Republic of the Philippines,

COMMISSION ON ELECTIONS
Manila

1.
2.
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3. Idnight of November 30, 2009, no

4.
5.

I herijby announce mv candidacy for the position of SENATOR, Republic of the Philippi'nes, in the May 10; 2010 elections;
al'ld aft~r having been sworn to ih accordance with law, hereby state the following~
.-
1. MY NAME IS : 3. MY GENDER IS : 4. MY AGE IS :

1.1 Last Name

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'MA,R,C,O,S,
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G Male DFemale 52
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5. MY DATE OF BIRTH IS:
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1.2 First Name 'F, ER, D, I, N,AN, D" ,J,R:
, i_. _ '0,9'-' 1,3 '-'1,95,1'
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1.3 Middle Name 'R.O,M,U ,A, L.D,E ,Z, Month· Day Year
- _." - - - - - - - - - . - - - -" - - 6. MY PLACE OF BIRTH IS :
2. I AI" GENERALLY OR POPULARLY KNOWN BY THE NICKNAME OR STAGENAME
(Indicate only one nickname or staqenarne)
City/Mun Manila
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:B:O:-N~G:B~O-:N:G~-:-;- ~ -:-;: -.:-:.. -: -:- ~ -: r -,-,-'J -'-, Province

~------~'------------~----~------~--------------------~'----------------------=-m---------~------------_48.MYCIVILSTATUSIS:
7. I AM OFFICIALLY NOMINATED BY: (Attach Certificate of Nomination)
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Single Wldow/er
. . _ _ _ ~~~i~n~li~ta _P~~y_ _ _ _ _ .. _ _ __
Married 0 Legally Separated

9. MY RESIDENCE!
ADDRESS IS:
9.1 Province
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,N,OH, T, E.
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.D Annulled I Divorced

9.2 Oty/fvlunidpality Full Name of SlIouse, if married

9.3 Barangay
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'.- - - - - - - - - - \._----- 10. MY PROFESSION OR

9.'\ House No./ Street! Subdivision OCCUPATION IS :
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Representative, 2nd District,

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11. MY POST OFFICE ADDRESS FOR ELECTION PURPOSES IS : (Could be the same as No.9) 12. I AM A REGISTERED VOTER OF
2/f Ejercit~ Building, 303 Tomas Morato Avenue cor.Timog Ave. Circle Precinct .18 _
Bgy Lacub
13. MY PERIOD OF RESIDENCE IN THE PHILIPPINES BEFORE MAY 10, 2010 IS: - - - - - -
City/Mun Batac
since birth since birth - llocos -Norte
No. of Months
.- ~-
No. of Years
Province
-
1.4. I AM A NATURAL BORN FILIPINO CITIZEN. b THOMBi1RtNT '
15. I AM NOT A PERMANENT RESIDENT OF, OR IMMIGRANT TO, A FOREIGN ~ . ,~

COUNTRY.
16. I AM ELIGIBLE FOR THE OFFICE I SEEK TO BE ELECTED TO.
17. I WILL SUPPORT AND DEFEND THE CONSTITUTION OF THE REPUBLIC OF THE
PHILIPPINES AND WILL MAINTAIN TRUE FAITH AND ALLEGIANCE THERETO. I
WILL OBEY THE LAWS, LEGAL ORDERS AND DECREES PROMULGATED BY THE
D.ULY CONSTITUTED AUTHORITIES. I IMPOSE THIS OBLIGATION UPON MYSELF
VOLUNTARILY, WITHOUT MENTAL RESERVATION OR PURPOSE OF EVASION.

Thumbprint

Signature of ~ndidate Over Printed Name

) OATH
SUBSCRIBED AND SWORN to before me this Jst" day' ofD.ec...~_~2009, at Manila Citi; affiant exhibiting to me bJs/~r
CTCfldentificationCard No.PP No. DP000026~ssued by: DFA - Manila On: 20 July T07 valid until 19 J1Yl/f010
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