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COMMISSION ON ELECTIONS
Polomolok,
South
Cotabato
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I hereby announce my candidacy for the position of Sangguniang Kabataan Chairman of Barangay
, Municipality of
, Province of
on February 21, 2015 Sangguniang Kabataan Elections; and
after having been sworn to in accordance with law, hereby state the
3. MY GENDER
4. MY AGE IS:
following:
IS:
1. MY NAME IS :
Male
Female
Month
City / Mun.
Province
8.1 Province
Year
Day
8.3
Single
Widow/er
Married
Legally Separated
Annulled / Divorced
Full Name of Spouse, If Married
10. MY POST OFFICE ADDRESS FOR ELECTION PURPOSES IS: (Indicate if the same
as No. 8)
9. MY PROFESSION
OR OCCUPATION IS:
11. MY PERIOD OF RESIDENCE IN THE PHILIPPINES BEFORE FEBRUARY 21, 2015 IS:
12. I AM A MEMBER OF
KATIPUNAN NG KABATAAN OF:
No. of Months
No. of Years
Precinct
Barangay
City / Mun.
Province
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I hereby certify that the facts stated herein are true and correct of my own personal knowledge.
OATH
SUBSCRIBED AND SWORN to before me this
his/her Identification Card No.
Issued by:
day of
, 2015 at
On:
, afant exhibiting to me
.
Doc. No.
Page No.
Book No.
Series of 2015.
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_;
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