University of Eastern Pangasinan
COMMISSION ON STUDENT ELECTIONS
SSC/COMELEC Office, Main Building,
Binalonan, Pangasinan
ELECTION RETURN FORM FOR BLOCK STUDENT COUNCIL ELECTION
Block/Year: College:
Total Valid Votes: Total Voters:
I. LIST OF ELECTED OFFICERS
Position Name of Student Candidates Total Votes
Mayor
Vice Mayor
Secretary
Assistant Secretary
Treasurer
Auditor
Press Relations Officer
Business Manager
II. CERTIFICATION
This is to certify that the Election Return Form for the 2025 Block Student Council Election, conducted on August __, 2025
via __________________________ has been duly prepared, verified, and signed by the authorized Election Officers.
The said ER Form contains the official count of votes cast for each candidate, as tallied and validated in accordance with
the election rules and regulations set forth by the UEP COMELEC.
Certified Correct by:
_____________________________
Name of Mayor-Elect
Mayor-Elect
College of
Conforme:
____________________________
Name of Faculty Adviser
Faculty Adviser
College of
____________________________
Name of Program Head
Program Head for
College of
____________________________
Name of Dean
College Dean
College of
NOTICE: All authorized recipients of any personal data, personal information, privileged information and sensitive personal information contained in this document, including pertinent
documents attached thereto that are shared by the Commission on Student Elections in compliance with the existing laws and rules, and in conformity with the Data Privacy Act of 2012
and its implementing rules and regulations, as well as the pertinent Circulars of the National Privacy Commission, are similarly bound to comply with the said laws, rules and regulations,
relating to data privacy, security, confidentiality, protection, and accountability.