Republic of the Philippines

COlVIMISSION ON ELECTIONS
Ma nil a

CERTIFICATE OF c,
SENAT
.1
lNSTRUcnONS: (Read well before filling up this form.) BY: •••
. 1. Ftle this in FIVE (5) LEGIBLEcopies.
;C. File this certificate of candidacy with the law Department, COMELEC Main Office , Intr arnur o s, l' anila , starting November 20, 2()09 Up to
midnight of November 30, 2009.
3. Attath to this certificate the Certificate of Party Nomination unless you are 3[1 independent candidate. After midnig'ht of November 30, 200'3, no
certificate of nomination shall be accepted.
4. litles such as 'Dr., Atty., Don, Ginoo, Senor, Datu, Hadji, Sultan, Bal, Senora, Kapitan or similar titles are expresslv prohibited.
5. This certificate shall be sworn before a notary public or any official authorized to administer oatil. COMELEC officials are not authorized to,
administer bath.

, ~'hj;!t~bY anneunca my t:andidaey fO~ the Itosltion of SENATOR, Republic of the Philippines, In the lViay 10; 2010 elet;tlons;
a,~d l!fter having been sworn tu In accordance with taw, hereby state the followln\l: ,

1. MY NAME IS ; 3. MY GENDER IS : 4. MY AGE IS :

1.1 Last Name

G 'ii 'de);"':":
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RA:MON: :J:R : : . : .. : ... , : : : . , .

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1.2 First Name

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::: .-.';.-,',~':.-.'~-.-.- ~~,":.~r ':.-;.,~~~~".;~~:: -:.':.-;.':.-; ;-:.~ ::: -:••,
1.3 Niddle Name NA:v:~ L : : . : : f·lonth Day Year
:....~.~.<.,:,.... :..,.~.,: ', ",'~".;~ :~.:. -,' ', .. ~, ..., .. .'.... ~.... '"., .... ~,.,:, : ... "'..,.:.~~'".~' .. ,~ 6. MY PLACE OF BIRTH IS :
2. I AM GENERALLY OR POPULARLY KNOWN BY THE NICKNAr'1E OR STAGENAME
Cil:j<'i~lun
B'ill a1onan
(Indicate' only o~~ ~i;~?~~~
_o.r~s~~~c.n.tl;~e)" ,..• " _,,~ . __ .,> •• f •• ~~. A," or ~'~~ ~ '0_ ~ •. I" ~ ~,~ " _ ••. H ~ f ~., -••• ,~" •. -,.,~ ••• " ••• ~ "~'~, prOVince ... :. :_:.~.~ ~n.:.~~~§~~~
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M;O:N:C:H: (NG . : : : i : : : : ' : : ... : .
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' •..,••••';.,.••••••:""•• "".••••.••'w""'! ,,",',..,.,'''''
••••••••••••'''''."",,(•••••.:..:...,...,••"'••••• ' i.,.:! ••••••••••••••• " ••• ,,.. •••••• i..:! .""'. "",' .""."": • ..,. • .,.,,'''0.:.•••••'' "",',,"-.,,,,: •..,.•••••• ·,..·.,:;;·'-1-8.MY CIVIL STATUS IS :
7. I AM OFFICIALLY NOMINATED BY: (Attach Celtificate of Nomination)
D Single 0 Widow/er
...., " ,..~·A¥A$.~r~.~~ s \
"., [1f] ~larried 0 Legally Separated
9. MY RESIDENCE!
ADDRESS IS :
9.1 Province
; -

:P:A:N:G:A:
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S; I:NA:N:
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o Annulled I Divorced

Full Name of Sf'ouse, if married

?:~~!t'!·(~!~~i;ip?~.ty"r.""."." " ",," '.' 'r'" 9.~ "e.a,:,:n.g.~y".,.. """", ,," ," _ __ ,,_ _. ARL YN GRACE VELICARIA otnco
:B:fN:A:L:O:N:A:N: : . : : : : :L:I:N:M:A:N' S'A'N'O'A'l\,!r: .~- .•.•...•....•.•......•..........•.
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: ~_ .~._ .!. _. ~... ;... ~ .• ~. _.!. ,~:_. _:_~":,.,,_:~ .. :,. ~.:. ~ .. ~~ ~ ~ ~ : .. __ ~.~~~_.:._.~ .. ~.. .' __ ~'.~ _;.~" :_~:. :~~_: .. ~,. 10. MY PROFESSION OR
9.4 House No.! Street f Subdivision OCCUPATION IS !
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I ' , ' • , • • ' , : ' • , I , , • , , ; , , , \ • , • , , ,
BUSINESSMAN/MUN. MAYOR

11. MY POST OFFICE ADDRESS FOR ELECTION PURPOSES IS : (Could be U1e same as No.9) 12. I AM A REGISTERED VOTER OF
Precinct 0013A

13. MY PERIOD OF RESIDENCE IN THE PHILIPPINES BEFORE MAY 10, 2010 IS:
Bgy _... Poblacion _.,.. _.... _... _
Binalonan
:0 ~5 ~ No. of ~'lonths No. of Years
Cltyft~UI1

Province
... lJ'al1gasman- ---.-.. --.....
r -
14. I At." A NATURAL BORN FILIPINO CITIZEN. I b lHUMBPRtNt
, z
15. I AM NOT A PERrvlANENT RESIDENT OF, OR IMMIGRANT TO, A FOREIGN
COUNTRY.
16. I AM ELIGIBLE FOR THE OFfICE I SEEK TO BE ELECTED TO.
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 fvlYSELF

" ..... V~LUN.TARJLYI WI~HO~T .ME~TAL.RE~.~R~A~I~~ :O~ p.U~~~~SEOF.~~~ION~." , L. ... Thumbprint

I hereby certify that the facts stated herein are true and corr f~ np s al 0 Jled{' "\ .

o , lCO, J .

OATH
SUBSCRIBED AND SWORN to before blOMiS 2.J)dJtlQ ovember, 2009, M A I\IOAlU or~£JI;tbiting to me his/her
<1i'Al~W'J@B:lTard No. XX0836246 Issued by: DFA - Manila On: ~ ~..-1.~~'.L-4..L.JA'VI

Doc. No.~; MA: '\He . RlA • GlRAO

Page No. ----!lJ.--i ~k! , blic
Book No. ~ ; D.?cember31,2010
Senes of 20o_. If-; <; Y 77{)390/1=B .•mm3atangas
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Rtlll 'Ji. 411.\'1'