R esolution N o.

9616 j Page 21 Gf 2 5
General Instructions for the Im plem entation of Resolution N o. 9476 as am ended

[Monitoring Checklist for internal use by Election Officers and Volunteer Monitors in their field
observation of campaign activities]
Annex "C"

C a m p a i g n M o n it o r i n g C h e c k l is t

N am e o f M onitor Date o f e vent

P osition/D ept o f M onitor O rganization

N am e o f C andidate/s (list nam e/nam es vU) Elective office sought

N am e o f Party
Type o f Party: □ Political Party
Municipality/City/Province -> □ P arty-List Org.
(ex. La Paz, Abra)
Type o f Event: L ocation/venue o f the event: ^ □ Local
□ Miting de Avance □ Open space C onstituency □ R egional
□ Door to door campaign □ Indoor stadium o f the Party-> □ Provincial
□ Campaign sortie □ Plaza □ National
□ Motorcade D uration of (ex. 1:00-2:00pm)
□ Gov't/public building
□ Forum/Seminar □ Hotel/restaurant e vent (start-
end tim e) ->
□ Other (pis specify) □ Covered court
□ Other (pis. specify) W as the field officer □ Yes
notified o f event? -> □ No

Name & address of venue (ex. Rizal Plaza, Main Avenue, Metro City)

Name of event organizer

E V E N T DETA ILS, LO G ISTIC S A N D A M E N IT IE S

Was any technical equipment used during the event? (ex. sound, lights, etc.) □ Yes □ No
If YES, pis. describe:
Was there a stage or raised platform during the event? □ Yes □ No
If YES, pis. describe:
Was there electricity provided or used during the event? (ex. generator, venue-provided) □ Yes □ No
If YES, pis. specify source:
Were refreshments or food items distributed/served to the people who attended? □ Yes □ No
If YES, pis. specify & estimate number: (ex. 100 sandwiches, 100 soda cans, 100 water bottles)
Were there giveaways or items distributed freely? (ex. baseball caps, t-shirts, pens, fans) □ Yes □ No
It YES, pis. describe & estimate number: (ex. 100 shirts, 50 caps, etc.)
Were there tents, tables, and chairs rented/setup for the event? □ Yes □ No
It YES, pis. specify & estimate number: (ex. 3 20x20 tents, 20 tables,40 chairs)
Was any form of transportation provided to the persons who attended the event? □ Yes □ No
If YES, pis. describe & estimate number: (ex. 2 pickup trucks with red plate, rented coaster/bus/ieeD e tc )
Were there any event staff present during the event? □
Yes □ No
It YES, pis. specify & estimate number: (ex. 10 ushers/marshals, 20 bodyguards/security, 2 ohotoaraDhers etc )
Was there any form of entertainment provided during the event? □ Yes □ No
If YES, pis. describe: (ex. live performance by XYZ, fireworks display, e tc )
Was the event promoted or publicized in any way? (ex. streamers, radio ads. mobile ads. etc.) □ Yes □ No
If YES, pis. describe: (ex. 15-sec radio ad, % page on local paper, mobile ad on L300 van e tc )
D E S C R IP T IO N O F TH E EV EN T (you may continue on the back page of checklist)
 9616.)
R esolution N o . ____Page 22 of 25
General Instructions for the Im plem entation of Resolution N o. 9476 as am ended

[Back page of Annex C]

_________________ D E S C R IP TIO N OF TH E EVEN T (continued from the front page)

M O N IT O R ’S U N D E R TA K IN G

•. ___________________________ o f legal age, Filipino, and w ith residence and postal

address a t ________ ____________________________ ____________ i do hereby ce rtify under oath that:

1. I personally accom plished the above C am paign M onitoring C he cklist a fte r conducting
an ocular inspection o f the prem ises w here the rally or m eeting w as held, in accordance with
Section 6 o f C O M E LE C R esolution N o ._______.

2. I have read all the inform ation contained therein and they are all true and correct o f
m y own personal know ledge.

3. T he foregoing C am paign M onitoring C hecklist w as not am ended nor in any m anner

m odified, and accordingly, the sam e m ay be relied upon should there be a legal issue as to its
veracity.

4. S hould there be a com plaint filed w here the contents o f the M onitoring C hecklist are in
issue, I am w illing to be a w itness to identify and authenticate the sam e.

IN W IT N E S S W H E R E O F, I have set m y hand to this U ndertaking on

2013 a t _________ .

M onitor’s signature over printed nam e

ACKNOW LEDGM ENT

S ubscribed and sw orn to before me this ____ day o f ________________ , 2013, at

_____________________ _ affiant exhibiting to me his/her identification docum ent
____________________w hich contains his/her photography and signature, bearing num ber
___________ , issued b y ______________________ o n _______________________.

N O TAR Y PU BLIC /
O FFIC ER A U T H O R IZ E D T O A D M IN IS T E R OATH

Doc. No. :____

Page N o .:____
Book No. :____
Series o f 2013.