Downloaded from: http://www.comelec.gov.
ph
CEF-1A
Republic of the Philippines
COMMISSION ON ELECTIONS
APPLICATION FOR REGISTRATION
(Voters Registration Record upon approval by the ERB)
Application No. Precinct No.
Instructions : (1) Accomplish separately in three copies; (2) print legibly; (3) check the appropriate box.
Part 1 PERSONAL INFORMATION (To be filled out by Applicant)
Name Illiterate Person with Disability
Last M A L A B A N A N Assisted by:
(Please fill-up Assistor's Oath)
First E M M A N U E L
Middle C A S A B A L Gender
Male Female
RESIDENCE/ADDRESS Province B A T A N G A S 62Kgs Height 158cm Weight
City/Municipality Barangay DATE OF BIRTH
T A N A U A N A M B U L O N G 0 1 - 2 5 - 1 9 7 8
House No. / Street Month Day Year
1 3 4 7 S I T I O L U D L O D PLACE OF BIRTH
CITIZENSHIP FILIPINO By Birth Naturalized Reacquired City/Mun TANAUAN
(If naturalized/reacquired, state date of naturalization/reacquisition and Certificate number of naturalization/order of approval of reacquisition) Province BATANGAS
Date of Naturalization/ Month Day Year Certificate No./Order of Approval CIVIL STATUS
Reacquisition Single Widow/er
COPY FOR THE ELECTION OFFICER
PERIOD OF RESIDENCE Married Legally
No. of Years No. of Months No. of Years Separated
In the City / Mun 3 0 0 8 in the Philippines 4 0 Name of Spouse, if married
PROFESSION / OCCUPATION none TIN 2 0 7 - 3 8 9 - 8 3 8 Rachelle Beverly S. Malabanan
NAME OF FATHER NAME OF MOTHER
Last M A L A B A N A N Last M A L A B A N A N
First N U M E R I A N O First C L A R I T A
Middle R O B L E S Middle C A S A B A L
Part 2 OATH ROLLED THUMBPRINTS / SPECIMEN SIGNATURES
I do solemnly swear that the above statements regarding my person are
true and correct; that I possess all the qualifications and none of the
disqualification of a voter; that I have no pending application for registration in
any city/municipality; and that I am not registered in any precinct in the
Philippines.
DATE 0 9 - 2 9 - 2 0 1 8 Emmanuel C. Malabanan
Month Day Year Signature of Applicant
Above Printed Name Left Thumb Right Thumb
EO / Administering Officer 1. 2. 3.
(Signature above Printed Name)
Part 3 ACTION BY THE ELECTION REGISTRATION BOARD
Month Day Year
Approved - - With precinct assignment No.
Disapproved Date Reason for disapproval
Member Chairman of the Board Member
(Signature above Printed Name) (Signature above Printed Name) (Signature above Printed Name)
Part 4 VOTER IDENTIFICATION NUMBER (To be filled out by Election Officer)
CITY/MUN/
DISTRICT CODE
Prov Code PRECINCT NO. Month Day Year
DATE OF BIRTH
ACKNOWLEDGEMENT RECEIPT Application No.
This is to acknowledge receipt of your Application for
Application for Registration registration. You are not yet registered unless approved by the
Election Registration Board (ERB). You need not appear in the
Last M A L A B A N A N ERB hearing unless required through a written notice.
First E M M A N U E L
EO/Interviewer Signature above Printed Name
Middle C A S A B A L
Downloaded from: http://www.comelec.gov.ph CEF1-A: COPY FOR THE ELECTION OFFICER (BACK)
VOTING RECORD
Voter's
DATE Ballot No. Chairman's Signature
Thumbmark Signature
Downloaded from: http://www.comelec.gov.ph
CEF-1A
Republic of the Philippines
COMMISSION ON ELECTIONS
APPLICATION FOR REGISTRATION
(Voters Registration Record upon approval by the ERB)
Application No. Precinct No.
Instructions : (1) Accomplish separately in three copies; (2) print legibly; (3) check the appropriate box.
Part 1 PERSONAL INFORMATION (To be filled out by Applicant)
Name Illiterate Person with Disability
Last M A L A B A N A N Assisted by:
(Please fill-up Assistor's Oath)
First E M M A N U E L
Middle C A S A B A L Gender
Male Female
RESIDENCE/ADDRESS Province B A T A N G A S Height Weight
City/Municipality Barangay DATE OF BIRTH
T A N A U A N C I T Y A M B U L O N G 0 1 - 2 5 - 1 9 7 8
House No. / Street Month Day Year
1 3 4 7 S I T I O L U D L O D PLACE OF BIRTH
CITIZENSHIP FILIPINO By Birth Naturalized Reacquired City/Mun TANAUAN
(If naturalized/reacquired, state date of naturalization/reacquisition and Certificate number of naturalization/order of approval of reacquisition) Province BATANGAS
Date of Naturalization/ Month Day Year Certificate No./Order of Approval CIVIL STATUS
Reacquisition Single Widow/er
PERIOD OF RESIDENCE Married Legally
COPY FOR THE PROVINCIAL FILE
No. of Years No. of Months No. of Years Separated
In the City / Mun in the Philippines Name of Spouse, if married
PROFESSION / OCCUPATION TIN - -
NAME OF FATHER NAME OF MOTHER
Last Last
First First
Middle Middle
Part 2 OATH ROLLED THUMBPRINTS / SPECIMEN SIGNATURES
I do solemnly swear that the above statements regarding my person are
true and correct; that I possess all the qualifications and none of the
disqualification of a voter; that I have no pending application for registration in
any city/municipality; and that I am not registered in any precinct in the
Philippines.
DATE - -
Month Day Year Signature of Applicant
Above Printed Name Left Thumb Right Thumb
EO / Administering Officer 1. 2. 3.
(Signature above Printed Name)
Part 3 ACTION BY THE ELECTION REGISTRATION BOARD
Month Day Year
Approved - - With precinct assignment No.
Disapproved Date Reason for disapproval
Member Chairman of the Board Member
(Signature above Printed Name) (Signature above Printed Name) (Signature above Printed Name)
Part 4 VOTER IDENTIFICATION NUMBER (To be filled out by Election Officer)
CITY/MUN/
DISTRICT CODE
Prov Code PRECINCT NO. Month Day Year
DATE OF BIRTH
Downloaded from: http://www.comelec.gov.ph
CEF-1A
Republic of the Philippines
COMMISSION ON ELECTIONS
APPLICATION FOR REGISTRATION
(Voters Registration Record upon approval by the ERB)
Application No. Precinct No.
Instructions : (1) Accomplish separately in three copies; (2) print legibly; (3) check the appropriate box.
Part 1 PERSONAL INFORMATION (To be filled out by Applicant)
Name Illiterate Person with Disability
Last Assisted by:
(Please fill-up Assistor's Oath)
First
Middle Gender
Male Female
RESIDENCE/ADDRESS Province Height Weight
City/Municipality Barangay DATE OF BIRTH
- -
House No. / Street Month Day Year
PLACE OF BIRTH
CITIZENSHIP By Birth Naturalized Reacquired City/Mun
(If naturalized/reacquired, state date of naturalization/reacquisition and Certificate number of naturalization/order of approval of reacquisition) Province
Date of Naturalization/ Month Day Year Certificate No./Order of Approval CIVIL STATUS
Reacquisition Single Widow/er
PERIOD OF RESIDENCE Married Legally
COPY FOR THE CENTRAL FILE
No. of Years No. of Months No. of Years Separated
In the City / Mun in the Philippines Name of Spouse, if married
PROFESSION / OCCUPATION TIN - -
NAME OF FATHER NAME OF MOTHER
Last Last
First First
Middle Middle
Part 2 OATH ROLLED THUMBPRINTS / SPECIMEN SIGNATURES
I do solemnly swear that the above statements regarding my person are
true and correct; that I possess all the qualifications and none of the
disqualification of a voter; that I have no pending application for registration in
any city/municipality; and that I am not registered in any precinct in the
Philippines.
DATE - -
Month Day Year Signature of Applicant
Above Printed Name Left Thumb Right Thumb
EO / Administering Officer 1. 2. 3.
(Signature above Printed Name)
Part 3 ACTION BY THE ELECTION REGISTRATION BOARD
Month Day Year
Approved - - With precinct assignment No.
Disapproved Date Reason for disapproval
Member Chairman of the Board Member
(Signature above Printed Name) (Signature above Printed Name) (Signature above Printed Name)
Part 4 VOTER IDENTIFICATION NUMBER (To be filled out by Election Officer)
CITY/MUN/
DISTRICT CODE
Prov Code PRECINCT NO. Month Day Year
DATE OF BIRTH
