Scribd
Upload
602 views1 page

RBI Form B

This document contains an individual record form for a barangay inhabitant. The form collects personal information such as name, date of birth, place of birth, sex, civil status, citizenship, profession, and residence address. It is certified by the person providing the information and attested by the barangay secretary, who will also fill in the household number. The form is used to document information for residents of Barangay Burol-1 in the city of Dasmarinas, province of Cavite, region IV-A of the Philippines.

Uploaded by

Gerald Floro Funa
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
602 views1 page

RBI Form B

This document contains an individual record form for a barangay inhabitant. The form collects personal information such as name, date of birth, place of birth, sex, civil status, citizenship, profession, and residence address. It is certified by the person providing the information and attested by the barangay secretary, who will also fill in the household number. The form is used to document information for residents of Barangay Burol-1 in the city of Dasmarinas, province of Cavite, region IV-A of the Philippines.

Uploaded by

Gerald Floro Funa
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
You are on page 1/ 1

RBI Form B

INDIVIDUAL RECORD OF BARANGAY INHABITANT

REGION I V - A CITY D A S M A R I Ñ A S
PROVINCE C A V I T E BRGY. B U R O L - 1

I. PERSONAL INFORMATION
NAME
(Last) (First) (Middle) (Ext)
DATE OF BIRTH PLACE OF BIRTH
MM DD YYYY
SEX MALE CIVIL STATUS SINGLE WIDOW / ER
FEMALE MARRIED SEPARATED

CITIZENSHIP: F I L I P I N O

PROFESSION/OCCUPATION

RESIDENCE ADDRESS :
House Street Name

Subdivision Name/Zone/ Sitio/Purok

I hereby certify that the above information is true and correct to the best my knowledge.

Date Accomplished Name/Signature of Person Accomplishing the Form

Attested by:

MR. ROQUE I. GALIT Left Right


Barangay Secretary Thumbmark Thumbmark

Household Number
Note: The Household No. shall be filled up by the Barangay Secretary
RBI Form B

INDIVIDUAL RECORD OF BARANGAY INHABITANT

REGION I V - A CITY D A S M A R I Ñ A S

PROVINCE C A V I T E BRGY. B U R O L - 1

I. PERSONAL INFORMATION
NAME
(Last) (First) (Middle) (Ext)
DATE OF BIRTH PLACE OF BIRTH
MM DD YYYY
SEX MALE CIVIL STATUS SINGLE WIDOW / ER
FEMALE MARRIED SEPARATED

CITIZENSHIP: F I L I P I N O

PROFESSION/OCCUPATION

RESIDENCE ADDRESS :
House Street Name

Subdivision Name/Zone/ Sitio/Purok

I hereby certify that the above information is true and correct to the best my knowledge.

Date Accomplished Name/Signature of Person Accomplishing the Form

Attested by:

MR. ROQUE I. GALIT Left Right


Barangay Secretary Thumbmark Thumbmark

Household Number
Note: The Household No. shall be filled up by the Barangay Secretary

You might also like