I'age 1 of 8

Republic of the Philippines

COMMISSION ON ELECTIONS
Intramuros, Manila

SUPPLEMENTAL GARCIA, George Erwin M. Clnirnmn

GUIDELINES FOR THE INTING, Socorro B. Conutissioncr
FILING OF CERTIFICATES CASQUEJO, Marlon S. Contntissiottar
OF CANDIDACY IN FEROLINO, Aimee P. Contrnissioner
CONNECTION WITH THE BULAY, Rey E. Comntissioner
PILOT TEST OF THE USE OF MACEDA, Ernesto Ferdinand P. Jr. Conmtissioner
AUTOMATED ELECTION CELIS, Nelson J.
Comruissioner
SYSTEM FOR THE
ocToBER 30, 2023
BARANGAY AND Promulgated: June 5, 2023
SANGGUNIANG KABATAAN
ELECTIONS IN
BARANGAYS ZONE II
POBLACION AND
PALIPARAN III,
DASMARINIAS CITY,
CAVITE AND BARANGAY
PASONG TAMO, QUEZON
CITY
x- ---------------- -- ----------- - - -- - - - -x

RESOLUTION NO. 10932

WHEREAS, consistent with Republic Act (RA) No. 8436, as amended by

RA No. 9369, and the Commission's efforts to use automated election system
even in the conduct of the bnrangay and sanggltniang kabataarT elections
(BSKE), the Commission En Banc approved the pilot test of automated
elections for the October 30, 2023 BSKE in Barangays Zone II Poblacion and
Paliparan III, both in Dasmariflas City, Cavite, ar.d Barangav Pasong Tamo,
Quezon City;

W'HEREAS, there is a need to provide additional guidelines for the filing

o{ Certificate of Candidacy (COC), particularly the inclusion of the
candidate's name to appear on the official ballot, withdrawal of COC and
substitution in case of death of the candidate, which are crucial for the design
 Page 2 of 8

and finalization of the official ballot template to be used for the automated
BSKE in the above-mentioned barangays;

NOW THEREFORE, the Commission on Elections, by virtue of the 1987

Constitution, the Omnibus Election Code, RA Nos. 6679, 7760,9164,9340,
9369, 71935 and other election laws, hereby RESOLVED as it hereby
RESOLVES to promulgate the following SUPPLEMENTAL GUIDELINES
FOR THE FILING OF CERTIFICATES OF CANDIDACY IN CONNECTION
WITH THE PILOT TEST OF THE USE OF AUTOMATED ELECTION
SYSTEM FOR THE OCTOBER 30,2023 BARANGAY AND SANGGUN/ANC
KABATAAN ELECTIONS IN BARANGAYS ZONE II POBLACION AND
PALIPARAN III, DASMARI]\IAS CITY, CAVITE AND I]ARANGA)'
PASONG TAMO, QUEZON CITY.

SECTION -1,. Application of the Resolution. - This Resolution shall

apply to the filing of COC for the automated BSKE in Bnrangnys Zone Il
Poblacion and Paliparan III, Dasmariflas City, Cavite and Barangay Pasong
Tamo, Quezon City, hereinafter referred to as the "Pilot Test Areas".

SECTION 2. Cefiificate of Candidacy. - No person can run for the

position of Punong Barangay, SB Member, Chairperson and SK Member in the
Pilot Test Areas, unless the aspirant fully accomplishes and files a sworn COC
in the form prescribed by the Commission for the position aspired for.

The COC shall be filed in four (4) legible copies with the Offices of thc
Election Officer of Dasmariflas City and Quezon City, 6tl' District, having
jurisdiction over the barangay where the aspirant seeks to be elected.

Any COC filed with the incorrect office shall be deemed as not filed

No COC filed by mail, electronic mail or facsimile shall be accepted

The COC forms are attached as Annexes u A", " A-a", " A-2" and, " A-3".

SECTION 3. Aspirant's Name to Appear on the Official Ballot,

Contents. - The name to appear on the official ballot shall contain in the
following order, the Aspirant's-

a. Surname; and
b. First name OR Nickname/Stage name.
 Page 3 of 8

Aspirants may use either their name or nickname/stage name,

whichever they prefer, together with their surname. Provided that the
nickname/ stage name should be that which they are generally or popularly
known in the locality. Provided further, that no candidate shall use the
nickname, stage name or initial or acronym of another.

The Name to Appear on the Official Ballot shall not exceed thirty (30)
characters. The count of the 3O-character limitation includes spaces, letters,
numbers and punctuations.

Example:

a. For male aspirant:

Reyes fuan Manuel Mike Santos

Sttrname First N mne Nickname Middle Nnme

Use of name Reyes, Juan Manuel

Use of nickname Reyes, Mike

b. For single female aspirant:

Dela Cruz Maria fuana Iane Torres

Surnarue First Namc Nickname Middle Name

Use of name Dela Cruz, Maria |uana

Use of nickname Dela Cruz, Jane

SECTION 4. Name to Appear on the Official Ballot of Married Female

Aspirants. - Married female aspirants may use either their maiden name or
married name or both, whichever they prefer, subject to the 30 - character
limitation.

Thus, a married female aspirant shall provide the following data in the
Name to Appear on the Official Ballot, in this order:

a. Last Name (maiden name OR married name OR both); and

b. First Name OR Nickname/Stage name.

Example:
Dela Cruz-Reyes Maria Tuana Mar), Torres
Surname First N arne Nicknane Middle Name
 Page 4 of 8

Use of maiden name Dela Cruz, Maria Juana OR

Dela Cruz,
Use of married name Reyes, Maria Juana OR

I
Use of both maiden and married name Dela Cruz-Reyes, Maria
Juana OR Dela Cruz-
Reyes, Mary

SECTION 5. Guidelines in Case Aspirants Failed to Indicate the Name

to Appear on the Official Ballot; or if the Name is Not in Accordance uith the
Guidelines, or if it is in Excess of the Required Number of Characters. - The
Law Department shall motu proprio determine the Name to Appear on the
Official Ballot of an aspirant if:

a. The aspirant fails to indicate the name to appear on the official

balloU
b. The name indicated is not in accordance with this Resolufion;
c. The name indicated is in excess of the 3O-character limitation;
d. There are multiple first names or nicknames/ stage names written,
the totality of which, together with the surname, exceeds the 30-
character limiU
e. The name written is a combination of the first names and nicknames
or multi-worded first names or nicknames, the totality of which,
together with the surname exceeds the 30-character limitation.

SECTION 6. Posting of the Tentatiae List of Candidates in the Pilot

Test Areas for the Automated Barangay Ltnd Sanggilniang Kabataan Electiotrs,
for Purposes of the Name to Appear on the Official Ballot. -The tentative list
of candiclates ancl the name to appear on the official ballot of candidates in the
pilot test areas for the automated BSKE will be posted starting September 8,
2023 (Frid,ay) at the website of the Commission at uttottt.comclec.goa.ph ancl at
the Office of the Election Officer concerned.

Candidates are encouraged to check their names to appear on the

official ballots for any clerical or typographical error.

SECTION 7. Last Day to File Request for Correction of Clerical or

Typographical Error on the Name to Appem on the Official Ballot. - In case of
any clerical or typographical error on the name to aPPear on the official ballot
as posted in the website or at the Office of the Election Officer concerned, the
 I']age 5 of 8

candidates in the pilot test areas may file with the Law Department,, copy
furnished the Election Officer concerned, a request for correction of the clerical
or typographical error until September 13, 2023 (Wednesday), in order to
reflect the correction in the official ballot.

No other entry in the name to appear on the official ballot shall be

changed or corrected except for clerical or typographical errors.

Any request filed beyond the deadline as stated shall not be

entertained.

SECTION 8. Withdrawal of Certificate of Candidacy. - Any person who

has filed a COC may withdraw the same at any time before election day, by
personally filing a sworn Statement of Withdrawal in four (4) copies with the
Office where the COC was filed.

No Statement of Withdrawal filed by mail, electronic mail, or facsimile

shall be accepted.

No Statement of Withdrawal shall be filed by a person other than the

aspirant, except in cases provided in Section 9 of this Resolution.

The Statement of Withdrawal shall be distributed in similar manner as

the COC. Provided that the Election Officer shall immediately notify the Law
Department through electronic mail at lau.coc@conrelec.gou.ph in PDF format
of the said withdrawal, stating the following:

a. Name of the withdrawing candidate;

b. Position aspired for;
c. Whether the Statement of Withdrawal is filed personally by the
candidate or through an authorized representative as provided in
Section 9 of this Resolution.
d. Copy in PDF format of the Statement of Withdrawal duly receivecl
by the Receiving Officer.

The filing of a Statement of Withdrawal of a COC shall not affect

whatever civil, criminal or administrative liability a candidate may have
incurred.

The form for the Statement of Withdrawal is attachecl as Annex "B".

 Page 6 of 8

SECTION 9. Fiting of stLtement of withdrawal by the Duly Authorized

Representatizte of the Candidate. - The duly authorized representative may
file, on behalf of the withdrawing candidate, the sworn Statement of
Withclrawal of COC, only in the following instances:

a. The withdrawing candidate was tested positive for COVID19;

b. The withdrawing candidate was identified as a close contact with
any person who was tested positive for COVID19 and on quarantine
or isolation.

The form for the Authority to File Statement of Withdrawal is attached

as Annex "C".

SECTION 10. Substitution of Candidates in Case of Death. - If a

candidate dies after the last day for filing of COC, the candidate who died
can be substituted by the spouse of the deceased candidate.

For this purpose, the candidate shall enter the name of his or her spouse
at thc back of the COC.

The substitute possessing all the qualifications and none of the

disqualifications provided by law for the office affected, may file with the
Election Officer concerned, a COC on or before September 13, 2023
(Wednesday) so that the name of the substitute will be reflected on the
official ballots. The substitute shall likewise submit a certified true copy of the
Death Certificate of the deceased candidate.

The Receiving Officer shall immediately furnish the Regional Election

Director concerned with a copy of the COC of the substitute candidate. The
Regional Election Director concerned is authorized to evaluate and act on all
substitution. All actions of the Regional Election Director shall remain valid
and effective unless otherwise reversed or set aside by the Commission.

The Regional Election Director shall notify the Law Department through
electronic mail at lau.coc@cornelec.goa.ph rn PDF format of the said
substitution, stating the following:

a .
Name of the deceased candidate;
b . Position aspired for;
C. Certified true copy of the Death Certificatei

d . Name of the substitute;

e . Copy in PDF format, of the COC of the substitute;
f. Action taken on the substitution
 Page 7 of 8

The substitute for a candidate who died, may file a COC up to mid-day
of Election Day, together with the certified true copy of the Death Certificate
of the deceased candidate;

If the death should occur between the day before the election day and
mid-day of election day, the substitute may file the COC and the certified
true copy of the Death Certificate of the deceased candidate, with any of the
Electoral Boards in the political subdivision where the deceased candidate
seeks to be voted.

No Substitution due to withdrawal or disqualification of the candiclate

shall be allowed.

SECTION 11.. Distibution of Certificates of Candidacy. - Copies of the

COC for the Barangay and SK Officials in the Pilot Test Areas shall be
distributed as follows:

a. Original Copy, to the ERSD, Commission on Elections, Manila;

b. Second Copy, to the Law Department;
c. Third Copy, to the Election Officer for file; and
d. Fourth Copy, to the candidate.

SECTION 12. Delioery of Certificates of Candidacy and Other

Doarments. - Copies of the COCs filecl in the Pilot Test Areas shall be
submitted to the Law Department and ERSD by the Election Officer
concerned, on or before September 5,2023 (Tuesday).

SECTION 13. Applicability of other Resolution of the Commission. -

The provisions on the filing of COC as provided in the Ceneral Guidelines nnd
Otlur Related Rules and Regulations for the October 30, 2023 Barnngny and
Sangguniang Knbataan Elections (BSKE) and all
Succeeding BSKEs Thereafter,
insofar as they are not inconsistent, are hereby adopted, incorporated and
made integral part of this Resolution.

SECTION 14. Effectioity. - This Resolution shall take effect on the

seventh day after its publication in two daily newspapers of general
circulation in the Philippines.
 10932 Page 8 of 8

SECTION "1.5. Publication and Disseminatiorr. - The Education and

Information Department shall cause the publication of this Resolution in two
daily newspapers of general circulation in the Philippines and furnish copies
of this Resolution to all field officials of the Commission

SO ORDERED.

GEORGE ERWIN M. GARCIA

Chairtnnrt

SOCORRO B.INTINC MARLON S. CASQUEJO

Commissioner Commissioner

AIMEE P. FEROLINO REY E. BULAY

Conmtissioner Commissioner

ERNESTO FERDINAND P. MACEDAV JR. NELSON I. CELIS

Cottr m issio ncr Commissioner

CERTIFICATION

APPROVED by the Commission En Banc during the regular online

meeting on June 5, 2023 , pursuant to Comelec Resolution No. 10671,
"Supplemental Resolution No. 9936 promulgated March 25,2015, Rule on
the Enactment and Promulgation of Executive or Administrative
Resolutions providing for other format of meetings to include online
meetings applicable in times of COVID-19 pandemic and the imposition of
Communi$ Quarantines and similar emergency situations".
,.-,

ATTY. CONSUELO B. DIOLA

Director IV
Office of the Commission Secretary

This Resolution can be verified at this number (02) 85272987; email address
come lec@c om e lec. go v. ph
 Annex "A"
Amx Latest
CERTIFICATE OF CANDIDACY FOR Photo Here

PUNONG BARANGAY I
Passport Size

INSTRUCTIO S: (Please.e.d well befor€ filling-out the COC form.)

Fill-orrt the items completely. Write N/A if an jtern is not applicable.
1.
2. Prjnt the COC Form on BOTH SIDES (front and bad) of a FOUO (8.5"x13') o. LEGAL (8.5'x14") size copy paper.
l. Tities such as Dr,, Atty., Don, Ginoo, Seffor. Datu, Sultan, Bal, Se6o6, Kapltan or other similartitles are exprcssly prohlbited.
4. This certificate shall be swom before a not.ry public or any official authorized to administer oath. The Election Officer may administe. tl|e oath on the
COCS flled within thcl. .rea ofjurisdlction, tre€ of charge.
5. File this in FOUR (4) LEGIBLE copies with the COI'IELEC Office concerned. on any day from August 28, 2023 (Monday) to September 2, 2023 (Saturday), from
8:OO AM to 5:O0 Pl'l ONLY.
6. o lili.g t€c shall be imposed.

I the position of PUNONG AARAIIGAY of SARANGAY-

hereby announce my candidacy for City/Municipality of
Province of , in the October 30, 2O2j Earangaf and *ngguniang Kabataa, (SK) Elections;
and after having been swom to in accordance with law, I h€reby state the tollowing:

1. NAME:
1.1 Last Name |] tl l tl
15. SEX:

! m"r"
I.6. AGE ON ELECTION DAY:

lvust be at least eighteen

1.2 First Name I
(18) years old on election day
I

1.3 Middle Name

tl 17. DATE OF BIRTH:
2. NICKNAME OR. STAGENAME; (Indicate ony one nickname or staqe name)

||li Monrh
tTl
Dav
|l
3. NAME TO APPEAR Ot{ THE OFFICIAL BALLOTT (Not to exceed 30 characters, including space, letter, 18. PLACE OF EIRTH:
number, symbo] and punctuation)

Illllllitill City/t4un.

Province

4. RESIDENCE/ADDRESS: 19. CIVIL STATUS:

4.1 Province Single

4.2 City/l"lunicipality

4.4 House No./ Sbeet

|lll|ll!lll
/ Subdivision
m
4.3 Barangay
I"larried

tull N.ru of Spou*, ia ruaed

20. PROFESSION OR OCCUPATION:

5. ADDRESS FOR ELECTION PURPOSES: (Could be the same as No. 4)

21, I AH A REGISTERED VOTER OF:
Precinct
Barangay
City/Mun.
6, PERIOD OF RESIDENCE IN THE PHILIPPINES UP TO THE DAY BEFORE OCT.30, 2023:
6.1 In the Philippines: No. of Years No. of Months
[E
6.2 In the aboveslated Barangay: No. ofYears ffi No. of l'4onths E 22. OFFICIAL E-MAIL ADDRESS:
(For notice and election purposes)
7. I AM A FILIPINO CITIZEN.
6. I EXECUTED A SWOR REIGN dTIZENSHTE, GE A'PLIC{BI.€, ATTACH A COPY)
9. I AI,I NOT A PERI.IATIENT RESIDENT OF, OR AN IMI'IIGRANT TO, A FOREIGN COUNTRY,
10. I AI4 EUGIBI.,E FOR THE OFRCE I SEEK TO BE ELECTED TO.
11. I WILL FIIf, WNH THE OFFICES OF THE COMMISSION, WTTHIN THIRTY (30) DAYS AFIER ELECNON DAY, MY FUI.! 23. Have you ever been found liable for an
TRUE AND ITEMIZEO STATEMENT OF CONTRIBUTIONS ANO EXPENDITURES (sOC€) IN CONNECNON WTTH THE offense \.rhich carries w'th rt the accessory
ELECNON,
penalty of perpetual disqualification to
12. l SUPPORT AND DEFENO THE CONSTITUTION OF THE REPUBUC OF THE PHIUPPINES AND wlLL I4AINTAIN
wlLL hold public offce, which has become final
TRUE FAITH AND ATIfGIANCE THERETO. I w]U OBEY TTIE LAWS, LEGAL ORDERS. AND DECREES PROI'IULGATED BY and executory?
THE DULY CONSTITUTED AUT}IORITIES. I
IMPOSE THIS OBLIcATION UPON I4YSELF VOLUNTARILY, WITHOUT
MFNTAI RESERVATION OR PURPOSE OF EVASION.
13. I SHALL NOT ADVOCAIE VIOTSNCE OR UNLAWFUL MEANS TO ACHIEVE I,ff GOAI"S, n lr?ase prouit" a"tuits at the back)
14, I
GIVE CONSENT TO THE COMI'IISSION ON ELECTIONS TO COLLECT, DISCLOSE OR SHARE, AND PROCESS THE
PERSONAL DATA I PROVIDED HERE1N FOR ELECTION AND OTHER LAWFUL PURPOSES IN ACCORDANCE \A]TTH THE
PRIVAC/ NONCE AT THE BAC( OF 1HI5 FORM, AND AS MAY BE AUTHORIZED BY EXIST]NG LAWS.
!ru"
I hereby certify that the facts stated herein are true and correct to the best of my knowledge.

Sigrature of Candid.te over Printed ame

OATI'
SUBSCRIBEO AND SWORN to before me this day of 2023, at amant exhibiting to me an Identification
documenvcard which contaans a photograph and signature bearing No. assued by
-
Doc. No.
Paoe No, : Affll P30 0O d@umstrry st mp)
Book No. (Officer Authorized to Administer Oath)
Series of 2023. -;
THIS FORM CAN AE PHOiOCOPIED OR RE'ROOUCED ANO 15 AVAJI.ABI! AT IHE CCHEIEC OFflCE5 EREE Of CHAR6E
OR MAY B€ OOW TOAO€D FROM lHE COT4ELEC OFHctA! WEBSTTE (ww.(mde@-oh)
-;
 Case Docket
D o Case Title Date
D Filedo Status

Name of the Substitute Spouse, if applicable

(in case of death of candidao

The collected personal data will be encoded in the information system developed by the Commission oo Ehctions (COI4ELEC). The p€lsonal
data inputted in the information system will be used by the COI4ELEC in the preparation, posting and/or publicntion of the list of €andidates
and other €ledion-related documenE or forms.

For legitimat€ research ne€ds and inquiries, and only for the purposes speclfied ln the request, the COMELEC may disclose and share your COC
and/or its contents. Moreover, the COIVIELEC may use and disclose your COC and/or its contents in any proceeding or investigation in which
your COC and/or its contents is/are in issue or may frod relevance.

Only authorized peBonnel are allowed to access and proces5 your peEonal data. Immediately after the election period or upon the expiration
ofthe storage pedod set in exrsting COIqELEC rules and policies, and laws and regulations, whichever applies, the physical and digitalcopies of
your personal data wall be anonymized, deleted, aod discarded following the disposition procedures of the COMELEC and the National Archives
of the Philippines.

You have Ule right to ask for a copy of your COC or any personal data it contains. Also, you may Mthdraw your candidacy in accordance with
th€ COMELEC rules afld policies on the matter.

If you have questions regarding this Privacy Notice, please send an email to dpo@comelec.govph,
 I

Annex ".A-1"

CERTIFICATE OF CANDIDACY FOR Affix Latest

Photo Here

MEMBER, SANGGUNIANG Passport Size

BARANGAY
INSTRUCTIOIS: (Please read well b€rore nlling-or]t the COC form.)
1. FilForrt the atems completely. Write N/A af an item is not applicable.
2. Prinlthe COC Fonn on BOTH SIDES (front and bad) of a FOLIO (8.5"x13') or LEClAL (8.5114) size copy paper.
3. Tides such as D.., Atty,, Doh, Glnoo, Seior, Datu, Sultan, Bai, Se6ora, Xapltan or other simlla. tldes are expressly prohibited.
4. notary publlc or any ofticial authorized to administer oath. The Election Officer may administer the oath on the
This certificate shall be sworn before a
COC9 filed witfiin th€ir area otjurisdiction, free ofcharg€.
5. File this in rOUR (4) LlGIaLE copies with the COI"IELEC Offlce concemed, on any day from August 28, 2023 (Monday) to Sept€mber 2, 2023 (Saturday), ,rom
a:00 Alt{ to 5:Oo PM OILY.
6. l{o filing fee shall be imposed,
I hereby announce my candidacy for the position ot MEITTBE& SANCGUNIAIIG AARANGAY of BARANGAY-
City/l.tunicipality of Province of in the October 30, 2023 Barangal anll Sangguniang
Kabataan (SK) Elerljons; and after having be,en swom to in accordan(r with law,I her€by state the following:

1. NAME: 15. SEX: 16, AGE ON ELECTION DAY:

1.1 Last Name

I
tl 14ale

l'4ust b€ at least eighte€n

1.2 First Name (18) years old on election day
l

lIi||l
I

1.3 t"liddle Name

titt L] 17. DATE OF BIRTH:
2. NICKNAME OR STAGENAME: (lndicate only one nickname or stage name)
-
I

tl t t tl llIl-ftfr-l Dav
L[
3. NAME TO APPEAR ON THE OFFICIAL BALLOT: (Not to exceed 30 characters, inctuding space, tetter, 18. PLACE OF BIRTH:
number, symbol and punctuation)

ilil City/!1un.

4. RESIDENCE/ADDRESS: 19. CML STATUSi

4.1 Province
I 4.3 Earangay
I Single

Married
tr
Itl
4.2 City/Municjpality

l|||l
4.4 Holse No./ Street / Subdivision
I

||l Flll Name of Spouse, if mad ed

TT
ttt
l 20. PROFESSION OR OCCUPATION:

5, ADDRESS FOR ELECTION PURPOSES: (Could be the same as No, 4)

21. I AM A REGISTERED VOTER OF:
Precinct
Baranqay
Oty/Mun,
6. PERIOD OF RESIDENCE IN THE PHILIPPINES UP TO THE DAY BEFORE OCT. 30,2023,. Provinae
6.1 In the Philippines: No, of Years
tl No. of lvonths

6.2 In the above-stated Barangay No. of Years No. of Months ffi 22. OFFICIAL E-HAIL ADDRESST
(For notice and election purposes)

7. I AM A FILIPINO OTIZEN.
A. I EXECUTED A SWORN RENUNCIANON OF FOREIGN CTTIZENSHIP, (IF APPUCABLE, ATTACH A COP\,
9. I At4 NOT A PERwIANENT RESID€N_r OF, OR AN IMMIGRANT TO, A FOREIGN COUNTRY.
23. Have you ever been found liable for an
IO. I AM EUGIBLE FOR THE OFFICE I SEEK TO BE ELECTED TO. offense which carries with it the accessory
11. I WIL]- RI.!, WTTH THE OFFICES OF THE COMMISSION, WTTHIN IH]RW (30) DAYS AFTER EI.TCNON DAY, IilY FULL. penalty of perpetual disqualification to
TRUE AND TTEMIZED STATEI4ENT OF CONTRIBUTIONS AND EXPENDITURES (SOCE) IN CONNECTION WITH THE
ELECTION.
hold publac office, which has become flnal
12. I W1LL SUPPORT AND OEFEND THE CONSTITUTION OF THE REPUEUC OF THE PHIUPPINES AND WILL MAINTAIN and executory?
TRUE FAITH AND ATLEGIANCE THEREIO. I wl[
OAEY THE LAWS, LEGAL ORDERS, AND DECREES PROMULGATED 8Y
I
THE DTJLY CONSTTTUTED AUTHORITIES, II'IPOSE THIS OEUGATION UPON IIYSEIf VOLUNTARILY, WTIHOUT
NIENTAL RESERVATION OR PURPOSE OF EVASION,
13. I SHALL NOT ADVOCITE VIOLENCE OR UNLAWFUL MEANS TO ACHIEVE MY GOALS'
tr Yes
(Please provide details at the back)
14. I GIVE CONSEIIT TO THE COMMISSION ON ETECTIONS TO COTIECT, DISCLOSE OR SHARE, AI']D PROCESS THE
PERSONAI. DATA I PROVIDED HEREIN FOR ELECNON AND OTHER LAWFUL PURPO5ES IN ACCOROANCE WTIH THE No
PRIVAC-Y NOTICE AT THE BACK OF THIS FORM, AND AS MAY BE AUTHORIZED BY EXIfiNG LAWS.

I hereby certify that the facts stated herein are true and correct to the best of my knowledge.

slgnature of cendidate over Printed Nam€

OATH
SUaSCRIA€D ANO SWORI{ to before me this day of 2023, at afflant exhibiting to me ah Identification
documenvcard which conrains a photograph and signature bearing No issued by
-
Doc. No. ________--;
Paoe No- | lAtfix Plo.oo d@mHtary stamD)
Book No.
(Officer Authorized to Administer oath)
Series of 2023.
.IHIs $AVAIIAELE AT IHE CqqEltC OFnCEs FREE Of CHARGE
FORM CAII 8E PIIOTOCOPIEO OR REPROOiJCED AI1O FRONI
OR MAY BE DOIIIILOADED FROM fHE COME.EC OFFICIAI WEBSIE (ww,OMdE.O@.Nh)
-;
 Case Docket
D o Case Title Date
D Filedo Status

Name of the Substitute Spouse, if applicable

(in case of death of candidat4

The collected personal data will be encoded in the informatlon system developed by the Commission oo Elections (COMELEC). The personal
data inputted in the information system will be used by the COMEI.fC in the preparation, posting andlor publicatiofl of the list of crodidates
and other electioo{elated documenE or forms.

For legiumate researah needs and inquiries, and only for tne purposes sp€aifled in the request th€ COIYELEC may disclose and share your COC
andlor its contents. Mo.eover, th€ CO}IELEC may use and disdose your COC and/or its contents in any proceeding or investigation in which
your COC and/or its contents is/are in issue or may fiM relevanc€.

Only autiodzed p€$onnel are allowed to access and process your peronal data, Immediatev after the election period or upon the expkation
oFthe storage pedod set in exisung COI'4ELEC rules and policies, and laws and regulations, whichever applies, the physical and digitalcopies of
your p€rsonal data will be anonlmized, deleted, and discarded following the disposition procedures of the COI"IELEC and the National Archives
of the Philippines.

Yo! have the riqht to ask for a copy of your COC or any pe.sonal data it contains. Also, you may withdraw your candidacy in accordance with
the cof4ELEC rules and policies on the matter.

Ifyou have questions rega.ding slis Privacy Notic€, please s€nd an emailto dpo@conelec.govph.
 Annex "A-2"

CERTIFICATE OF CANDIDACY FOR Affix Latest

Photo Here

CHAIRPERSON, Passport Size

SANGGUNIANG KABATAAN
CTIO S: (Please read well before filling-out the COC form.)
1. Fill-out the ite.ns compl€tery. Wrjt€ N/A if an item is not applk ble.
2. Print the COC Fom on EOTH SIDES (frcnt aod back) ola FoUO (8.s" x 13") or LEGA (8.5" or 14") eze copy paper.
3. Itles such as Dr,, Atq., Don, Glnoo, Se6or, Datu, Sullan, B.l, Seiora, K.pltan or other similar tftl€s arc expr.srly prohibltod,
4. This certifi.ate shall be swom bcfole a nobry publlc or ary offi.ial authoriz€d lo admlnletcr o.th. The Eledlon Offlcor may adnininer the oatfi on the COCa filed
within tnear .re. ot rurisdiauon, ft.€ o( charge.
5. Fle this in fOUR (4) L"EGIBLE copies with the COMELEC Otrice concemed, on any day from Augun 28, 2023 (Honday) to S€ptember 2. 2023 (Saarrday), rmm E:00 AH to
5:OO Pt{ OI{LY.
6. t{oriling f6! shallb€ lmposed.

I he.eby announce my candidacy for the position ol

CHAIRPERSOII, SA GGUNIANG IGBAIAAN of BARANGAY
City/Municipality of Province of , in the October 30, 2023 Earangay and Sangguniang Kabataan
(SX) Electlonsi and after havlng been sworn to in accordance with law, I hereby state the followingl

1. NAMEI 18. SEX: 19. AGE ON ELECTION DAY

1.1 Last Name
Lttttttttt li
l
E,," years l,4onth/s Oay/s
1.2 First Name

-
I

I tl I I

!r".r.
Must be at kan dEhtM (18) yeau
old but not more than tBenty-folr
(24) yea6 old o. eletiM day. (8om
1.3 l,liddle Name on Oct. 10, 1999 to oct, 10, 2005 to
I pass the aoe rcquarcment)

2. NICXNAME OR STAGENAME: (lndicate only one nickname or stage name) 20. DATE OF BIRTH:
I I
tl tl fr'.] - tT tT
l.4onth Day
3. NAME TO APPEAR ON THE OFFICIAL BALLOT: (Not to exceed 30 characters, inctuding space, tetter,
number, symbol and punctuation)
21. PLACE OF BIRTH:
l Oty/lv1un

4. RESIDENCE/ADDRESS; Province
4.1 Province I
I I

4.2 City/lvlunicipality 4.3 Barangay 22, CIVIL STATUS:

l||
4.4 House No./ Steet /
1|t Il
Subdivjsaon
|ltiIl!lIl !
!
sinsre

na.ieo
tr
l|ll I
l
Full Name ol Spoue, if maried

5. ADDRESS FOR ELECTION PURPOSES: (could be the same as No.4) 23. PROFESSION OR OCCUPATION:

24. I AM A REGISTERED VOTER OF:

Precinct
6. PERIOD OF RESIDENCE IN THE PHILIPPINES UP TO THE DAY BEFORE OCT. 30, 2023: Bardngay
ruo. or Months
6.1 ln the Philippines: No. of Years
[-l l City/14un,
6.2 In the above-stated BararEay; No. of Years No. of l'lonths
L _L__l
Province

7. I Al,l A FIUPINO
S, I AECUTED A sl,I/ORN RENUNCIAT1OTI OF FOREIGN CTTIZENSHIP. OF APPUCABLE, ATTACH A COPY) 25. OFFICIAL E.MAIL ADDRESS:
9. I AM NOT A PERXAAENT RESIOENT OF, OR AiI IMMIGRAI{T TO, A fOREIGN COUNTRY. (For notice and election purposes)
10. I AM A QUALIFIED VOTER OF THE KAT1PUNAN NG SBATAAN OF THE ABOVE.STATED BARANGAY'
11. I AM NOT REIATED WIIHTN TT]E 2TD ClvIL OEGREE OF CONSANGUINITY OR AFFINIIY IO ANY INCUMBEI{T ELECTED
NATIONALOFFICIA!ORTOANYINCUMAENT€LECTEDREGIONA!,PROVINCIAI,CT,MUNICIPA!,ORBARANGAYOFFICIAL
IN IHE LOCJLITY W]ERE I SEEX TO BE ELECITD TO. 26. Have you ever been found liable for an
12. I HAVE NOT BEEN CONVICTED BY FINAL ,]UDGMENT OF ANY CRIME INVOLVING IIORAI TURPTIUDE.
13. I Al"1 EUGIBLE mR THE OFFICE I SEEK TO BE ELECTED TO.
offense which cardes with it the
T4.IWILL'I!E,U'TTHTHEOFFICESOFTHECOMI4ISSION,WTHINIHIRTY(]O)DAYSAFTERELECNONOAY,I'Yf!'LL,IRUE accessory penalty of
Perpetual
ANDITE,"IIZEDSTATEI"IEI{IOFCONTRIBUTIONSANDEXPENomTRES(sOCE)INCONNECTIONWTTHTHeELECTIOI'I' disqualificatjon to
hold public office,
15. I WILL SUPPORT AI{D DEFEND THE CONSTITUTION OF THE REPUELIC OF THE PHTUPPINES AND WILT HAINTAIN TRUE FAITH which has become final and executory?
AND ATLEGIANCE THERETO.I WILT OBEY ThE LAWS, LEGAL ORDERS AND DECREES PROIIULGATEO BYIH€ DULY
coNSTtTUTEoAutHounes.IIMPosETHIsoBUGATIoNUPoNMYSELFVoLUNTARILY,WTTHoUTI.4ENTALRESERvAnoN
OR PURPOSE OF EVASION.
15. I SHALI NOT ADVOCATE VIOTENCE OR UNLAWFUT I\IEANS TO ACHIEVE MY GOAs, x YeJ (Please provide details at the
back)
17. t 6IvE coNsENT To THE coMMISs]oN oN ELEmoNS To coLLEcT, oIscLoSE oR sHARE, AND PRocEsS THE PERSoNAL
oATAIPRoVIDEDHEREINfoREtEcTIoNANooTHERL^WFULPURPoSESINAccoRDANcEWITHTHEPRIVACYNoTIcEAT
IHE EACK OF THIS FORM, AND AS I\4AY BE AUIHORIZED BY ENST1NG LAWs.
tr No

I hereby certify that the facts stated herein are true and correct to the best of my knowledge'

saoDtur€ o, cindi.Lte oEr ?rinted ame

OATH
2023, at affiant exhibiting to me an
SUBSCRIBED AND SWORN to before me this day of
on
issued by
Identification documenvcard which contains a photograph and signature bearing No'
-
Doc. No. -----------j
Page No. (Atu P30.0O dru.dttrv stamp)
(Offlcer Authorized to Administer Oath)
Book No.
series of 2023.
OF CNARGE
-;
THIS fORM CAN AE OTOCOPIED OR REPiO{XJCED AND IS AVIILAAIE AT TIIE @I{ELEC OFFICES FREE
' (!44,TCE&,9C]A!b)
-;
OR MAY B€ DOWNIOAO€D FROI'I THE COMELEC OFFIOAL WEBSITE
 Case Docket
D o Case Title Date
D Filedo Status

Name of the Substitute Spouse, if applicable

(in case of death of candidate)

The collected personal data will be encoded in the iofomation slstem developed by the Commission on Elections (COIVIELEC). The p€rsonal
data inpotted in the informatjon system will be used by the COI'{ELEC in the preparalhn, posting and/or publication of tlE list of candidat€s
and other election-related documenG or Forms.

For legitimate research needs and inquiries, and only for the purposes specified in the requst, the COMELEC may disclose and share your COC
and/or iLE contents. Moreover, th€ COIIELEC may use and disdose your COC and/or its contents in any proceeding or investlgation in which
your COC and/or ib contents is/are in is$e or may flnd relevance.

Only authorized p€Eonnel are allowed to a.cess and prccess your personal data. lmrnediately after the election period or upon the expiration
of the storaqe period set in existjng CIMELEC rules d policies. and laws and regulations, whkh€ver applies, the physical aod digital copies of
your personal data will be anonymi2ed, deleted, and discarded followinq the disposition procedures of the COMELEC and the National Archives
of the Philippines.

You have the right to ask for a coPy of your COC or any peEonal data it contaans. Also, you may witMrdw your candidacy in accordance with
the COMETEC rul€s and pollcies on the matter.

Ifyou have questions regarding this Privacy Notjce, please send an emailto dpo@conetec.govph,
 Annex "A-3"
I Affix Latest
CERTIFICATE OF CANDIDACY FOR Photo Here l

MEMBER, SANGGUNIANG I

Passport Size

KABATAAN l
STnUCTIONSI (please read well before filling-out U'e COC form.)
]' Fillout the items €omplet€ly. Wdt€ N/A if an item is not applicable.
2. Print the COC Form on SOTH SIDES (front and back) of a FOUO (8,5" x 13) or IEGAI (8.5" or t4'l size copy paper.
3. Titles such as Dr., Atty., Oon, Ginoo, S€ftor, Oatu, Sultan, Bai, S€ioi., Kaplt n or o$cr simll.r tttlcs .re €lpressly prohiblted.
4. This certiRcate shall te swom betote a notary publlc or.try orfi€ial authorlzed to administer oath. The Election Officer may ldminBler th€ o.th on tne COCS ,iled
wlthin tn€ir ,r€. of ju.ldicrion, fr€e o, charg€.
5. File thls in fouR (4) LEGTBLE coples with the cof4ELEc office concemed, on any day from augun 2a, 2023 (Monday) to s€ptember 2, 2023 (s.turday), rfom 6:00 aH to
5:00 PM ONLY.
5. o nling t € shall te imposed,

I hereby announce my candidacy for the posilion ol MEMBE& SANGGUNIANC KABAA,4,,V ot SARANGAY City/Municipality ot
Province of . in the October 30, 2023 Barangay and S.ngguniang Kabataan (SK) Elections; and
after having been swom to in accordance with law. I hereby state the following:

1. AME: 18. sEx: 9. AGE ON ELECTION DAY:

1.1 Last Name ||tl ! ,u," Years Month/s Dayls
1.2 First Name Ml.!l b€ at least aghle€n (18) yeaB
oU but not nm h.n tuaty{our
(24) yeu old on eledio. day (bom
1.3 lvliddle Name on O.t, 30, 1999 to Od. 30, 2005 to
p6 d'e age rcquirffio

2, NICKNAME OR STAGENAMEi (lndicate only one nickname or stage name) 20. DATE OF BIRTH:

tl l,lonth Day
3. i{AME TO APPEAR ON THE OFFICIAL BALLOT: (Not to exceed 30 characters, inctuding space, tetrer,
numb€r, symbol and punctuation)

ttt I
21. PLACE OF BIRTH:
City/11un.

4, RESIDENCE/ADDRESST Ptovince

4.2 City/Municipality
4.1 Province
ltttl 22, CIVIL STATUS:
4.3 Earangay

I
Slngle

Married
4.4 House No./ Sbeet / Subdivision

ltl ful Nare oi S9ou*, il nanied

5. ADDRESS FOR ELECTION PURPOSES| (Could be the same as No.4) 23. PROFESSION OR OCCUPATION:

24. I AM A REGISTERED VOTER OF:

Precinct
6, PERIOD OF RESIDENCE IN THE PHIUPPINES UP TO THE DAY BEFORE OCT.3Ot 2OZ3l Barangay

6.1 ln the Philippines: No. ofYears fT l No of Months

l I
City/14un.
Province
6.2 In the above-stated Barangayr No. ofYears
E ruo. of mooths
l] i
I AM A FILIPINO CITIZEN.
8. I E€CUTEO A SWORN REIIUNCLATION Of FORAGN CTNZENSHIP. Of APPUCABLE, AITACTI A COPY) 25. OFFICIAL E.MAIL AOORESS:
9. I AL NOT A PERI'4ANENT RESIDENI oF, oR AN IMMIGRANT TO, A FOREIGN @UNTRY. (For notice and election purposes)
10. I r'fi A QUALIFIEO VOTER OF THE KATIPUNAN NG KABATAAT'I OF THE ABOVE-STATED BAIANGAY.
11. i Ani NOT RELATED u/TTHIN THE 2ro CNIL OEGREE OF CONSAT'IGUINITY OR AFFINITT TO AilY INCUMBENT EIECTEO
NATIONAL OTFICIAL OR TO ANY INCIJI4BENT ELECIEO REGIONAI, PROVINCIAL, CITY, MUNICIPAL, OR &6.RANGAY OFF]CLAL
IN THE LOCALITY WHERE I SEEK TO BE ELECIEO IO. 26. Have you ever been found liable for an
12. I HAVE NOI EEEN COI'IVICTEO 8Y FINAL ]UOGMENT OF ANY CRII4E INVOI-VING MORA TURPTTUOE. offense which carries with the it
13. I AI,4 EUGIBTE FOR THE OFFICE IsEEK TO BE EI,ECTED TO. accessory penalty of
perpetual
I'. I WIL! FILE WITH THE OFflCES OF THE COMMISSION, WM]IN THIRTY (30) DAYs AFTER ELECTION OAY, MY FULL, IRUE disqualification to
hold public office,
AND ITEI"IIZED SIATEMENT oF CONTRIzuTIONS aND EXPENDnTRES (socE) IN CONNECTIoN !!TIH THE ELEfioN. which has become finaland executory?
15. I wlILSUPPORT AND DEfEND THE CONSTTTUTION OF THE REPUBIIC OF THE PHIUPPINESAND WIIL MAINTAIN TRUE FAITH
AND ALIEGIANCE THERETO. I WIU OBEY THE LAWS, TfGAL ORDERS, AND DECREES PROMULGATEO BY THE DULY
CONSTIIU]TD AUTHORITIES. I IMPOSE THIS OEUGATION UPON MYSELF VOLUNTARITY, WITHOUI MENTAL RESERVANON T-] Yes (Please provde details at the
OR PURPOSE OF EVISION. LJ uacr<y
16. I SIIALL NOT ADVOCJTE VIOLENCE OR UNLAWFUT MEANS TO ACHIEVE I'IY GOALS.
17. I GTVE CONSENT IO IHE COMMISSION ON ELEMONS TO @LLECI, DISOOSE OR sHARE, ANO PROCESS THE PERsONAL No
DATA I PROVIDED HEREIN FOR ELECTION AND OTHER IAWFUL PURPOSES IN ACCORDANCE !\iTI}l THE PRIVACY NOTICE AT
THE OACK OF THIS AND As l4AY BE AUTHORIZTD BY EXIST]NG LAWs,

I hereby certify that the facts stated herein are true and correct to the b€st of my knowledge.

sign.ture of6ndid:te over Print€d N.me

OATH
SUBSCRIBED AND SWORN to before me this day of 2023, at affiant exhibiting to me an
issued by on
Identification documenvcard which contains a photograph and signature bearing No.
-
Doc. No. ---------j
Page NO. (amx P3o 0o d@llFtary sm')
Eook No. ___-_-j
(Officer Authorized to Administer Oath)
Series of 2023.
-;
THIS FORI,I CAN 8T PHOTOCOPIEO OR REPROOUCED AND IS AVAJLAEI.E AT THE @I4EI.EC OFNCES FREE OF CHARGE
OR MAY BE DOWNLOADED TRO TIIE COMELEC OFEICTAL WE&STTE (@CITOdEC4OIND
 Case Docket
D o Case Title Date
D Filed Status

Name of the Substitute Spouse, if applicable

(in case ofdeath of candidate)

The collected personal data wjll be encoded in Sle lnforfiation system develop€d by the Commission on Eledions (COM€LEC). The personal
data inputted in the lnformation system will be us€d by the COMELEC in the preparation, posting and/or publication of the last of crndidates
and other eledion-relat€d doorments or forms.

for legitimate res€ar€h needs a.d inquines, and only for th€ purposes sp€cified in the requen, the COMEIEC may disclose and share your COC
and/or its contents. Moreover, the COMELEC may us€ and disdose your COC and/or ats contenb in any proceeding or investigation in which
your COC and/or its contents irare in issue or may fiod relevance,

Only authorized personnel are allowed to access and process your personal data. Immediately after the election period or upon the expiration
ofthe storage period set in existing COMELEC rules and policles, and laws and regulations, whichever applies, the physicaland dlgitalcopies of
your personal data will be anonymized, deleted, and discarded following the disposition procedures of the COMELEC and the National Archlves
of the Philippines.

You have the right to ask for a copy of your COC or any personal data it contains. Also, you may withdraw your candidacy in a(cordance with
the coMEGC rules ard policies on the matter.

lf you have questions rega.ding thb Privacy Notice, please s€nd an emailto dpo@cohetec.9ov.ph,
 Alnex "B"

STATEMENT OF WITHDRAWAL

I (Name of candidate), of legal age,

Filipino, and a resident of after having been
duly sworn to in accordance with law, state as follows

1. On I filed mv Certificate of Candidacv for the

position of before the Office of the Election Officer

2. I am hereby withdrawing my candidacy for the position of

IN WITNESS WHEREOF, I hereunto affix my signature this _ day of

1n Philippines.

(Name and Signature of Candidate)

(Date)

SUBSCRIBED AND SWORN to before me this of at

-day document/card
affiant exhibiting to me an Identificalion which
contains a photograph and signature bearing No, issued by
on

(Officer Authorized to Administer Oath)

Doc. No. ;
Pase No. :

BookNo. ;

Series _.

NOTICE/DISCLAIMER: AII authorized recipients of any personal data, personal information, privileged information
and sensihve personal information contained in this documenq including other pertinent documents dttached thereto
that are shared by the Commission on Elections in compliance with existing laws and rules, and in conJornlity with
the Data Pdvacy Act of 2012 @.A. No. 10173) and its Implementing Rules and Regulations, as well as the Pertinent
Circulars of the National Privacy Commission, are similarly bound to comply with said laws, rules and regulations,
relating to data privacy, secudty, confidentiality, Protection and accountability
 Annex ,,C,'

AUTHORITY TO FILE STATEMENT OFWITHDRAWAL OF

CERTIFICATE OF CANDIDACY

L (name of candidate), of legal age,

Filipino, and a resident of
hereby authorize
also of lega1
age, Filipino and a resident of
to file my Sworn
Statement of Withdrawl of Certitificate of Candidacy for the position of
in the Barangay and
Sangguniang Kabataan Elections, for the reason that I -

_ tested positive for COVID19;

was identified as a close contact with a person who was tested positive
- for COVID19 and on quarantine or isolation.
no other reason shall be allowed by the Commission.
-
IN WITNESS V\II{EREOF, I hereunto affix my signature this day of
_, in Philippines -

(Name and Signature of Candidate)

(Active Cellphone Number and Email Address)

(Date)

(Name and Signature of Agent)

(Date)

SUBSCRIBED AND SWORN to before me this of at

document/card which
affiant exhibiting to me an Identification-day
contains a photograph and signature bearing No. issued by
on _----

(Officer Authorized to Administer Oath)

Doc. No.
Paqe No. :

Book --i
No. :

Series

NOTICE/DISCLAIMER: All authorized recipients of any personal data, personal information, Privileged ir{omatron and
sensitive
personal rnJormation contained in this dor:ument, irrcluri.ing other pertinent d.ruments attached thereto that are sharcd by thc
bommission on Elections in compliance with existing laws ;d rules, and in conJormity wrth the Data Privacy Act oI2012
(R'A' No-
10123) and its Implementing Ruies ancl RegIlatio"s, as well as the pertinent Circulars of the National
Privacy Comnussion, arc
similJr]y bound to comply iith said laws, iules and regulations, reliting to data privacy, security, conJidentiality, Prote'rion and
accountability.