Republic of the Philippines
COMMISSION ON ELECTIONS
MAY 12, 2025
NATIONAL, LOCAL AND BARMM ELECTIONS
APPOINTMENT OF DEPED SUPERVISOR OFFICIAL
LOPEZ JAENA, DISTRICT 1, MISAMIS OCCIDENTAL, X
(City/Municipality, District, Province, Region
____________________
(Date)
Name: _________________________________________________________
Address: ________________________________________________________
SIR/MADAM:
You are hereby appointed DESO TECHNICAL SUPPORT STAFF in Clustered Precinct No/s.______________________, with polling place located
(DESO/DESO SS/ DESO TSS/EB SS)
at _____________________________________________ in Barangay ____________________________________ Municipality of Lopez
Jaena, District 1, Province of Misamis Occidental, Region X.
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 of 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:
MARY JANE E. JUMAWAN
Election Officer as representative of the
Commission on Elections
(Signature Over Printed Name)
……………………………………………………………………………………………………………………………………………………………………………………………………………………………
…………………………
C.E. Form No. A5-A
Lopez Jaena, District 1, Misamis Occidental, Region X
OATH OF DEPED SUPERVISOR OFFICIAL, DESO SUPPORT STAFF, DESO TECHNICAL SUPPORT STAFF AND EB SUPPORT STAFF
I, __________________________________________, solemnly swear that I will faithfully perform the duties of
___________________________________________, in Precinct No/s. _________________________________________
(DESO/DESO SS/ DESO TSS/EB SS)
In Barangay _______________________ of the above-stated municipality 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 marital reservation or purpose of evasion. SO HELP
ME GOD!
___________________________________________
(Signature Over Printed Name)
____________________________________________
(Date)
SUBSCRIBE AND SWORN to before me this ______________ day of__________________ 2025.
___________________________________________________
(Signature Over Printed Name)
Administering Officer
Electoral Board
Registered Voter of the Precinct
PREPARE IN THREE (3) COPIES: The Original and Second copies shall be retained by the Municipal Election Officer, one (1) copy shall be for his/her file and other shall be attached
to the payroll for payment of honorarium of the Poll workers and the Third copy shall be issued to the poll workers concerned.
