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Commission on Elections

October 30, 2023


Barangay and Sangguniang Kabataan Elections ARC
Authority to Receive Contribution
Date filed:

The undersigned candidate herein grants the authority to the agent,

(SURNAME) (FIRST NAME) (MIDDLE NAME) (EXT. )


To receive contributions and issue receipts for the same on behalf of the candidate and shall be responsible for the actions of the said agent.

MABELLE A. CIPRES
SIGNATURE OVER PRINTED NAME OF CANDIDATE]
Date signed:

CANDIDATE INFORMATION: Accomplish this part only if you are a candidate.


NAME OF CIPRES MABELLE ABELLANO
CANDIDATE: (SURNAME) (FIRST NAME) (MIDDLE NAME) (EXT)

Elective
Barangay
Position
SK CHAIRMAN CABIT
Contact information:
(Mobile no. and e-mail address)

AGENT INFORMATION: (Person authorized to receive contributions, whose name appears in main body)
Home/Office
Address:

Mobile No.: E-mail Address:

ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES )
City/Municipality of __________________)

BEFORE ME, on ___(date) and in (city/municipality) , personally appeared the following persons with competent evidence of their
identity:
Name I.D. Type Expiry Date Issuing Authority

aid persons acknowledged under oath to me under penalty of law, that the whole contents of this document are true and the same are their free
and voluntary acts and deeds.
AUTHORIZED PERSON TO ADMINISTER OATH
Commission on Elections
October 30, 2023
Barangay and Sangguniang Kabataan Elections ARC
Authority to Receive Contribution
Date filed:

The undersigned candidate herein grants the authority to the agent,

(SURNAME) (FIRST NAME) (MIDDLE NAME) (EXT. )


To receive contributions and issue receipts for the same on behalf of the candidate and shall be responsible for the actions of the said agent.

EFREN D. CASTILLON JR.


SIGNATURE OVER PRINTED NAME OF CANDIDATE]
Date signed:

CANDIDATE INFORMATION: Accomplish this part only if you are a candidate.


NAME OF CASTILLON EFREN DADO JR
CANDIDATE: (SURNAME) (FIRST NAME) (MIDDLE NAME) (EXT)

Elective
Barangay
Position
SK KAGAWAD CABIT
Contact information:
(Mobile no. and e-mail address)

AGENT INFORMATION: (Person authorized to receive contributions, whose name appears in main body)
Home/Office
Address:

Mobile No.: E-mail Address:

ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES )
City/Municipality of __________________)

BEFORE ME, on ___(date) and in (city/municipality) , personally appeared the following persons with competent evidence of their
identity:
Name I.D. Type Expiry Date Issuing Authority

aid persons acknowledged under oath to me under penalty of law, that the whole contents of this document are true and the same are their free
and voluntary acts and deeds.
AUTHORIZED PERSON TO ADMINISTER OATH

Commission on Elections
October 30, 2023
Barangay and Sangguniang Kabataan Elections ARC
Authority to Receive Contribution
Date filed:
The undersigned candidate herein grants the authority to the agent,

(SURNAME) (FIRST NAME) (MIDDLE NAME) (EXT. )


To receive contributions and issue receipts for the same on behalf of the candidate and shall be responsible for the actions of the said agent.

KRISTINE A. DAWAL
SIGNATURE OVER PRINTED NAME OF CANDIDATE]
Date signed:

CANDIDATE INFORMATION: Accomplish this part only if you are a candidate.


NAME OF DAWAL KRISTINE ATULI
CANDIDATE: (SURNAME) (FIRST NAME) (MIDDLE NAME) (EXT)

Elective
Barangay
Position
SK KAGAWAD CABIT
Contact information:
(Mobile no. and e-mail address)

AGENT INFORMATION: (Person authorized to receive contributions, whose name appears in main body)
Home/Office
Address:

Mobile No.: E-mail Address:

ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES )
City/Municipality of __________________)

BEFORE ME, on ___(date) and in (city/municipality) , personally appeared the following persons with competent evidence of their
identity:
Name I.D. Type Expiry Date Issuing Authority

aid persons acknowledged under oath to me under penalty of law, that the whole contents of this document are true and the same are their free
and voluntary acts and deeds.
AUTHORIZED PERSON TO ADMINISTER OATH
Commission on Elections
October 30, 2023
Barangay and Sangguniang Kabataan Elections ARC
Authority to Receive Contribution
Date filed:

The undersigned candidate herein grants the authority to the agent,

(SURNAME) (FIRST NAME) (MIDDLE NAME) (EXT. )


To receive contributions and issue receipts for the same on behalf of the candidate and shall be responsible for the actions of the said agent.

JHON PAUL A. DIAZ


SIGNATURE OVER PRINTED NAME OF CANDIDATE]
Date signed:

CANDIDATE INFORMATION: Accomplish this part only if you are a candidate.


NAME OF DIAZ JHON PAUL ABELLANO
CANDIDATE: (SURNAME) (FIRST NAME) (MIDDLE NAME) (EXT)

Elective
Barangay
Position
SK KAGAWAD CABIT
Contact information:
(Mobile no. and e-mail address)

AGENT INFORMATION: (Person authorized to receive contributions, whose name appears in main body)
Home/Office
Address:

Mobile No.: E-mail Address:

ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES )
City/Municipality of __________________)

BEFORE ME, on ___(date) and in (city/municipality) , personally appeared the following persons with competent evidence of their
identity:
Name I.D. Type Expiry Date Issuing Authority

aid persons acknowledged under oath to me under penalty of law, that the whole contents of this document are true and the same are their free
and voluntary acts and deeds.
AUTHORIZED PERSON TO ADMINISTER OATH
Commission on Elections
October 30, 2023
Barangay and Sangguniang Kabataan Elections ARC
Authority to Receive Contribution
Date filed:

The undersigned candidate herein grants the authority to the agent,

(SURNAME) (FIRST NAME) (MIDDLE NAME) (EXT. )


To receive contributions and issue receipts for the same on behalf of the candidate and shall be responsible for the actions of the said agent.

ELOISA MAE V. LANA


SIGNATURE OVER PRINTED NAME OF CANDIDATE]
Date signed:

CANDIDATE INFORMATION: Accomplish this part only if you are a candidate.


NAME OF LANA ELOISA MAE VIÑAS
CANDIDATE: (SURNAME) (FIRST NAME) (MIDDLE NAME) (EXT)

Elective
Barangay
Position
SK KAGAWAD CABIT
Contact information:
(Mobile no. and e-mail address)

AGENT INFORMATION: (Person authorized to receive contributions, whose name appears in main body)
Home/Office
Address:

Mobile No.: E-mail Address:

ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES )
City/Municipality of __________________)

BEFORE ME, on ___(date) and in (city/municipality) , personally appeared the following persons with competent evidence of their
identity:
Name I.D. Type Expiry Date Issuing Authority

aid persons acknowledged under oath to me under penalty of law, that the whole contents of this document are true and the same are their free
and voluntary acts and deeds.
AUTHORIZED PERSON TO ADMINISTER OATH
Commission on Elections
October 30, 2023
Barangay and Sangguniang Kabataan Elections ARC
Authority to Receive Contribution
Date filed:

The undersigned candidate herein grants the authority to the agent,

(SURNAME) (FIRST NAME) (MIDDLE NAME) (EXT. )


To receive contributions and issue receipts for the same on behalf of the candidate and shall be responsible for the actions of the said agent.

GINO D. LANA
SIGNATURE OVER PRINTED NAME OF CANDIDATE]
Date signed:

CANDIDATE INFORMATION: Accomplish this part only if you are a candidate.


NAME OF LANA GINO DE LOS ANGELES JR
CANDIDATE: (SURNAME) (FIRST NAME) (MIDDLE NAME) (EXT)

Elective
Barangay
Position
SK KAGAWAD CABIT
Contact information:
(Mobile no. and e-mail address)

AGENT INFORMATION: (Person authorized to receive contributions, whose name appears in main body)
Home/Office
Address:

Mobile No.: E-mail Address:

ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES )
City/Municipality of __________________)

BEFORE ME, on ___(date) and in (city/municipality) , personally appeared the following persons with competent evidence of their
identity:
Name I.D. Type Expiry Date Issuing Authority

aid persons acknowledged under oath to me under penalty of law, that the whole contents of this document are true and the same are their free
and voluntary acts and deeds.
AUTHORIZED PERSON TO ADMINISTER OATH
Commission on Elections
October 30, 2023
Barangay and Sangguniang Kabataan Elections ARC
Authority to Receive Contribution
Date filed:

The undersigned candidate herein grants the authority to the agent,

(SURNAME) (FIRST NAME) (MIDDLE NAME) (EXT. )


To receive contributions and issue receipts for the same on behalf of the candidate and shall be responsible for the actions of the said agent.

JOHN PAUL D. GONZALES


SIGNATURE OVER PRINTED NAME OF CANDIDATE]
Date signed:

CANDIDATE INFORMATION: Accomplish this part only if you are a candidate.


NAME OF GONZALES JOHN PAUL DAGTA
CANDIDATE: (SURNAME) (FIRST NAME) (MIDDLE NAME) (EXT)

Elective
Barangay
Position
SK KAGAWAD CABIT
Contact information:
(Mobile no. and e-mail address)

AGENT INFORMATION: (Person authorized to receive contributions, whose name appears in main body)
Home/Office
Address:

Mobile No.: E-mail Address:

ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES )
City/Municipality of __________________)

BEFORE ME, on ___(date) and in (city/municipality) , personally appeared the following persons with competent evidence of their
identity:
Name I.D. Type Expiry Date Issuing Authority

aid persons acknowledged under oath to me under penalty of law, that the whole contents of this document are true and the same are their free
and voluntary acts and deeds.
AUTHORIZED PERSON TO ADMINISTER OATH
Commission on Elections
October 30, 2023
Barangay and Sangguniang Kabataan Elections ARC
Authority to Receive Contribution
Date filed:

The undersigned candidate herein grants the authority to the agent,

(SURNAME) (FIRST NAME) (MIDDLE NAME) (EXT. )


To receive contributions and issue receipts for the same on behalf of the candidate and shall be responsible for the actions of the said agent.

LENNIE ANN B. TAPAO


SIGNATURE OVER PRINTED NAME OF CANDIDATE]
Date signed:

CANDIDATE INFORMATION: Accomplish this part only if you are a candidate.


NAME OF TAPAO LENNIE ANN BAGAY
CANDIDATE: (SURNAME) (FIRST NAME) (MIDDLE NAME) (EXT)

Elective
Barangay
Position
SK KAGAWAD CABIT
Contact information:
(Mobile no. and e-mail address)

AGENT INFORMATION: (Person authorized to receive contributions, whose name appears in main body)
Home/Office
Address:

Mobile No.: E-mail Address:

ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES )
City/Municipality of __________________)

BEFORE ME, on ___(date) and in (city/municipality) , personally appeared the following persons with competent evidence of their
identity:
Name I.D. Type Expiry Date Issuing Authority

aid persons acknowledged under oath to me under penalty of law, that the whole contents of this document are true and the same are their free
and voluntary acts and deeds.
AUTHORIZED PERSON TO ADMINISTER OATH

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