C.E. Form No.
A5
Republic of the Philippines
COMMISSION ON ELECTIONS
MAY 12, 2025
NATIONAL, LOCAL AND BARMM ELECTIONS
APPOINTMENT OF DEPARTMENT OF EDUCATION SUPERVISOR OFFICIALS/DESO SUPPORT STAFF / DESO TECHNICAL
SUPPORT STAFF
Guihulngan City, District I, Negros Oriental, NIR
(City/Municipality, District, Province,Region)
_____________________
(Date & Time)
Name: ______________________________________________________________________
Address: _____________________________________________________________________
(Home no., Street, Barangay, City, Municipality and Province)
SIR/MADAM:
You are hereby appointed _____________________________________________________ _________________________________of the Electoral Board (EB) in
(DEPARTMENT OF EDUCATION SUPERVISOR OFFICIALS/DESO SUPPORT STAFF / DESO TECHNICAL SUPPORT STAFF )
Clustered Precinct No/s. _________________________________________________________________________________________________, with polling place
located at ________________________________________________________________________ in Barangay ________________________________, City/ Municipality
of Guihulngan, District I, Province of Negros Oriental, Region NIR.
You may immediately assume office upon taking your oath as required by law. However, this appointment will be automatically
cancelled and considered null and void if you are related to any candidate or to any member of the Electoral Board of said precinct/s
within the fourth civil degree of consanguinity or affinity. In such case, you shall not assume the duties of the office and shall
immediately return this appointment to the Election Officer. Assumption to office notwithstanding this prohibition is punishable under
the law.
BY AUTHORITY OF THE COMMISSION:
ATTY. EARL M. TABASUARES
Election Officer as representative of the
Commission on Elections
(Signature over Printed Name)
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C.E FORM NO. A5-A
Guihulngan City, District I, Negros Oriental, NIR
(City/Municipality, District, Province, Region)
OATH OF DEPARTMENT OF EDUCATION SUPERVISOR OFFICIALS/DESO SUPPORT STAFF / DESO TECHNICAL SUPPORT STAFF
I, ________________________________________________________________________, solemnly swear that I faithfully perform the duties of
____________________________________________________ __________________ in Precinct No/s. ___________________________________________
(DEPARTMENT OF EDUCATION SUPERVISOR OFFICIALS/DESO SUPPORT STAFF / DESO TECHNICAL SUPPORT STAFF )
__________________________________________________________________, in Barangay __________________________________ of the above-stated
City, district, province and region to the best of my knowledge and ability, without favoring any person, candidate, political
party or group; that I will obey the laws and legal orders promulgated by the duly constituted authorities, and that I
voluntarily impose upon myself this obligation without mental reservation or purpose of evasion. SO HELP ME GOD!
____________________________________________
(SIGNATURE OVER PRINTED NAME)
____________________________________________
(DATE)
SUBSCRIBED AND SWORN to before me this _________ day of _______________________________________ 2025.
ATTY. EARL M. TABASUARES
(Signature over Printed name)
Administering Officer
Electoral Board Chairperson/ Co- Member
Registered Voter of the Precinct
PREPARE IN THREE (3) COPIES: The original and second copies shall be retained by the City/ Municipal Election Officer; one (1) copy shall be for
his/her file and the other shall be attached to the payroll for payment of honorarium of the Electoral Board and the third copy shall be issued to the
Chairperson, Members and Support Staff of the Electoral Board concerned.
