Form SCE-C
COMMISSION ON ELECTIONS
Statement of Contribtion! " E#$en%itre! &Can%i%ate'
DATE OF ELECTION May 09, 2016
(A)T (A)T A* (E)SONAL (E)SON AL INFO)MATION OF T+E CANDIDA CAND IDATE TE A.1.
CANDIDATES NAME* (SURNAME)
A.2.
CANDIDATE T/(E* (Use "X" in appropriate box)
A.3.
NAME of (OLITICAL (A)T/*
(FIRST NAME)
(MIDDLE NAME)
INDE(ENDENT CANDIDATE (Indiate "!A" for Part A.#.) CANDIDATE IT+ S.((O)T OF A (OLITICAL (A)T/ (COMPLETE NAME OF THE PARTY)
A.4. A.5.
(ACRONYM)
ELECTIE (OSITION*
(Skip Part A.5. if national position)
CONSTIT.ENC/ OF T+E ELECTIE (OSITION*
(CITY/MUNICIPALITY)
(DISTRICT) Indiate "$%!&" if onl'
A.6.
CONTACT DETAILS*
A.7.
(E)MANENT ADD)ESS*
(PROVINCE/REGION)
MOILE(+ONE NOS3* E-MAIL ADD)ESS*
(ARANGAY)
A.!.
(HOUSE NO./UNIT)
(NAME OF UILDING/SUDIVISION)
(STREET NAME)
(DISTRICT/AREA)
(CITY/MUNICIPALITY)
(PROVINCE)
Taxpayer Taxpayer Identification No. (TIN)
(efers to t*e personal t*e personal +I! of t*e andidate)
(A)T * CONT)I.TIONS )ECEIED ) ECEIED &Itemi4e% entrie! in Form SC), in%i5ate 0300 if none re5ei7e%' .1.
CAS+ CONT)I.TIONS RECEIVED CONT)I.TIONS RECEIVED FROM OT+E) SO.)CES SO.)CES
₱".""
.2.
IN-IND CONT)I.TIONS RECEIVED FROM OT+E) FROM OT+E) SO.)CES SO.)CES
₱".""
.3.
CAS+ CONT)I.TIONS RECEIVED FROM (OLITICAL (A)T/ (A)T/ (0 ,-&'*'-$ *# -*$ &)
₱".""
.4.
IN-IND CONT)I.TIONS RECEIVED FROM (OLITICAL (A)T/ (A)T/ (0 ,-&'*'-$ *# -*$ &)
₱".""
TOTAL TOTAL CONT)I.TIONS )ECEIED
₱".""
(A)T C* E8(ENDIT.)ES INC.))ED &Itemi4e% entrie! in Form SOE' C.1.
E8(ENDIT.)ES PAID E8(ENDIT.)ES PAID OUT OF (E)SONAL F.NDS )ESO.)CES*
C.2.
E8(ENDIT.)ES PAID OUT OF CAS+ OF CAS+ CONT)I.TIONS*
C.3.
E8(ENDIT.)ES INCURRED E8(ENDIT.)ES INCURRED USING IN-IND CONT)I.TIONS* CONT)I.TIONS*
TOTAL TOTAL E8(ENDIT.)ES INC. ))ED
₱".""
(A)T D* CE)TIFICATION " ACNOLED:MENT T#$ %&'$*+&$' ,-&'*'-$ -0$ $*&+ '% & #$$ '$$ -&' -$ #- (1) T#* S-$:$& -&' * --,#$' S,#$'%$ #*,# -$ %$' $,$* 9%,#$ -&' #$ ',%:$& $0$,*&+ #$ 0% %$ -,,%-$ -&' ,:$$ ,&*%*& $,$*9$' -&' $8$&'*%$ *&,%$' #$ %&'$*+&$' ,-&'*'-$ -&' #*/#$ '% -%#*$' $$$&-*9$B (2) T#$ $8$&'*%$ *&,%$' -$ 0 -0% %$ -&' #$ ,&*%*& $$ & $,$*9$' 0: $& $&**$ #**$' - +*9$ ,&*%*&. IN ;IT NESS ;HEREOF ;HEREOF #$ %&'$*+&$' #$$%& -00*8 #*/#$ *+&-%$ & [date signed].
AFFI SIGNATURE SIGNATURE HERE E511 SUSCRIED AND AND S;ORN TO $0$ :$ &
date notarized *%$'
(ID N%:$)
(T$ 0 *'$&*0*,-*& ',%:$&)
D,. N. P-+$ N. ? N. S$*$ 0
-00*-& $8#***&+ #*/#$ $8**&+ & <'-$ 0 $8*=.
(G9$&:$& A+$&, *%*&+ #$ ID)
(P-,$ N-*- S$- > S*+&-%$ #$$)
T+IS SECTION IS FO) COMELEC .SE ONL/ ONL/ - DO NOT ENCODE )ITIN: AN/T+IN: E/OND T+IS LINE
Indicate Indicate "✓" beside beside form form code/doc code/documen umentt name name if submi submitted tted,, "✗ " if not. not. @ SCR (Sched of Contributions Rcd
☐ Contribution Receipts
@ SOE (Sched of Expenditures
☐ Expenditure Receipts
@ SUO (Sched of Unpaid Obi!ations
☐ Obi!ations #a$abe
@ S%E (Sum. Report of %a&fu Exp. @ Others' ps. specif$'
NO. OF PAGES: _________ (T#* -,$ * 0 #$ $,$*9*&+ '-$/*:$ -: 0 #$ $,$*9*&+ 00*,$)
Form SC)-C
COMMISSION ON ELECTIONS DATE OF ELECTIONS
"
NAME OF CANDIDATE*
DATE )ECEIED
)ECEI(T N.ME)
S5;e%
May 09, 2016 "
"
(SURNAME)
(FIRST NAME)
MIDDLE NAME
F.LL NAME OF CONT)I.TO)
ADD)ESS OF CONT)I.TO)
Contribtion T/(E " SO.)CE
"
CANDIDATES TIN* DESC)I(TION &for in-=in% 5ontribtion!'
AMO.NTAL.E OF CONT)I.TION
Contribtor! TIN
TOTAL CONT)I.TIONS )ECEIED CE)TIFICATION
₱".""
ACNOLED:MENT SUSCRIED AND S;ORN TO EFORE ME #*
I #$$ ,$*0 #- (1) #$ ,&*%*& *$' -9$ $$ :-'$ :$ - - ,-&'*'-$B (2) - $&*$ $,*0*$' -9$ -$ %$ > ,$,B (3) #$ -$ %$' #$ 00*,*- $,$* *%$' :$ %& -,,$-&,$B (4) #$ ,&*%*& -$ 0: %,$ & #**$' #$ O:&*% E$,*& C'$ -&' #$ $*&$& -.
-00*-& $8#***&+ #*/#$
<'-$ 0 -#=
"
*%$' #$
"
<'-$ 0 $8*=.
$8**&+ &
<*%*&+ 00*,$=
D,. N. B P-+$ N. B ? N. B DATE SI:NED
S$*$ 0 .
NOTA)/ (.LIC
Form SOE-C S5;e%
COMMISSION ON ELECTIONS DATE OF ELECTIONS
May 09, 2016
NAME OF CANDIDATE
DATE INC.))ED
)ECEI(T N.ME)
"
"
"
(SURNAME)
(FIRST NAME)
(MIDDLE NAME)
F.LL NAME OF .SINESS FI)M O) CONT)ACTO)
ADD)ESS OF .SINESS FI)M O) CONT)ACTO)
TIN OF CONT)ACTO) or .SINESS FI)M
CANDIDATES TIN*
" E#$ Ty$e &A-'
DESC)I(TION OF :OODS O) SE)ICES
AMO.NTAL.E OF E8(ENDIT.)E
TOTAL E8(ENDIT.)ES INC.))ED CE)TIFICATION
₱".""
ACNOLED:MENT SUSCRIED AND S;ORN TO EFORE ME #*
I #$$ ,$*0 #- (1) #$ $8$&$ *$' -9$ $$ *&,%$' :$ - - ,-&'*'-$ : '% -%#*$' $$$&-*9$/B (2) - $&*$ $,*0*$' -9$ -$ %$ > ,$,B (3) #$ -$ %$' #$ 00*,*- $,$* *&9*,$ #$ *:* - ',%:$&B (4) #$ $8$&$ ,: *# S$,*& 1"2 0 #$ O:&*% E$,*& C'$.
-00*-& $8#***&+ #*/#$ *%$' #$
<'-$ 0 -#=
" <*%*&+ 00*,$=
" $8**&+ &
D,. N. B P-+$ N. B ? N. B S$*$ 0 . DATE SI:NED
NOTA)/ (.LIC
<'-$ 0 $8*=.
Form SOE-C S5;e%
COMMISSION ON ELECTIONS DATE OF ELECTIONS
May 09, 2016
NAME OF CANDIDATE
DATE INC.))ED
"
)ECEI(T N.ME)
"
CANDIDATES TIN*
"
(SURNAME)
(FIRST NAME)
(MIDDLE NAME)
F.LL NAME OF .SINESS FI)M O) CONT)ACTO)
ADD)ESS OF .SINESS FI)M O) CONT)ACTO)
TIN OF CONT)ACTO) or .SINESS FI)M
" E#$ Ty$e &A-'
DESC)I(TION OF :OODS O) SE)ICES
AMO.NTAL.E OF E8(ENDIT.)E
TOTAL E8(ENDIT.)ES INC.))ED CE)TIFICATION
₱".""
ACNOLED:MENT SUSCRIED AND S;ORN TO EFORE ME #* -00*-& $8#***&+ #*/#$
I #$$ ,$*0 #- (1) #$ $8$&$ *$' -9$ $$ *&,%$' :$ - - ,-&'*'-$ : '% -%#*$' $$$&-*9$/B (2) - $&*$ $,*0*$' -9$ -$ %$ > ,$,B (3) #$ -$ %$' #$ 00*,*- $,$* *&9*,$ #$ *:* - ',%:$&B (4) #$ $8$&$ ,: *# S$,*& 1"2 0 #$ O:&*% E$,*& C'$.
*%$' #$
<'-$ 0 -#=
" <*%*&+ 00*,$=
" $8**&+ &
<'-$ 0 $8*=.
D,. N. B P-+$ N. B ? N. B S$*$ 0 . DATE SI:NED
NOTA)/ (.LIC
Form SLE-C
COMMISSION ON ELECTIONS DATE OF ELECTION
Smmary )e$ort of La>f< E#$en%itre! &Can%i%ate'
May 09, 2016
(A)T A* (E)SONAL INFO)MATION OF T+E CANDIDATE A.1.
CANDIDATES NAME*
"
"
(SURNAME)
A.2.
"
(FIRST NAME)
(MIDDLE NAME)
INDE(ENDENT CANDIDATE (Indiate "!A" for Part A.#.)
CANDIDATE T/(E* (Use "X" in appropriate box) A.3.
CANDIDATE IT+ S.((O)T OF A (OLITICAL (A)T/
NAME of (OLITICAL (A)T/*
" (COMPLETE NAME OF THE PARTY)
A.4. A.5.
ELECTIE (OSITION* CONSTIT.ENC/ OF T+E ELECTIE (OSITION*
"
" (DISTRICT) Indiate "$%!&" if onl'
A.6
(ACRONYM)
(Skip Part A.5. if national position)
"
"
(CITY/MUNICIPALITY)
Taxpayer Identification No. (TIN)
(PROVINCE/REGION)
" (efers to t*e personal +I! of t*e andidate)
(A)T * S.TOTAL OF LAF.L E8(ENDIT.)ES (E) E8(ENSE T/(ECATE:O)/ A
)rae expenses of candidate * campai!n personne durin! the campai!n * incidenta persona expenses
₱".""
Compensation of campai!ners, cer+s, steno!raphers, messen!ers, * other persons empo$ed in the campai!n
₱".""
C
)eephone, mobie phone usa!e fees, prepaid phone oad, internet access, posta!es, frei!ht * courier char!es
₱".""
D
S-*&$ *&*&+ > '**%*& 0 *&$' :-$*- $-*9$ ,-&'*'-,B
₱".""
E
E::$& 0 -,#$ - #$
₱".""
F
R$& :-*&$&-&,$ > 0%&*#*&+ 0 ,-:-*+& #$-'%-$ 00*,$ -,$ 0 :$$*&+
₱".""
:
P**,- :$$*&+ > -*$ > #$ %$ 0 %&' $: *+# > '$,-*& '%*&+ -*' :$$*&+ > -*$
₱".""
+
e&spaper, radio, )- * other adertisements to promote the candidac$, incudin! &ebsite/internet ad pacements
₱".""
S.TOTAL
(A)T C* E8(ENDIT.)ES INC.))ED &Itemi4e% entrie! in Form SOE'
₱".""
Form SLE-C
COMMISSION ON ELECTIONS DATE OF ELECTION
Smmary )e$ort of La>f< E#$en%itre! &Can%i%ate'
May 09, 2016
(A)T A* (E)SONAL INFO)MATION OF T+E CANDIDATE A.1.
CANDIDATES NAME*
"
"
(SURNAME)
"
(FIRST NAME)
A.2.
(MIDDLE NAME)
INDE(ENDENT CANDIDATE (Indiate "!A" for Part A.#.)
CANDIDATE T/(E* CANDIDATE IT+ S.((O)T OF A (OLITICAL (A)T/
(Use "X" in appropriate box) A.3.
NAME of (OLITICAL (A)T/*
" (COMPLETE NAME OF THE PARTY)
A.4. A.5.
ELECTIE (OSITION* CONSTIT.ENC/ OF T+E ELECTIE (OSITION*
"
"
(Skip Part A.5. if national position)
"
(DISTRICT) Indiate "$%!&" if onl'
A.6
(ACRONYM)
"
(CITY/MUNICIPALITY)
Taxpayer Identification No. (TIN)
(PROVINCE/REGION)
" (efers to t*e personal +I! of t*e andidate)
(A)T * S.TOTAL OF LAF.L E8(ENDIT.)ES (E) E8(ENSE T/(ECATE:O)/ A
)rae expenses of candidate * campai!n personne durin! the campai!n * incidenta persona expenses
₱".""
Compensation of campai!ners, cer+s, steno!raphers, messen!ers, * other persons empo$ed in the campai!n
₱".""
C
)eephone, mobie phone usa!e fees, prepaid phone oad, internet access, posta!es, frei!ht * courier char!es
₱".""
D
S-*&$ *&*&+ > '**%*& 0 *&$' :-$*- $-*9$ ,-&'*'-,B
₱".""
E
E::$& 0 -,#$ - #$
₱".""
F
R$& :-*&$&-&,$ > 0%&*#*&+ 0 ,-:-*+& #$-'%-$ 00*,$ -,$ 0 :$$*&+
₱".""
:
P**,- :$$*&+ > -*$ > #$ %$ 0 %&' $: *+# > '$,-*& '%*&+ -*' :$$*&+ > -*$
₱".""
+
e&spaper, radio, )- * other adertisements to promote the candidac$, incudin! &ebsite/internet ad pacements
₱".""
S.TOTAL
₱".""
(A)T C* E8(ENDIT.)ES INC.))ED &Itemi4e% entrie! in Form SOE' I
E::$& 0 ,%&$
₱".""
?
Cop$in! * cassif$in! ists of oters, inesti!atin! * chaen!in! the ri!ht to ote of persons re!istered in the ists
₱".""
#rintin! of sampe baots in such coor, sie * maximum number as ma$ be authoried b$ the Commission
₱".""
TOTAL E8(ENDIT.)ES INC.))ED
₱".""
(A)T D* CE)TIFICATION " ACNOLED:MENT T#$ %&'$*+&$' ,-&'*'-$ -0$ $*&+ '% & #$$ '$$ -&' -$ #- (1) T#* S-$:$& -&' * --,#$' S,#$'%$ #*,# -$ %$' $,$* 9%,#$ -&' #$ ',%:$& $0$,*&+ #$ 0% %$ -,,%-$ -&' ,:$$ ,&*%*& $,$*9$' -&' $8$&'*%$ *&,%$' #$ %&'$*+&$' ,-&'*'-$ -&' #*/#$ '% -%#*$' $$$&-*9$B (2) T#$ $8$&'*%$ *&,%$' -$ 0 -0% %$ -&' #$ ,&*%*& $$ & $,$*9$' 0: $& $&**$ #**$' - +*9$ ,&*%*&. IN ;ITNESS ;HEREOF #$ %&'$*+&$' #$$%& -00*8 #*/#$ *+&-%$ & [date signed].
AFFI SIGNATURE HERE
E511 SUSCRIED AND S;ORN TO $0$ :$ &
date notarized *%$'
(T$ 0 *'$&*0*,-*& ',%:$&)
D,. N. P-+$ N. ? N. S$*$ 0
(ID N%:$)
-00*-& $8#***&+ #*/#$ $8**&+ & <'-$ 0 $8*=.
(G9$&:$& A+$&, *%*&+ #$ ID)
(P-,$ N-*- S$- > S*+&-%$ #$$)
T+IS SECTION IS FO) COMELEC .SE ONL/ - DO NOT ENCODE )ITIN: AN/T+IN: E/OND T+IS LINE
(T#* -,$ * 0 #$ $,$*9*&+ '-$/*:$ -: 0 #$ $,$*9*&+ 00*,$)
Form S.O-C S5;e%
COMMISSION ON ELECTIONS DATE OF ELECTIONS
May 09, 2016 "
NAME OF CANDIDATE DATE INC.))ED
Contra5t Loan No3
"
"
(SURNAME)
(FIRST NAME)
(MIDDLE NAME)
NAME OF C)EDITO)
ADD)ESS OF C)EDITO)
Ta#$ayer ID No3 &TIN' of C)EDITO)
"
CANDIDATES TIN* De!5ri$tion of t;e Ob
(r$o!e &for in5rrin@ ob
AMO.NTAL.E OF OLI:ATION
TOTAL .N(AID OLI:ATIONS CE)TIFICATION
₱".""
ACNOLED:MENT SUSCRIED AND S;ORN TO EFORE ME #*
I #$$ ,$*0 #- (1) #$ *+-*& *$' -9$ $$ *&,%$' :$ - - ,-&'*'-$ *# : -%#* : '% -%#*$' $$$&-*9$B (2) - $&*$ $,*0*$' -9$ -$ %$ > ,$,B (3) #$ -$ %$' ,&-, :* &$ > #$ *:*- ',%:$&.
-00*-& $8#***&+ #*/#$ *%$' #$
<'-$ 0 -#=
" <*%*&+ 00*,$=
" $8**&+ &
D,. N. B P-+$ N. B ? N. B DATE SI:NED
S$*$ 0 .
Contribution Type & Sourc Nature of Exp. Cash from others A Cash from party B In-kind from others C In-kind from party D E F G H I J K
NOTA)/ (.LIC
<'-$ 0 $8*=.
Contribution Type & Sourc Nature of Exp. Cash from others A Cash from party B In-kind from others C In-kind from party D E F G H I J K
