St. Mandaluyong City 008-222-274-0000 Gas A ₱ 1,500.00
4/6/2019 1096525 Neighborhood Fuel and Lubes Corp. Santo Nino NCR, Fourth District City of Paranaque 009-197-708-0000 Gas A ₱ 900.00
3/2/2019 556716 La Nueva Supermarket, Inc. Briones St. Cebu City 000-312-822-003 Meals A ₱ 1,882.00
3/10/2019 414312 Asian Marine Tranportation Corp. 40 Gorordo Ave, Camputhaw, Cebu City 203-052-586-000 Transportation A ₱ 1,230.00
2/20/2019 130728 JM UY and SONS TRADING Corp. Mc, Briones St. San Roque, Cebu City 225-947-691-001 Office Supplies D ₱ 1,100.00
2/20/2019 412118 La Nueva Supermarket, Inc. M.C. Briones St. Cebu City 000-312-822-003 Meals A ₱ 1,362.00
2/23/2019 21649 Vitagarian Commodities Inc. Plaridel St., Ermita, Cebu City 406-984-280-000 Meals A ₱ 2,200.00
3/17/2019 491811 First Auto-LPG Gas Holding Corp. Gorordo Ave., Cor. Sanson Rd., Lahug, Cebu City 244-935-042-001 Gas A ₱ 500.00
2/15/2019 13674 ARROW SM City Cebu Wing 205-883-000-038 Meals A ₱ 2,890.00
2/25/2019 229811 La Nueva Supermarket, Inc. M.C Briones St., Cebu City 000-312-822-003 Meals A ₱ 1,521.00
2/24/2019 338802 FOODA SAVERSMART F. Cabahug St. Kasambagan Cebu City 218-479-030-0004 Meals A ₱ 202.00
2/21/2019 229207 La Nueva Supermarket, Inc. M.C Briones St., Cebu City 000-312-822-003 Meals A ₱ 114.00
2/25/2019 66979 SM Supermarket North Reclamation Area, Mabolo, Cebu City 002-628-069-000 Maintenance F ₱ 409.00
2/25/2019 367511 SM Supermarket North Reclamation Area, Mabolo, Cebu City 002-828-069-000 Personal Expenses A ₱ 257.00
4/21/2019 601538 CITI PRIME GAS Juan Luna Ave. Cebu City 263-013-561-000 Gas A ₱ 200.00
4/11/2019 513083 Cebu Port Authority Pier 1 Port Area, San Roque, Cebu City 004-269-886-018 Transportation A ₱ 25.00
4/8/2019 2455 Palawan Pawnshop Sitio Sto. Nino, Brgy. Lahug, Cebu City 007-939-383-01066 Maintenance F ₱ 345.00
4/11/2019 A0406562 Puerto Servicio de Cebu M.J. Cuenco Ave. San Roque Cebu City 002-884-388-000 Transportation A ₱ 50.00
4/11/2019 910184 Cokaliong Shipping Lines, Inc Osmeña Ave. North Reclamation Area Cebu City. 000-553-566-000 Transportation A ₱ 585.00
4/12/2019 491857 Cebu Port Authority Port Area, Carreta, Cebu City 004-269-886-00022 Transportation A ₱ 25.00
3/29/2019 118748 Cebu Arrastre and Stevedoring Services Corp. Cor. Arellano Blvd, Tinago, Cebu City 000-948-237-000 Services A ₱ 50.00
3/29/2019 1042020 Lite Shipping Corporation Brgy. Tinago Cebu City 001-702-805-000 Transportation A ₱ 480.00
Madrigal Business Park, Ayala Alabang Muntinlupa
4/6/2019 1409911 Fast Cat City
223-662-279-000 Courier Charges C ₱ 2,835.00
4/6/2019 CEA0110000074038 LBC EXPRESS Lot 8-12 Cargo Area MCIAA Mactan Cebu 000-762-140-00024 Courier Charges C ₱ 865.00
5/24/2019 383324 Mini Stop M.J Cuenco Ave. Talamban Cebu City 237-008-147-006 Meals A ₱ 110.00
4/6.2019 549731 Philippine Ports Authority San Vicente, Dapitan City 000-352-232-00045 Transportation A ₱ 129.00
4/6/2019 92518 Upland Oil Sitio Lugsongon Basak, Lapu2 City 289-660-647-007 Gas A ₱ 500.00
4/5/2019 00-065563 Mandaue Electronics Corp. M.C. Briones St. Cebu City 706-905-813-000 Maintenance F ₱ 1,600.00
5/5/2019 55202033 Cebu Pacific, Inc Osmeña Blvd. Capitol Site Cebu 000-948-229-00000 Transportation A ₱ 1,332.00
2/21/2019 2172291 2GO Express Brgy. 191 Pasay City,NCR. Phils 000-855-492-00008 Courier Charges C ₱ 33.00
2/26/2019 TMR0210000017666 LBC EXPRESS Pinagkaisahan, Cubao, Quezon City 000-762-140-01939 Courier Charges C ₱ 815.00
2/25/2019 TMR0210000017666 LBC EXPRESS Pinagkaisahan, Cubao, Quezon City 000-782-140-01439 Courier Charges C ₱ 815.00
2/28/2019 NAA0710000115925 LBC EXPRESS Villamor Airbase Pasay City 782-140-00748 Courier Charges C ₱ 815.00
2/23/2019 116004 Victory Liner, Inc Edsa Brgy. 143 Pasay City NCR 000-616-906-00005 Transportation A ₱ 674.00
3/22/2019 126257 Victory Liner, Inc Edsa Brgy. 143 Pasay City NCR 000-616-906-00005 Transportation A ₱ 452.00
3/21/2019 125910 Victory Liner, Inc Edsa Brgy. 143 Pasay City NCR 000-616-906-00005 Transportation A ₱ 146.00
2/23/2019 116003 Victory Liner, Inc Edsa Brgy. 143 Pasay City NCR 000-616-906-00005 Transportation A ₱ 674.00
4/22/2019 4295295 Cebu Pacific, Inc Osmeña Blvd. Capitol Site Cebu 000-948-229-00000 Transportation A ₱ 3,134.00
3/28/2019 872119 Partas Transportation Co., Inc Kaunlaran, Cubao, Quezon City 001-096-359-001 Freight and Courier Charges C ₱ 2,200.00
3/25//2019 871621 Partas Transportation Co., Inc Kaunlaran, Cubao, Quezon City 001-096-359-001 Freight and Courier Charges C ₱ 405.00
4/16/2019 4293090 Cebu Pacific Air Inc. Osmeña Blvd. Capitol Site Cebu 000-948-229-0000 Transportation A ₱ 8,947.00
4/17/2019 4293520 Cebu Pacific Air Inc. Osmeña Blvd. Capitol Site Cebu 000-948-229-0000 Transportation A ₱ 1,780.00
4/6/2019 4290591 Cebu Pacific Air Inc. Osmeña Blvd. Capitol Site Cebu 000-948-229-0000 Transportation A ₱ 7,523.00
4/5/2019 4290357 Cebu Pacific Air Inc. Osmeña Blvd. Capitol Site Cebu 000-948-229-0000 Transportation A ₱ 13,815.00
3/27/2019 2096712 2GO Express Brgy/ 191 Pasay City, NCR, Fourth District Phils 000-855-492-00008 Courier Charges C ₱ 2,158.00
3/21/2019 54678654 Cebu Pacific Air Inc. Osmeña Blvd. Capitol Site Cebu 000-948-229-00000 Transportation A ₱ 4,052.00
3/23/2019 4285433 Cebu Pacific Air Inc. Osmeña Blvd. Capitol Site Cebu 000-948-229-00000 Transportation A ₱ 2,224.00
3/30/2019 87492 Goldenbridge Shipping Inc. Latasan, Labongon, Mandaue City 224-289-114-000 Courier Charges C ₱ 3,700.00
3/8/2019 4279887 Cebu Pacific Air Inc. Osmeña Blvd. Capitol Site Cebu 000-948-229-00000 Transportation A ₱ 3,763.00
3/5/2019 4278728 Cebu Pacific Air Inc. Osmeña Blvd. Capitol Site Cebu 000-948-229-00000 Transportation A ₱ 16,383.00
3/29/2019 4280186 Cebu Pacific Air Inc. Osmeña Blvd. Capitol Site Cebu 000-948-229-00000 Transportation A ₱ 4,397.00
3/5/2019 4278920 Cebu Pacific Air Inc. Osmeña Blvd. Capitol Site Cebu 000-948-229-00000 Transportation A ₱ 5,277.00
2/28/2019 4277170 Cebu Pacific Air Inc. Osmeña Blvd. Capitol Site Cebu 000-948-229-00000 Transportation A ₱ 6,950.00
3/2/2019 4277820 Cebu Pacific Air Inc. Osmeña Blvd. Capitol Site Cebu 000-948-229-00000 Transportation A ₱ 965.00
2/28/2019 NAA0410000043420 LBC EXPRESS Inc. Aguinadlo Highway, Roxas Blvd 000-782-140-00775 Courier Charges C ₱ 1,830.00
2/28/2019 NAA0410000043421 LBC EXPRESS Inc. Aguinadlo Highway, Roxas Blvd 000-782-140-00775 Courier Charges C ₱ 1,330.00
3/11/2019 707825 METRO Colon Stree Cebu City 226-527-915-012 Meals A ₱ 1,140.00
3/9/2019 3776 MJP GAS STATION Cawayan Dalaguete Cebu 916-570-805-000 Gas A ₱ 1,883.00
5/12/2019 112608 Cebu Pacific Air Inc. MCIA Lapu-lapu City, Cebu 000-948-00026 Courier Charges C ₱ 429.00
3/22/2019 47006 Conceptiion Pia Native Chicken and Fastfood Soriano St. Carreta, Cebu City 256-197-731-000 Meals A ₱ 1,195.00
3/22/2019 1891 Cream n Bake Cakes and Pastries Ouano Ave., Tipolo, Mandaue City 227-784-816-000 Meals A ₱ 247.00
3/22/2019 24277 Sagwanamu Cebu I.T Park 009-342-255-001 Meals A ₱ 330.00
3/24/2019 27206 Heritage 1963 Inc Limketkai Center Lapasan CDO 008-976-871-008 Meals A ₱ 85.00
3/25/2019 4711 J&E Restaurant & General Merchandise Sitio Cevolig Lunotan, Gingoog City 424-373-864-000 Meals A ₱ 1,545.00
3/25/2019 20749 Chali Beach and Resort Corp. Zone 3, Old Road Cugman, CDO City 006-238-129-000 Travel Expenses A ₱ 850.00
3/24/2019 27210 Heritage 1963 Inc Limketkai Center Lapasan CDO 008-976-871-008 Meals A ₱ 690.00
3/25/2019 4357 Montlake Inc Aquino Ave. Lapu-Lapu Butuan City 008-174-699-039 Meals A ₱ 298.00
3/26/2019 13038 Sun City Computer Center $ Net Cafe Rajah Soliman, Butuan City 916-674-302-000 Printing D ₱ 64.00
3/26/2019 1501 Yellow Cab Pizza Co. Limketkai Center Lapasan CDO 241-437-266-00079 Meals A ₱ 753.00
3/24/2019 27205 Heritage 1963 Inc Limketkai Center Lapasan CDO 008-976-871-008 Meals A ₱ 540.00
3/24/2019 1450 Yellow Cab Pizza Co. Limketkai Center Lapasan CDO 241-437-266-00079 Meals A ₱ 1,523.00
3/21/2019 899 Bigby's Quality Food Corp. Cebu I.T Park 004-997-510-029 Meals A ₱ 2,937.00
3/21/2019 24161 Sagwanamu Corp. Cebu I.T Park 009-342-255-001 Meals A ₱ 360.00
4/7/2019 17205 Moms Small Hotel & Restaurant Ledesma, San Carlos City, Neg. Occ. 173-046-762-000 Meals A ₱ 423.00
4/252019 1911 Cebu Cardinal Bakeshop Avila St. Capitol Site Cebu City 184-196-368-002 Meals A ₱ 2,000.00
4/13/2019 0001-00068183 The Tinder Box Bauhina Drv. Kasambagan, Cebu City 009-125-342-000 Political Meeting G ₱ 1,580.00
3/31/2019 31945 Royal BTC M. Cuenco Ave. Banilad Cebu 270-776-370-000 Political Meeting G ₱ 2,245.00
4/9/2019 402 TAVALOTA Ayala Business Park Cebu City 421-612-234-001 Dinner Meeting G ₱ 4,905.00
4/8/2019 78863 S $ R PIZZA, Inc Cardinal Rosales Ave. Mabolo Cebu 009-316-981-032 Dinner Meeting G ₱ 2,065.00
4/8/2019 1750 Cebu Cardinal Bakeshop Don Jose Avila St. Capitol Site Ceu City 184-196-368-002 Political Meeting G ₱ 1,100.00
4/15/2019 14348 San-Vic Foodchain Corp. Corner Cabancalan Nasipit, Talamban Cebu 249-689-713-002 Meals A ₱ 2,390.00
4/23/2019 A0416978 Puerto Servicio de Cebu M.J. Cuenco Ave. San Roque Cebu City 002-884-388-000 Transportation A ₱ 50.00
4/23/2019 A0416978 Puerto Servicio de Cebu M.J. Cuenco Ave. San Roque Cebu City 002-884-388-000 Transportation A ₱ 50.00
4/23/2019 915284 Cokaliong Shipping Lines, Inc Don Serging Osmeña Ave. Cebu City 000-553-566-000 Courier Charges C ₱ 585.00
4/23/2019 542633 Cebu Port Authority Pier 3 Port Area, Tinago Cebu City 004-269-886-00019 Transportation A ₱ 25.00
4/23/2019 542632 Cebu Port Authority Pier 3 Port Area, Tinago Cebu City 004-269-886-00019 Transportation A ₱ 25.00
4/23/2019 542636 Cebu Port Authority Pier 3 Port Area, Tinago Cebu City 004-269-886-00019 Transportation A ₱ 25.00
4/23/2019 542635 Cebu Port Authority Pier 3 Port Area, Tinago Cebu City 004-269-886-00019 Transportation A ₱ 25.00
4/23/2019 542634 Cebu Port Authority Pier 3 Port Area, Tinago Cebu City 004-269-886-00019 Transportation A ₱ 25.00
4/8/2019 1212342 Ocean Fast Ferries Inc. Subangdako Pinahagbong, Mandaue City 000-258-937-000 Transportation A ₱ 1,800.00
3/28/2019 4801600265446 Golden Arches Development Corp. Osmeña Blvd. Cor. Arlington Cebu City 000-121-242-082 Meals A ₱ 445.00
4/1/2019 405452 RDC Petroleum Trading Corp. Rodriguez St. Sambag 1 Cebu City 460-752-264-0000 Gas A ₱ 1,000.00
4/10/2019 4/6/5798 Ocean Fast Ferries Inc. Insular Wharf, Tagbilaran City Bohol 000-258-937-004 Transportation A ₱ 500.00
4/8/2019 2576372 Ocean Fast Ferries Inc. Insular Wharf, Tagbilaran City Bohol 000-258-937-004 Transportation A ₱ 500.00
4/5/2019 1174 D'Crown Hotel Disud, Sindagan Zamboanga del Norte 712-740-656-000 Accomodation A ₱ 3,000.00
5/6/2019 465934 AFFINIS M.L Quezon Highway, Pusok, Lapu2 City 425-173-899-001 Meals A ₱ 42.00
4/21/2019 54683 Grand City Hotel, Inc. Abejuela St. CDO City 002-915-620-000 Accomodation A ₱ 2,598.00
5/6/2019 873 Boodotz Seafod Grill Inc. Verde, Mepz 2, Basak, Lapulapu City 009-392-568-000 Meals A ₱ 964.00
5/9/2019 1927 Baliwag Lechon Manok Inc Quezon St. Casuntingan Mandaue City 000-856-105-465 Meals A ₱ 649.00
5/10/2019 252314 Rustans Supermarket Business Park AS Fortuna St. Mandaue 201-160-401-065 Meals A ₱ 288.00
5/9/2019 366621 Gaisano Grand Mall Gov. Cuenco Nasipit Talamban Cebu City 000-704-113-005 Meals A ₱ 2,357.00
5/10/2019 4/21/2777 Metro Supermarket A.S Fortuna H. Cortes St. Banilad Mandaue 226-527-915-036 Meals A ₱ 214.00
5/10/2019 5056 Northline School and Office Supplies A.S Fortuna St. Banilad, Mandaue City 319-640-988-000 Maintenance F ₱ 851.00

TOTAL EXPENDITURES INCURRED ₱237,130.41

CERTIFICATION ACKNOWLEDGMENT
I hereby certify that: (1) the expenses listed above were incurred by me as a candidate or by my duly SUBSCRIBED AND SWORN TO BEFORE ME this [date of oath]
authorized representative/s; (2) all entries specified above are true and correct; (3) they are supported by the affiant exhibiting his/her
official receipts, invoices or other similar documents; (4) the expenses comply with Section 102 of the issued by the [issuing office] expiring on [date of expiry].
Omnibus Election Code.
DATA PRIVACY ACT
The undersigned consents on the general use and sharing of information obtained in this disclosure and its
attachments for legitimate and authorized purposes.
Doc. No. ________;
Page No. ________;
Book No. ________;
Series of ________.
NAME AND SIGNATURE DATE SIGNED NOTARY PUBLIC
COMMISSION ON ELEC
May 13, 2019

Local Elections
Summary Report of Lawful E
PART A: PERSONAL INFORMATION OF
A.1. NAME OF CANDIDATE: 0
(SURNAME)

A.2.
CANDIDATE TYPE:
(Use "X" in appropriate box)

A.3. NAME of POLITICAL PARTY: 0


(COMPLETE NAME OF THE P

A.4. ELECTIVE POSITION: 0


A.5. CONSTITUENCY OF THE ELECTIVE POSITION:

0 0
(DISTRICT) Indicate "LONE" if only 1 (CITY/MUNICIPALITY

PART B: SUBTOTAL OF LAWFUL EXPENDITURES P


Travel expenses of candidate and campaign personnel during the campaign and inciden
A
Compensation of campaigners, clerks, stenographers, messengers, and other persons em
B
Telephone, mobile phone usage fees, prepaid phone load, internet access, postages, freig
C
Stationery, printing and distribution of printed materials relative to candidacy;
D
Employment of watchers at the polls
E
Rent, maintenance and furnishing of campaign headquarters, office or place of meetings
F
Political meetings and rallies & the use of sound systems, lights and decorations during
G
Newspaper, radio, TV and other advertisements to promote the candidacy, includ
H placements
PART C: EXPENDITURES INCURRED
Employment of counsel
I
Copying and classifying lists of voters, investigating and challenging the right to vote o
J lists

Printing of sample ballots in such color, size and maximum number as may be authoriz
K
TOTAL EXPEN

PART D: CERTIFICATION & ACKNO


The undersigned candidate, after being duly sworn to, hereby depose and state that:
(1) This disclosure and its attachments, are supported by receipts, vouchers, and o

contributions received and expenditures incurred by the undersigned candidate and his
(2) The expenditures incurred are for lawful purposes and the contributions were
contributions.
(3) The undersigned consents on the general use and sharing of information obtained i
purposes.
IN WITNESS WHEREOF, the undersigned hereunto a

AFFIX SIGNATURE HERE


SUBSCRIBED AND SWORN TO before me on

(Type of identification document) (ID Number)

Doc. No.:
Page No.:
Book No.:
Series of
ISSION ON ELECTIONS FORM

Local Elections
4National and
SLE
Report of Lawful Expenditures
AL INFORMATION OF THE CANDIDATE
0 0
(FIRST NAME) (MIDDLE NAME)

INDEPENDENT CANDIDATE (Indicate "N/A" for Part A.3.)

CANDIDATE WITH POLITICAL PARTY

0 0
(COMPLETE NAME OF THE PARTY) (ACRONYM)

0 (Skip Part A.5. if national position)

0 0
(CITY/MUNICIPALITY) (PROVINCE/REGION)

UL EXPENDITURES PER EXPENSE TYPE/CATEGORY


g the campaign and incidental personal expenses
₱188,473.41

ngers, and other persons employed in the campaign


₱0.00

ternet access, postages, freight and courier charges


₱18,815.00

ative to candidacy;
₱1,324.00

₱0.00

s, office or place of meetings


₱3,205.00

hts and decorations during said meetings and rallies


₱11,895.00
mote the candidacy, including website/internet ad
₱13,418.00
SUBTOTAL ₱237,130.41
NCURRED (Itemized entries in Schedule of Expenditures)

₱0.00
allenging the right to vote of persons registered in the
₱0.00

number as may be authorized by the Commission


₱0.00
TOTAL EXPENDITURES INCURRED ₱237,130.41

IFICATION & ACKNOWLEDGMENT


y depose and state that:
receipts, vouchers, and other documents reflecting the full, true, accurate, and complete

dersigned candidate and his/her duly authorized representative;


d the contributions were not received from persons or entities prohibited by law to give

g of information obtained in this disclosure and its attachments for legitimate and authorized

the undersigned hereunto affix his/her signature on [date signed].

Err:511

date notarized , affiant exhibiting his/her


issued by expiring on [date of expiry].
(Government Agency issuing the ID)

(Place Notarial Seal & Signature here)


COMMISSION ON ELECTIONS FORM
May 13, 2019
National and Local Elections 5
Schedule of Unpaid Obligations SUO

NAME OF CANDIDATE: DESCRIPTION OF THE


(SURNAME) (FIRST NAME) (MIDDLE NAME)
OBLIGATION

PURPOSE REMAINING
DATE CONTRACT / LOAN ADDRESS OF AMOUNT/VALUE OF
NAME OF CREDITOR (for incurring OBLIGATION (Partial
INCURRED NO. CREDITOR OBLIGATION
obligation) Payments were made)

(i.e.
loan, etc.)

TOTAL UNPAID OBLIGATIONS ₱0.00

CERTIFICATION ACKNOWLEDGMENT
SUBSCRIBED AND SWORN TO BEFORE ME this [date of oath]
I hereby certify that: (1) the obligations listed above were incurred by me as a
candidate or with my authority by my duly authorized representative; (2) all entries affiant exhibiting his/her
specified above are true & correct ; (3) they are supported by contracts, issued by the [issuing office] expiring on [date of expiry].
promissory notes & other similar documents.
DATA PRIVACY ACT
The undersigned consents on the general use and sharing of information obtained in this
disclosure and its attachments for legitimate and authorized purposes.
Doc. No. ________;
Page No. ________;
Book No. ________;
NAME AND SIGNATURE DATE SIGNED Series of ________. NOTARY PUBLIC

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