8/14/2019 Teofisto Guingona III

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Republic of the PhlllppiuesCOMMISSION ONELECTIONSIHauila

--~~~,~~~.--~~~~~~~~~~~-------------------------------------------INSTI1UCTIQNS: (Read well before filling up this forrn.)1. . File thls 11 1 FIVE (5) LEGJljLE copies.2. File this cernncate or candlclacy wll.ll tile Law uepertment, CO~1ELEC f"lain Offlce.: jntramuros, Hailila, starting November' 20, :Z009L1p to

mlrjnlght or November 3D, 2009.3. Attacl1 to tllis ce rtmcet e the Certlflcate op.Pmty f'!ominatlull unless you ale an independent canotuate. Arter nlldllight of November 30, lU 09 , not',;,rlificate of nomination shall be accepted. . .'I. Titlt:s such as 'Dr., AUy., Don, Glnoo, Se nor, Datu, tladJI, Sultan, Btll, senora, Kapitan or stmnarttttes are expressly prullibitecl.

S. This certlrlcate sltall be sworn before a notary public or any official authortzed to aclmlnlster ceth. COI'lELEC officials are not authorized toadminister oath.---.---.~~ ......:..;.,;;.;,;,.---..,..----,.--,-,-~

[ I t"ial~ DFemale. . , , ; 1 . 0 . .5. f'1Y DATE Or- BiRTI-I IS :

Lt. NY POST OFfICE ADDHESS ron ELECTION PURPOSESJ!; : (couro be tile s~Jne as No.9).. ... ~ .\J .R.QK..1-, .. I { J \ . J ; . , . v V l : > J L G . hJ:i-' r.1 !:\~l\X}?h 1AY C . J ; l '. Y J J?Qlq: lJJ:J9l'J _.13. IVI'PERIOD OF RESIDENCE 11 '1 TIlE PI-HURPINES BEFORE FlAY 10 2010 IS:

I r - - - " ; "- ~ - - : - : -- .- - - j- -- - ~ .': i ! No. or t'lontl15 ! 56 ! No. of 'rearst .. _.:... ! . L __ . . ' 1 --~J,.4. I Af"l A NATURAL BORN FIUPTIIJO CITIZEN.15. [Afv1 NOT ;'\ PERfVlANENT HESJDENT OF, OR IfY1HIGRANT TO, A FOREIGN

COUNTRY.:l6.1 AfvlEUGl BLE FOR Tt-lE OFFICE I SEEI, TO BE ELECTED TO.-17. I WILL SUPPORT AND DEFEI'JD THE COI'JSTITUTION Or- THE REPUBLIC OF THEPI-llLIPPINES AND WILL HAINTAIN TRljE FAITH AND ALLEGIANCE THERETO. IWILL 08E'( :THE LAWS, LEGAL ORDEI