RBI FORM D (Revised 2024)

MONITORING REPORT
for ___ Semester of CY ________

REGION : ________________________
PROVINCE: ________________________
CITY/MUNICIPALITY: ________________
TOTAL NO. OF BARANGAYS: ___________
NO. OF BRGYS. WITH RBI: _____________

NAME OF BARANGAY WITH RBI REMARKS NAME OF BARANGAY WITH RBI REMARKS

Prepared by:

City/Municipal RBI Task Force Secretariat

(Signature over Printed Name)

Date Accomplished: ____________________________

Note: This form, once accomplished, shall be submitted to the City/Municipal Mayor as Head of the RBI Task Force.