HOUSEHOLD

RECORDS OF BARANGAY INHABITANTS (RBI)

RBI FORM B

A. REGION: CARAGA 13
B. PROVINCE: AGUSAN DEL SUR A. 1 PSGC: _______________________
C. CITY/MUNICIPALITY: SAN FRANCISCO B. 1 PSGC: _______________________
D. BARANGAY: C. 1 PSGC: _______________________
E. HOUSEHOLD NO: D. 1 PSGC: _______________________

NAME ADDRESS DATE OF SEX CIVIL CITIZENSHIP OCCUPATION REMARKS

1 2 PLACE OF BIRTH BIRTH STATUS
LAST FIRST MIDDLE QUALIFIER NUMBER STREET NAME NAME OF SUBD. IF POSSIBLE

.(1.1) .(1.2) .(1.3) .1.4) .(2.1) .(2.2) .(2.3) .(3) .(4) .(5) .(6) .(7) .(8) .(9)

Legend:
Remarks: Utilize this column for any information necessary to generate additional info/data
PSGC: Philippine Standard Geographic Code shall be made available by the DILG City/Municipal Offices
HOUSEHOLD is a social unit consisting of a consisting of a living alone or a group of person's who
1.) sleep in the same housing unit; and 2) have a common arrangement in the prparation and consumption of food.
QUALIFIER is the additional and /or inclusion of the word "JR", "II" etc. as the case maybe after the person's surname (s)

Prepared by: ________________________________________ Certified Correct: _______________________________________ Validated by: __________________________________

Barangay Secretary Punong barangay