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V1Ntar Pedro F A LV - Ar: Region

The document is a form for recording individual inhabitants in a barangay, including personal information such as name, date of birth, sex, civil status, citizenship, and profession. It requires the signature of the person filling it out and is attested by the barangay secretary. The form also includes a section for the household number to be filled by the barangay secretary.

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23 views1 page

V1Ntar Pedro F A LV - Ar: Region

The document is a form for recording individual inhabitants in a barangay, including personal information such as name, date of birth, sex, civil status, citizenship, and profession. It requires the signature of the person filling it out and is attested by the barangay secretary. The form also includes a section for the household number to be filled by the barangay secretary.

Uploaded by

lovely alip
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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RBl Form B

INDIVIDUAL RECORD OF BARANGAY INHABITANTS

REGION: CITY/MUN: V1 NTAR

PROVINCE: O C 0 S N O RTE BRGY: PE DRO F A LV | AR

I.PERSONAL INFORMATION

NA
ME:
(Last) (First) (Middle) (Ext)

DATE OF BIRTH PLACE OF BIRTH


MM DD YYYY

SEX MALE CIVIL STATUS SINGLE WIDOW/ER

FEMALE MARRIED SEPARATED

|CITIZENSHIP:

PROFESSION/OCCUPATION:

RESIDENCE ADDRESS:
House No. Street Name

Subdivision Name/Zone/Sitio/Purok

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

Date Accomplished Name/Slgnature of Person Accompllshing the Form

Attested by:

Left Right

Thumbmark Thumbmark
LIZA JANE A,RABI
Barangay Secretary

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

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