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FORM
October 30, 2023 Barangay and
Sangguniang Kabataan Elections 1
Statement of Contributions and Expenditures
PART I: PERSONAL INFORMATION OF THE CANDIDATE
1 BERIN MARK ANTHONY ORENDAY
NAME OF CANDIDATE: (SURNAME) (FIRST NAME) (MIDDLE NAME)
GENDER: MALE
(EXTENSION)
2 ELECTIVE POSITION: SK KAGAWAD
3 CONSTITUENCY OF THE ELECTIVE POSITION:
KILIB 4-A
LUCBAN QUEZON
(BARANGAY) (CITY/MUNICIPALITY) (PROVINCE (REGION)
SUB-TOTAL (Item I to K) 0
TOTAL EXPENDITURES INCURRED 0
THIS SECTION IS FOR COMELEC USE ONLY - DO NOT ENCODE / WRITING ANYTHING BEYOND THIS LINE
Indicate "✓" beside form code/document name if submitted, "✗" if
☐ FORM 1 ☐ Contribution Receipts
☐ FORM 2 ☐ Expenditure Receipts
☐ FORM 3 ☐ Obligations Payable
☐ Others: pls. specify: NO. OF PAGES: _________
(This space is for the receiving date/time stamp of the receiving office)