Commission on Elections
October 30, 2023
Barangay and Sangguniang Kabataan Elections
ARC
Authority to Receive Contribution
Date filed:
The undersigned candidate herein grants the authority to the agent,
,
,
(SURNAME)
(FIRST NAME)
(MIDDLE NAME)
(EXT. )
To receive contributions and issue receipts for the same on behalf of the candidate and shall be responsible for the actions of the
said agent.
SIGNATURE OVER PRINTED NAME OF CANDIDATE]
Date signed:
CANDIDATE INFORMATION: Accomplish this part only if you are a candidate.
NAME OF
CANDIDATE:
(SURNAME)
Elective
Position
(FIRST NAME)
(MIDDLE NAME)
(EXT)
Barangay
Contact information:
(Mobile no. and e-mail address)
AGENT INFORMATION: (Person authorized to receive contributions, whose name appears in main body)
Home/Office
Address:
Mobile No.:
E-mail Address:
ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES
)
City/Municipality of __________________)
BEFORE ME, on ___(date)
evidence of their identity:
Name
and in
(city/municipality)
, personally appeared the following persons with competent
I.D. Type
Expiry Date
Issuing Authority
aid persons acknowledged under oath to me under penalty of law, that the whole contents of this document are true and the same
are their free and voluntary acts and deeds.
AUTHORIZED PERSON TO ADMINISTER OATH