[go: up one dir, main page]
Scribd
Upload
74 views3 pages

Rbi Form

This document appears to be a form for registering barangay inhabitants by household. It collects information such as names, addresses, dates of birth, gender, citizenship, civil status and occupation of residents.

Uploaded by

Barangay Baculanad
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
74 views3 pages

Rbi Form

This document appears to be a form for registering barangay inhabitants by household. It collects information such as names, addresses, dates of birth, gender, citizenship, civil status and occupation of residents.

Uploaded by

Barangay Baculanad
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
You are on page 1/ 3

RBI FORM A

REGISTRY OF BARANGAY INHABITANT


A. REGION: PSG
C
B. PROVINCE: O

C. CITY/MUNICIPALITY: E

D. BARANGAY: S

E. HOUSEHOLD NO.:

NAME (1) ADDRESS (2

STREET
LAST NAME FIRST NAME MIDDLE NAME EXT NO.
NAME
(1.1) (1.2) (1.3) (1.4) (2.1)
(2.2)

Prepared by:

Household Head/Member Barangay Secretary


( Signature Over Printed Name) ( Signature Over Printed Name)

I/we (as “Data Subject”) grant my/our free, voluntary and unconditional consent to the collection and processing of all Personal Data, and account or transaction information o
in person or by my/our authorized agent/representative/s to the information database system Barangay Pilit Sta. Fe, Leyte and/or any of its authorized agent/sor representati
10173, otherwise known as the “Data Privacy Act of 2012” of the Republic of the Philippines, including its Implementing Rules and Regulations (IRR) as well as all other guidelin
ARANGAY INHABITANTS BY HOUSEHOLD

DATE ACCOMPLISHED:
ADDRESS (2)

NAME OF PLACE DATE


CIVIL
STREET SUBDIVISION OF OF SEX CITIZENSHIP
STATUS
NAME /ZONE/PUROK BIRTH BIRTH (5) (7)
(6)
(2.2) (If applicable) (3) (4)
(2.3)

Certified by: Validated by:

Barangay Secretary Punong Barangay


( Signature Over Printed Name) ( Signature Over Printed Name)

and account or transaction information or records (collectively, the "Information") relating tome/us disclosed/transmitted by me/us
of its authorized agent/sor representative/s as Information controller, by whatever means in accordance with Republic Act (R.A.)
ulations (IRR) as well as all other guidelines and issuances by the National Privacy Commission (NPC) .
OCCUPATION
(8)

d by:

ong Barangay
Over Printed Name)

You might also like