Republic of the Philippines

Province of La Union
Municipality of Bauang

CITY/MUNICIPAL AGRICULTURAL AND FISHERY COUNCIL

CERTIFICATE OF CANDIDACY

Instructions: (Read well before filling up this form.)

1. File this in TWO (2) LEGIBLE copies with the Electoral Board before the conduct of Election
2. No filing fee shall be imposed
I hereby announce my candidacy for the position of _______________________________________________ in the
______________ (date) _____________________ (state the level e.g. RAFC/PAFC/CAFC/MAFC) AFC Election,
and after having been sworn to in accordance with law, I hereby state the following:
Last First Middle
1. NAME

2. Nickname 3. Age 4. Gender 5. Civil Status

6. Birthday 7. Birthplace 8. Contact Number

9. Religion 10. Home Address

11. Organizational Involvements

12. Awards and Recognition

13. Position sought for

14. That I am a Filipino citizen;

15. That I am an official representative of a bonafide agriculture and/or fisheries-related
organization/an individual who meets the requirements in accordance with item VIII;
16. That I am familiar with the local agriculture and fisheries situation in my locality;
17. That I am presently engaged in agricultural and/or fishery related activities;
18. That I am active for at least one (1) year in the AFC
19. That I am mentally and physically fit;
20. That I possess strong leadership qualities; and
21. That I am committed to serve voluntarily and fully support all activities of the Council; and

I hereby submit this Certificate of Candidacy and certify that the facts and contents herein are true
and correct according to my personal knowledge.

________________________________________
Signature of the Candidate over Printed Name

______________________________________
Date of Filing