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Commission on Elections
Annex F
Elective office
sought
Home/office
address
Telephone &
Mobile Nos.
FOR PARTIES:
BERNARD
ECHAVEZ
(Surname)
(First Name)
(Middle Name)
Municipality/City/Province
of the elective office
Davao City
City Councilor
2nd floor, Sangguniang Panlungsod Bldg., San Pedro Street,Davao City
Email address
082 2220855 loc 423 Taxpayers Identification No.
913 - 875 - 506
(TIN) of candidate
09209245758
Name of Party
Name of party
treasurer
(Surname)
(First Name)
(Middle Name)
Office address
of the party
Email address
Telephone &
Taxpayers Identification No.
___-___-___
Mobile Nos.
(TIN) of party
CONTRIBUTIONS RECEIVED: (Itemized details in Annex G/Schedule of Contributions)
N/A
Total contributions from party
N/A
Total contributions from other persons
TOTAL CONTRIBUTIONS RECEIVED N/A
EXPENSES INCURRED: (Itemized details in Annex H/Schedule of Expenditures, to be filed with
Annex H-1/Summary Report of Lawful Expenditures):
For Candidates:
CERTIFICATION
I,
BERNARD E. AL-AG, after being duly sworn to, hereby depose and state that:
(1) This Statement and its attached Schedules, which are supported by receipts, vouchers, and other documents
reflecting the full, true, accurate and complete election contributions received and expenditures incurred by
him/her and/or by his/her duly authorized representative;
(2) The expenditures incurred are for lawful purposes and the contributions were not received from persons or
entities prohibited by law to give contributions.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
day of
, 20
BERNARD E. AL-AG
(Name & Signature of person filing this Statement)
SUBSCRIBED AND SWORN TO before me this
day of
, 20
, affiant
exhibiting his/her Cedula with number 01775900, issued by City Government of Davao with expiry date
.
Doc. No.
Page No.
;
;
NOTARY PUBLIC
Book No.
;
Series of 2014.