WATCHERS REPORT No.

1
May 09, 2016 National and Local Elections
INSTRUCTIONS:
1. Fill-up every blank.
2. Use the back portion of this Report for your notes on any untoward incident inside
the polling place.
3. Submit this Report to the Polling Place Coordinator.
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Clustered Precinct Nos.: _______________
Barangay
: _______________

Voting Center : _________________

City
: _________________

Names of Members of the Board of Election Inspectors:

Chairman : ________________________
Poll Clerk : ______________________
3rd Member: ________________________
Technician : _______________________
Names of Watchers Present:
1. ___________________________
2. ___________________________
3. ___________________________
4. ___________________________

:
:
:
:

Political Party
_______________________
_______________________
_______________________
_______________________

Total Number of Voters in the Clustered Precincts : _________________

Total No. of Official Ballots Received : _________________
Serial No. of Seal Used in the VCM Box : _________________
Serial No. of Seal Used to Seal the SD Card Slot A : _________________
Serial No. of Seal Used to Seal the SD Card Slot B: _________________
Serial No. of Seal with Steel Wire for the Ballot Box : _________________
Total Number of Challenged Voters : _________________
Total Number of Rejected Ballots : _________________
Time Voting Ended : __________________
Submitted by: ____________________________
Name of Watcher [Sign over printed name]
Address:
CellPhone #:

Received by: _________________________

Date:_______________ Time:__________

_____________________________
_____________________________
_____________________________