D LIST OF PUBLIC SCHOOL TEACHERS WHO ARE WILLING, AVAILABLE AND QUALIFIED TO SERVE AS MEMBERS OF THE ELECTORAL BOARDS

For the OCTOBER 30, 2023 BARANGAY AND SANGGUNIANG KABATAAN ELECTIONS

Willing, Served in the

Available and REGISTERED Prev. Elections
PLACE OF Qualified to VOTER WITH as EB (Indicate ADDRESS SIGNATURE OF THE
NAME POSITION in TIN NO. APPLICANT (The signature is
ASSIGNMENT serve as ACTIVE election year (Brgy.Only)
NO. the Electoral Electoral STATUS & position CONTACT NO. EMAIL ADDRESS an attestation to the
Board Board held) truthfulness of all the facts
indicated in this certificate)

(LAST NAME, 1ST NAME, MIDDLE NAME) (BRGY./SCHOOL)

(YES/NO) (YES/NO) (YES/NO)
1
2
3
4
5
6
7
8
9
10

I hereby certifiy that the foregoing public school teachers ae qualified, willing and available to serve as Member of the Electoral Boards for the October 30, Barangay & SK Elections.

Date of the Request of the OEO:

Date of Submission to the OEO:

School Head PSDS

Subscribed and Sworn to me this ______, day of _______________; affiant exhibiting to me his/her competent evidence of identity: _______________________________________

ATTY. AINEE K. TAÑEZA

Election Officer / as Administering Officer

NOTICE/DISCLAIMER: All authorized recipients of any personal data, personal information, privileged information and sensitive personal information contained in this document, including other pertinent documens attached hereto that are shared by the Commission on Elections in compliance
with the existing laws and rules, and in comformity with the data Privacy Act of 2021 (R.A. No. 10173) and its Implementing Rules and Regultions, as well as the pertinent Circulars of the National Privacy Commission, are similary bound to comply with the said laws, rules and regulations relating
to data privacy, security, confidentiality, protection and accountability.
D LIST OF PUBLIC SCHOOL TEACHERS WHO ARE WILLING, AVAILABLE AND QUALIFIED TO SERVE AS MEMBERS OF THE ELECTORAL BOARDS

For the OCTOBER 30, 2023 BARANGAY AND SANGGUNIANG KABATAAN ELECTIONS

Willing, Served in the

Available and REGISTERED Prev. Elections
PLACE OF Qualified to VOTER WITH as EB (Indicate ADDRESS SIGNATURE OF THE
NAME POSITION in TIN NO. APPLICANT (The signature is
ASSIGNMENT serve as ACTIVE election year (Brgy.Only)
NO. the Electoral Electoral STATUS & position CONTACT NO. EMAIL ADDRESS an attestation to the
Board Board held) truthfulness of all the facts
indicated in this certificate)

(LAST NAME, 1ST NAME, MIDDLE NAME) (BRGY./SCHOOL)

(YES/NO) (YES/NO) (YES/NO)
11
12
13
14
15
16
17
18
19
20

I hereby certifiy that the foregoing public school teachers ae qualified, willing and available to serve as Member of the Electoral Boards for the October 30, Barangay & SK Elections.

Date of the Request of the OEO:

Date of Submission to the OEO:

School Head PSDS

Subscribed and Sworn to me this ______, day of _______________; affiant exhibiting to me his/her competent evidence of identity: _______________________________________

ATTY. AINEE K. TAÑEZA

Election Officer / as Administering Officer

NOTICE/DISCLAIMER: All authorized recipients of any personal data, personal information, privileged information and sensitive personal information contained in this document, including other pertinent documens attached hereto that are shared by the Commission on Elections in compliance
with the existing laws and rules, and in comformity with the data Privacy Act of 2021 (R.A. No. 10173) and its Implementing Rules and Regultions, as well as the pertinent Circulars of the National Privacy Commission, are similary bound to comply with the said laws, rules and regulations relating
to data privacy, security, confidentiality, protection and accountability.
with the existing laws and rules, and in comformity with the data Privacy Act of 2021 (R.A. No. 10173) and its Implementing Rules and Regultions, as well as the pertinent Circulars of the National Privacy Commission, are similary bound to comply with the said laws, rules and regulations relating
to data privacy, security, confidentiality, protection and accountability.

D LIST OF PUBLIC SCHOOL TEACHERS WHO ARE WILLING, AVAILABLE AND QUALIFIED TO SERVE AS MEMBERS OF THE ELECTORAL BOARDS

For the OCTOBER 30, 2023 BARANGAY AND SANGGUNIANG KABATAAN ELECTIONS

Willing, Served in the

Available and REGISTERED Prev. Elections
PLACE OF Qualified to VOTER WITH as EB (Indicate ADDRESS SIGNATURE OF THE
NAME POSITION in ASSIGNMENT serve as ACTIVE election year TIN NO. (Brgy.Only) APPLICANT (The signature is
NO. the Electoral Electoral STATUS & position CONTACT NO. EMAIL ADDRESS an attestation to the
Board Board held) truthfulness of all the facts
indicated in this certificate)

(LAST NAME, 1ST NAME, MIDDLE NAME) (BRGY./SCHOOL)

(YES/NO) (YES/NO) (YES/NO)
21
22
23
24
25
26
27
28
29
30

I hereby certifiy that the foregoing public school teachers ae qualified, willing and available to serve as Member of the Electoral Boards for the October 30, Barangay & SK Elections.

Date of the Request of the OEO:

Date of Submission to the OEO:

School Head PSDS

Subscribed and Sworn to me this ______, day of _______________; affiant exhibiting to me his/her competent evidence of identity: _______________________________________

ATTY. AINEE K. TAÑEZA

Election Officer / as Administering Officer
NOTICE/DISCLAIMER: All authorized recipients of any personal data, personal information, privileged information and sensitive personal information contained in this document, including other pertinent documens attached hereto that are shared by the Commission on Elections in compliance
with the existing laws and rules, and in comformity with the data Privacy Act of 2021 (R.A. No. 10173) and its Implementing Rules and Regultions, as well as the pertinent Circulars of the National Privacy Commission, are similary bound to comply with the said laws, rules and regulations relating
to data privacy, security, confidentiality, protection and accountability.

D LIST OF PUBLIC SCHOOL TEACHERS WHO ARE WILLING, AVAILABLE AND QUALIFIED TO SERVE AS MEMBERS OF THE ELECTORAL BOARDS

For the OCTOBER 30, 2023 BARANGAY AND SANGGUNIANG KABATAAN ELECTIONS

Willing, Served in the

Available and REGISTERED Prev. Elections
PLACE OF Qualified to VOTER WITH as EB (Indicate ADDRESS SIGNATURE OF THE
NAME POSITION in TIN NO. APPLICANT (The signature is
ASSIGNMENT serve as ACTIVE election year (Brgy.Only)
NO. the Electoral Electoral STATUS & position CONTACT NO. EMAIL ADDRESS an attestation to the
Board Board held) truthfulness of all the facts
indicated in this certificate)

(LAST NAME, 1ST NAME, MIDDLE NAME) (BRGY./SCHOOL)

(YES/NO) (YES/NO) (YES/NO)
31
32
33
34
35
36
37
38
39
40

I hereby certifiy that the foregoing public school teachers ae qualified, willing and available to serve as Member of the Electoral Boards for the October 30, Barangay & SK Elections.

Date of the Request of the OEO:

Date of Submission to the OEO:

School Head PSDS

Subscribed and Sworn to me this ______, day of _______________; affiant exhibiting to me his/her competent evidence of identity: _______________________________________

ATTY. AINEE K. TAÑEZA

Election Officer / as Administering Officer
NOTICE/DISCLAIMER: All authorized recipients of any personal data, personal information, privileged information and sensitive personal information contained in this document, including other pertinent documens attached hereto that are shared by the Commission on Elections in compliance
with the existing laws and rules, and in comformity with the data Privacy Act of 2021 (R.A. No. 10173) and its Implementing Rules and Regultions, as well as the pertinent Circulars of the National Privacy Commission, are similary bound to comply with the said laws, rules and regulations relating
to data privacy, security, confidentiality, protection and accountability.