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COMMISSION ON ELECTIONS

LA~' DEPARTMENT ~
Republic of the Philippines

I COMMISSION
Manila
ON ELECTIONS

CERTIFICATE0 i~
~~~~~P=RE~S~ID~E~N~T~~~~~4~
INSTRUCTIONS: (Read well before filling up this form.)
1. File this in FIVE(5) LEGIBLEcopies.
2. File this certificate of candidacy with the Law Department, COMELEC Main Office, Intramuros, Manila, starting November 20, 2009 up to
midnight of November 30, 2009.
3. Attach to this certificate the Certificate of Party Nomination unless you are an independent candidate. After midnight of November 30, 2009, no
certificate of nomination shall be accepted.
4. TItles such as 'Dr., Atty., Don, Ginoo, Senor, Datu, Hadji, Sultan, Bai, Senora, Kapitan or Similartitles are expressly prohibited.
5. This certificate shall be sworn before a notary public or any official authorized to administer oath. COMELEC officials are not authorized to
administer oath.
, J ' ., ,

l herebll/anno\lnc:e mv
c:aJ;ldidac:y for thE: posjtiqn of PR~IDENT, Republic of the Philippines, in the May 10, 2010 .
elec:tionsi 'and after having been sworn to in accordance with law, hereby state..,!he following:
-c: ; •

3. MY GENDER IS : 4. MY AGE IS:

o
1. MY NAME IS :

Male DFemale 49
1.1 Last Name -,
........ '.
5. MY DATE OF BIRTH IS :
1.2 Rrst Name
.. _-.-._-_._.- .... .... - .., __ .

1.3 Middle Name : C 0 J U A N G:C: 0 : , , , .. Month Day Year


-_ --_
6. MY PLACE OF BIRTH IS :
2. I AM GENERALLY OR POPULARLY KNOWN BY THE NICKNAME OR STAGENAME
(Indicate only one nicknameor stagename)
,.-,
.; ,...... ..-
City/Mun MANJLA
Province
:NO:YN:O:Y
~------------- .•. -.. -.-..•. -..- .•.•.. ---.. ------.-.--- •. -..•.•.. -.--.---------·-.- •..•-.-.-.- •..•---------------+S.MYCIVILSTATUsis:
7. I AM OFFlOALLY NOMINATED BY: (Attach Certificate of Nomination)
_.LIBERAL _PARTY _ .. _,__.__.. ._." __, . ._
~ Single 0 Widow/er

Political Pa D Married 0 Legally Separated


9. MY RESIDENCE!
ADDRESS IS: 9.1 Province : T :A: R: LA: C :
............... -.-----.-_._------
• , ••
.. __ .-
, I
o Annulled / Divorced

Fu'liName of Spouse, if married


9.2 Oty/Munidpality 9.3 Ba'!lng~'y' . , . _',' _.• ' . , .. ',_ ..

:C:E:N:T:R:AL
. - ' ... ~.. :. - .' ...' ----- .. ---.-- .... - 10. MY PROFESSION OR
9,4 ~ouse No/. St~eetl. Su~divi~lon OCCUPATION IS :
'S:I;T:I:O: A'L;T:O SENATOR
11. MY POST OFFICE ADDRESS FOR ELECTION PURPOSES IS : (Could be the sameas No.9) 12. I AM A REGISTERED VOTER OF

SIl'I() AL 1'(),BRcrY·CEl'T.TMLJ.l' i-\R.-I--i-\c;_ql'Y,_ :r AcRLA-.c. . Precinct 175~A- _


Bgy CENTRAL
~.,. MY PERIOD OF RESIDENCE IN THE PHILIPPINES BEFORE MAY 10, 2010 IS:
Clty/Mun TARLAC CITY
: 0 ; 3: No. of Months : 5 : 0: No_of Years
Province TARLAC
-- --- ---- ---~-~--, -~
14. I AM A NATURALBORN FILIPINO CrnZEN. D THUMBPRINT '
1 .",J.,
15. I AM NOT A PERMANENTRESIDENT OF, OR IMMIGRANT TO, A FOREIGN
COUNTRY. :;>

16 ..J AM ELIGIBLE FOR THE OFFICE I SEEK TO BE ELECTEDTO.


17. I WILL SUPPORT AND DEFEND THE CONSTITUTION OF THE REPUBLIC OF THE
PHILIPPINES AND WILL MAINTAIN TRUE FAITH AND ALLEGIANCE THERETO. I
WILL OBEY THE LAWS, LEGAL ORDERS AND DECREES PROMULGATED BY THE
DULY CONSTITUTED AUTHORITIES. I IMPOSE THIS OBLIGATION UPON MYSELF
VOLUNTARILY,WITHOUT MENTALRESERVATION OR PURPOSE OF EVASION.

Thumbprint

I hereby certify that the facts stated herein are true and corr

OATH
- SUBSCRIBED _I.NO SWORN to before me this 28thctay of November, 2009, at Quezon City, affiant exhibiting to me his/her
CTCjldentification Card No~TIN NO. 121-211-191 Issued by: On: + _
Doc. No.
pageNo.~
451',~
i
'1~~~t~~~~=-::~J~U~
q N EMMANUEL
Notary Public for and in Quezon City
M. REYES
Book No. ----,~:c..=' __ ~ Expires on 3'\ December 2009
Series of 20c8. IBP No. 736897- "iI14/0B-Tarrac
PTR. No. 5105660 -1/9/09 - pasig
RQII N§. 81922

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