Republic of the Philippines

COMMISSION ON ELECTIONS
Manila

INSTRUCTIONS:'(Read well before fifling up this form.) II¥:

1. File this In -FIVE (5) LEGIBLE copies. '
2. File this certificate of candidacy with the Law Department, COMElEC Main Office, Tnt m os, Manlfa, starting November 20, 2009 up to
midnight of November 30, 2009. " "
3. Attach to tll;5 certificate the Certificate of Party Nomination unless you are antndependent candidate. After' midnight of November 30, 2009, no
certificate of nomination shall be accepted. .
4.. litles such as 'Dr., Atty., Don, Glnoo, Senor, Datu, Hadji, Sultan,'BaI, Senora, Kapitan or similar titles are expressly prohibited.
5. This certificate shall be sworn before a notary public or any offldal authorized to administer oath. COMELEC offidals are not author1zed to
administer oath ..

3. MY GENDER IS :

1.1 last Name ffI8i.T:[NJ.([tJ.$TALJ:::r::[ ..:L:.L.T::~LL.·.LT·~.·.L:.L·::L

..CLJJ 5. ~ :a~~E
S2::::~H IS :

1.2 \=irst Name (gI~jY:rbilA[:b[Q(QI:~:l::~J:::l:::I~~~I.:J.:.:::.:C:C~L~r~~r.:I~~l:~.:~C

-,LI~..l [.QI51=[i]~1-[j'}i[SQj
1.3 Middle NarneJS'J.~L~[YJ.~LLL~L.L.L..l
..:L.L..L..L..L.L.1....L..L ..L.1..L..L.L ..j 6. MY P~~~~ OfD:~RT~ IS ~ear

~~~i~~ !~~~~~~~eRo~~~~';:'!~ Y KNOWN BY THE NICKNAME OR STAGENAME . Clty/Mun ..k.l.(;!}..O............ .. .

~~~_~~:~~:l=·~~l=j~I=Q~I~¢~Jt=~~~~J~=~I~=~I~=~[==~C~J=~~]==~~===I==~[~~~[=J~~=]=~~I=~~I=~~C~J~~=
:~;~~~;; --.
o Sln~le 0 Widow/er

~ Married 0 legally separated

o Annulled / Divorced
Full Name of Spquse, If mar . ii:'C.. A
. . ARY... .5 ... 1. ~..... . .0~u.t:I
10. MY PROFESSION OR
OCCUPATION IS·:
.........LAW.Y..f..R · .
11. MY POST OFFICE ADDRESS FOR ELECTION PUR?OS'cS IS; (Could be the same as No.9)

.....SlJJT.~.V4.sA1tANIO'NtQ~Z\J2~:
..~~ ..~WN.A~.dQC .
13. MY PERIOD OF RESIDENCE IN THE PHILIPPINES BEFORE MAY 10, 2010 IS:

('o:'ii}1
•••••••••• _,/
No. of Months n·Til
•••••••••••• 1
No. of Yea~

14. r AM A NATURAL BORN FIUPINO CITIZEN.

15. I AM NOT A PERMANENT RESIDENT OF, OR IMMIGRANT TO, A FOREIGN
, ., COUNTRY.
L :6. I AM ELIGlBLE FOR THE. OfFICE I SEEK TO BE ELECTED TO.
1.7. I WILL SUPPORT AND DEFEND THE CONSTITUTION Of THE REPUBLIC or- THE

T
PHILIPPINES AND WILL MAINTAIN TRUE FAITH, AND ALLEGIANCE TI-IERETO. I
WILL OBEY THE LAWS, LEGAL ORDERS AND DECREES PROMULGATED BY TIlE
DULY CONSTITUTED AUTHORmES. I IMPOSE THIS OBliGATION UPON MYSELF
VOLUNTARILY, INITHOUT MENTAL RESERVATION OR PURPOSE OF EVASION .
••• Thumbprtnt

I hereby certify that the facts stated herein '

;f Srgnature or'.Candldate Over Print.;'d Name

I OAH! ' 'tfFlt

, SUBSCRIBED AND SW, OR, N to b' for+~e
crC/Identifi ation.A=ar0 No. I,} 0 . __ -1 !t5
fJY ~~Oa~aoovember,
Issued by ; Li&.Z C(
2009, at'AN'~~
:5?D : ~ ..•.
a, fflant
(,.=CJ~q,--__
exhlbtt'ing to me his/her

Doc. No. t( Y L }..to •. YO£<64 0~ . -TO I 00 . ItJ. .!'5'f:J.O( c:':tl

Page No. ; ,_...n' n___·-·iATTY. -iL.ELiR.tSiMA:; hI'
&x:k No.. j\l(:G tel'< lJtfumiz!~h!fi~t\iminister Oath)
Senes of 200 ;l'WlStarnp")}s:>lun
iCxpu'es ~n De-c. 31, 201U
350 U-.F GfF Goct:ino Bu.tldtrig .
A.l,Vil~("'~"''''
<;t •• ~/"mita, Manila /
II-< I- N c,<. 7 'l·H·.,.··.', 1.1',;0.11",1", :t-'7-;:t.vo9
PTR No. 727733 Manila 1-7-2009
Roll No. 33567
Commission No. 2009-206 -'