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RBI FORM A by Household - Revised 2024

This document is a form used by barangays to record information about household members. It collects names, birth details, citizenship, occupation, and other demographic information for each member. The form includes spaces for the signatures of the household head, barangay secretary, and punong barangay to certify the accuracy of the recorded information. It also contains a statement for inhabitants to consent to their personal information being processed by the barangay in accordance with legal mandates and the Data Privacy Act.

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barangay three
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16K views1 page

RBI FORM A by Household - Revised 2024

This document is a form used by barangays to record information about household members. It collects names, birth details, citizenship, occupation, and other demographic information for each member. The form includes spaces for the signatures of the household head, barangay secretary, and punong barangay to certify the accuracy of the recorded information. It also contains a statement for inhabitants to consent to their personal information being processed by the barangay in accordance with legal mandates and the Data Privacy Act.

Uploaded by

barangay three
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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RBI FORM A (Revised 2024)

RECORDS OF BARANGAY INHABITANTS BY HOUSEHOLD

REGION :
PROVINCE:
CITY/MUNICIPALITY:
BARANGAY :
HOUSEHOLD ADDRESS :
NO. OF HOUSEHOLD MEMBERS:

NAME
Indicate if Labor/employed,
Unemployed, PWD, OFW, Solo
PLACE OF BIRTH DATE OF BIRTH AGE SEX CIVIL STATUS CITIZENSHIP OCCUPATION Parent, Out of School Youth
LAST NAME FIRST NAME MIDDLE NAME EXT (OSY), Out of School Children
(OSC) and/or IP

Prepared by: Certified Correct: Validated by:

Name of Household/Head Member Barangay Secretary Punong Barangay


(Signature over Printed Name) (Signature over Printed Name) (Signature over Printed Name)

I hereby certify that the above information are true and correct to the best of my knowledge. I understand that for the Barangay to carry out its mandate pursuant to Section 394 (d)(6) of the Local Government Code of 1991, they must necessarily process my personal information for easy identification
of inhabitants, as a tool in planning, and as an updated reference in the number of inhabitants of the Barangay. Therefore, I grant my consent and recognize the authority of the Barangay to process my personal information, subject to the provision of the Philippine Data Privacy Act of 2012.

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