FORM B
HOUSEHOLD
                                                                                         RECORD OF BARANGAY INHABITANTS (RBI)
     A.    REGION                        : VII                                                        A. 1 PSGC: ___________________
     B.    PROVINCE                      : BILIRAN                                                    B. 1 PSGC: ___________________
     C.    MUNICIPALITY                  : CULABA                                                     C. 1 PSGC: ___________________
     D.    BARANGAY                      : POBLACION                                                  D. 1 PSGC:___________________
     E.    HOUSEHOLD No                  :
                                         NAME                                                               ADDRESS
                                          (1)                                                                 (2)                        PLACE       DATE     SEX    CIVIL                 OCCUPATION   RELATIONSHIP
                                                                                                                         NAME OF        OF BIRTH   OF BIRTH   (5)   STATUS   CITIZENSHIP      (8)            TO
          LAST                  FIRST                  MIDDLE            QUALIFIER     NUMBER       STREET NAME      SUBD/ZONE/SITIO/      (3)        (4)             (6)         (7)                    HOUSEHOLD
           (1.1)                 (1.2)                  (1.3)              (1.4)        (1.5)           (1.6)             PUROK                                                                           HEAD (9)
                                                                                                                           (1.7)
Legend:
Philippine Standard Geographic Code shall be made available by the DILG City/Municipal Offices
Household is a social unit consisting of a person living alone or a group of person who
     1) sleep in the same housing unit and 2) have a common arrangement in the preparation and consumption of food
Qualifier is the additional and/or inclusion of the word “JR.”, “SR.”, “II”, etc as the case maybe after the person’s surname(s)
Prepared by:                                                                     Certified Correct:                                                             Validated by:
                    ARVIN CONSTANTINE TAGNIPES                                                                  NANCY P. ARPON                                                  NANCY P. ARPON
                          Barangay Secretary                                                                     Punong Barangay                                                 Punong Barangay