ANNEX A

Republic of the Philippines

COMMISSION ON ELECTIONS
Barangay and Sangguniang Kabataan Elections

October 30, 2023

DEED OF CONTRIBUTION
(for Domestic Corporation)

KNOW ALL MEN BY THESE PRESENTS:

This Deed of Contribution, made and executed by into and between:

____N/A______, a corporation duly organized and existing under the laws of the Republic of
the Philippines with office address at ______________N/A________________, represented by
_____N/A_____, who is the ___N/A____, hereinafter called the CONTRIBUTOR,

- and -

RUEL O. ACABAL JR. who is running for SK CHAIRPERSON of DUNGO-AN,

MANJUYOD NEGROS ORIENTAL, represented by _______________N/A________________,
with address at
__________________________N/A___________________________________, hereinafter
called the DONEE.

WITNESSETH

Page 1 of 3
That for and in consideration of a desire to support the electoral campaign of the DONEE
for the 2023 Barangay and Sangguniang Elections, the CONTRIBUTOR has freely and
voluntarily given, transferred and conveyed by way of contribution to the DONEE,

Details of the Contribution Amount/Fair Market Value (for in-kind

donations)
____________N/A_______________ ______________N/A_______________
___________________________ _____________________________

IN WITNESS WHEREOF, the CONTRIBUTOR has hereto subscribed this ____ day of
____________, 2023.

______________________________
SIGNATURE OF THE AUTHORIZED
REPRESENTATIVE
(Signature over Printed Name)

ACCEPTANCE

For and in behalf of the RUEL O. ACABAL JR., the DONEE expresses his/her most sincere
appreciation for the generosity shown by the CONTRIBUTOR. The DONEE, hereby accepts and
acknowledges the above Contribution/s.

IN WITNESS WHEREOF, the DONEE has hereto subscribed this ____ day of ____________,
202_.

__RUEL O. ACABAL JR. _

DONEE
(Signature over Printed Name)

SIGNED IN THE PRESENCE OF:

Page 2 of 3
 _________N/A_______________ ___________N/A_____________
(Signature over Printed Name) (Signature over Printed Name)

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES)

____________________________) Ss.

BEFORE ME this ________ (date) __________, personally appeared:

NAME Identification Card and No. Date of Issue or Validity

________N/A________ ________N/A____________ ________N/A____________
___________________ _______________________ _______________________

Known to me to be the same persons who executed the foregoing instrument, and they acknowledged to
me that the same is free and voluntary act and deed, including that of the entities that they represent.

This instrument refers to a Deed of Contribution and Acceptance that consists of 2 pages, including this
page whereon this acknowledgement is written, and which is signed by the parties concerned on each and
every page thereof.

WITNESS MY HAND AND SEAL, this ___________ day of ______ 202__ in the
____________________, Philippines.

NOTARY PUBLIC

Doc. No. ______

Page No.______
Book No. _____
Series 2023.

Page 3 of 3