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Henry Caunan
Henry Caunan
COMMISSION ON ELECTIONS
. Manila
CERTIFICATE OF ~r
SENAl
INSTRUCTIONS:(Readwellbeforefilling up this form.) L1
1. Filethis in FIVE(5) LEGIBLE copies. TIME: --:::-:;,-_:-:-L-;:::""!'-
2. File this ce-nncare of candidacy with the La.w.Department,. CO~Ttto>'-"'","UW""-'''''''''..!ll!!£'!.!'.!!!~-!:!:~
midnight 0: Nove.mber 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
certirocate<>f
nominationshallbe accepted.
.4. Titles such as 'Dr., At~., Don, Ginoo, Senor, Datu, Hadjl, Sultan, Bait Seiiora, Kapitan or similar titles are expressty prohibited.
5. This certificate 'shall be sworn before a notary' publlc or 'any ofilelal authorized to administer oath. COMELECofficials are not authorized to
administer oath.
1.1 Lastf'l<Ime
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5. MY DATE OF BIRTH IS :
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1.2 First Name
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1.3 Middle Name- (~\t~·:·~·':A·:~./:E·::N·:T\j·~·i'AJ
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Month
6. MV PLACE OF BIRTH IS :
2. I A~' GENERALLY OR POPULARLY KNOWN BY THE NICKNAME OR STAGENAME
(Indkate. only one nickname or stacename)
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..~.-.~,.-·~·-··-·~·-··~·-·~·-t8.MYCIVILSTATUSlS:
7. I AM OFFICIALLY NOMINATED BY: (Attleh Certificateof Nomination)
................ p. D.P:-: .I.-A.t?AN : , _ _ .
o Single D Widow!er
o ~nnulled I Divorced
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9.1 House No.f sm..t! Subdwlslon
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OCCUPATION IS :
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11. MY POST OFFICE ADDRESS fOR ELECTION PURPOSES IS: (Couldbethe sameas No.9) 12. IAM'A REGISTERED VOTER OF
~'7S
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Precinct ...t.-:~ _ .
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f'06LACION -
13. MY PERIOD OF RESIDENCE IN THE PHIUPPI/iES BEFORE MAY ,,0, 2010 IS:
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No. of Month~ ~6:~.~ No. of Years
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Province eATANGAS
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