FROM CITY/MUNICIPAL TREASURER

CEF NO. DESCRIPTION RATE OF DISTRIBUTION

PER CLSUTERED
PRECINT
ELECTION FORMS
A3 Poster Indicating the Clustered Precincts 1 Piece
Numbers
A6 Official Ballots 1 Piece per voter
A12 Paper Seal 48 Pieces
A14 Certificate of Receipt of Official Ballots. Other 3 Pieces
Forms of Supplies by EB
A27 Official Receipt of Election Returns 10 Pieces
ENVELOPES FOR VOTING AND COUNTING
A15 For Rejected ballots, Half of Torn Unused 3 Pieces
Official ballots and Other Half of Torn Unused
Official Ballots
A17 For Election Returns 30 Pieces
OTHER ENVELOPES
A18-B For main SD Card 1 Piece
A18-C to Initialization Report, Audit Log, and Precinct 3 Pieces
A18-E Statistical Report
OTHER FORMS
A30/ A31 Temporary Appointment of Chairperson/ Poll 10 Pieces
Clerk/ Third Member/ Support Staff
A35 Certificate of Challenge or protest and 10 Pieces
Decision of the EB
A39 Oath of Voter Challenge for Illegal Acts 10 Pieces
A40 Oath of Identification of Challenged Voter 10 Pieces
SUPPLIES
Bond Paper(long) 20 Pieces
Ballot Secrecy Folder 12 Pieces
Thumprint Taker 1 Piece
Plastic seal for the Ballot Box 5 Pieces
Indelible Stain Ink 5 Pieces
Ballpens 4 Pieces

FROM THE ELECTION OFFICER

a.) Two copies of the Precinct Comnputerized Voters List (PCVL)

i.One copy to be posted outside the polling place; and
ii.One copy to be used by the EB during the voting
b.) The Election Day Computerized Voters List (EDCVL); and
c.) Copies of Appointment and Oath of Office of the EB and Support Staff (CEF No. A5 &
CEF No. A5-A)
 WATCHER'S BIO-DATA

Name:_________________________________________________________________
(Surname) (Given Name) (Middle Name)
Address: _______________________________________________________________
(House No.) (Street) ( Brgy.) (Municipality)

Date of Birth:_________________ Place of Birth:_______________________

Civil Status:_________________ Citizenship:_________________________
Height:___________________ Weight:____________________________
Religion:_________________ Gender:____________________________
Civil Status:_________________ If married, Name of
Spouse ____________________________
His/Her Occupation:__________________
No. of Children:___________________ Names &Age of Children
_____________________________________
_____________________________________
_____________________________________
Father's Name:___________________________________________________
Occupation:_______________________
Mother's Name:___________________________________________________
Occupation:_______________________
Languages or Dialects you can speak :________________________________
Education Attainment:______________________________________________
Present Occupation or Employment, if any:_____________________________
Have you ever been convicted of any election offense
or of any crime? Yes:_______ No:_________
Any experience as a watcher? Yes ______ No________
If Yes, when and name of candidate or Political Party
represented:____________________________
Did you vote during the 2019 elections: Yes: _____ No:______
Precinct No. & Barangay where you are presently
registered:____________________

I hereby certify that the above information are true and correct of my own
knowledge.

_________________
Signature