Republic of the Philippines

Commission on Election
BOARD OF ELECTION INSPECTORS
_____________, Cagayan

PROTEST

I, _________________________ , of legal age, Filipino, and a

resident of ________________________ , Cagayan, hereby
depose and states that:

1. I am the duly authorized watcher of

____________________ Party and/or for Leonides N. Fausto;

2. I am duly assigned at _________________ (precinct no.)

in Barangay _________________ , _________________ , Cagayan;

3. During the proceedings in the above-mentioned

precinct on election day, I observed and witnessed the
following irregularities:

____ The members of the Board of Inspectors (BEI) are

not public school teachers

____ The members of the BEI who are not public school
teachers were not duly appointed by the
COMELEC in accordance with law

____ The members of the BEI are not registered voters

of the Municipality to which they were
assigned

____ The BEI Chairman is not a public school teacher

____ The BEI Chairman/member is not of good moral

character and irreproachable reputation

____ The BEI Chairman/member has been convicted of

an election offense/crime punishable by more than
six (6) months

____ The BEI Chairman/member has a pending case

filed against him in COMELEC or in any court for
any election offense

____ The BEI Chairman is unable to speak English or the

local dialect
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 ____ The BEI Chairman/member was relieved or
disqualified from duty without cause and
hearing

____ The BEI Chairman/member is related within the

fourth civil degree of consanguinity or affinity
to a member of the same BEI

____ The BEI Chairman/member is related within the

fourth civil degree of consanguinity or affinity
to a candidate to be voted for

____ The BEI Chairman/member is related within the

fourth civil degree of consanguinity or affinity
to a candidates spouse

____ The BEI Chairman/member is married to someone

related within the fourth civil degree of
consanguinity or affinity to a member of the same BEI

____ The BEI Chairman/member is married to someone

related within the fourth civil degree of
consanguinity or affinity to a candidate to be voted for

____ The BEI Chairman/member is married to someone

related within the fourth civil degree of
consanguinity or affinity to a candidates spouse

____ The BEI Chairman/member is engaged in partisan

political activity or took part in the election

____ The BEI Chairman/member, while voting is going

on, announced the registered voters who
already voted or not

____ The BEI Chairman/member, while voting is going

on, announced how many already voted, or
failed to vote or any other fact tending to
show or showing the state of the polls

____ The watcher of ______________________ is not a

registered voter of _________________ , Cagayan
comprising the above precinct he/she is assigned

____ The watcher of ____________________ has been

convicted by final judgment of an offense/crime
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 ____ The watcher of ____________________ is related
within the fourth civil degree of consanguinity or affinity to
the BEI Chairman/member in the polling place where he was
appointed as watcher

____ The ballot box/boxer was/were unlawfully opened.

____ A voter is not included in the EDCVL.

____ The BEI Chairman fails to authenticate the ballot by

affixing his/her signature in the space dedicated for the
purpose

____ The BEI member issued the ballot not the

Chairman

____ A voter used a fictitious name in order to vote

____ The BEI Chairman/member issues more than one

(1) ballot for the same voter

____ A voter brought his/her ballot, ballot secrecy

folder, or marking pen outside the polling place

____ A voter prepared his/her ballot without using

secrecy folder or show its contents

____ A voter filled his ballot with the company of

another wherein the said voter is not an illiterate or
person with disability

____ A voter erased any printing in the ballot

____ A voter put a distinct mark on his ballot

____ A voter used a carbon paper, paraffin paper, or

other means of making a copy of the contents of the
ballot

____ A voter made use of camera, cellular phone, other

gadgets or other scheme to identify his vote

____ A voter intentionally torn or deface the ballot

____ A voter disrupted or attempted to disrupt the

normal operation of the PCOS
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 ____ A voter used a ballot other than official ballot
____ A voter used a ballot other than that provided by
the BEI

____ An illiterate voter or disabled voter (PWD) was not

assisted by his/her relative within the fourth civil degree of
consanguinity or affinity by a person of the voters
confidence who belongs to the same household

____ An illiterate voter or disabled voter (PWD) was not

assisted by a person of the voters confidence who belongs
to the same household

____ An illiterate voter or disabled voter (PWD) was not

assisted by any member of the BEI

____ The assistor is not of voting age

____ The assistor who is not a BEI member assisted

more than three times

____ The assistor did not accomplish the ballot in

accordance with the desired candidates of the
illiterate/disabled voter.

____ An individual acted in such a disorderly manner as

to interrupt or disrupt the work or proceedings to the end
of preventing the BEI or BOC during any of its meetings
from performing its functions

____ An individual carried out threats, intimidation,

terrorism, used fraudulent devices or other forms of
coercion

____ Bringing of deadly weapons into the polling place

and within a 100 meter radius from the polling place,
without having been so authorized by COMELEC

____ An individual employed means of scheme to

discover the contents of the ballot of a voter who is
preparing or casting his vote or who has just voted

____ An individual compelled a voter to reveal how such

voter voted

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 ____ An individual interfered with anothers exercise of
his right to vote

____ A voter was arrested or detained without lawful

cause

____ An individual molested a voter in such a manner as

to obstruct or prevent him from going to the polling place
to cast his vote or from returning after casting his vote

OTHER IRREGULARITIES

________________________________________________________

________________________________________________________

________________________________________________________

________________________________________________________

IN WITNESS HEREOF, I hereby affixed my signature this

9th
day of May 2016 at ______________________________
,Cagayan.

________________________

Watcher for _____________

Received by:

_______________________________