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Rbi Form B

The document is an individual record form for a barangay inhabitant in Gattaran, Cagayan, detailing personal information of Precious Shammah Matias Ocampo. It includes data such as birth date, address, occupation, and educational attainment, along with consent for processing personal information by the barangay. The form is to be certified by the individual and attested by the barangay secretary.

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24 views1 page

Rbi Form B

The document is an individual record form for a barangay inhabitant in Gattaran, Cagayan, detailing personal information of Precious Shammah Matias Ocampo. It includes data such as birth date, address, occupation, and educational attainment, along with consent for processing personal information by the barangay. The form is to be certified by the individual and attested by the barangay secretary.

Uploaded by

maricelmocampo11
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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RBI FORM B (Revised 2024)

INDIVIDUAL RECORDS OF BARANGAY INHABITANT

REGION: Region II (Cagayan Valley) CITY/MUNICIPALITY: Gattaran


PROVINCE: Cagayan BARANGAY: Baraoidan

PERSONAL INFORMATION

(PhilSys Card No.)

OCAMPO PRECIOUS SHAMMAH MATIAS

(Last Name) (Suffix) (First Name) (Middle Name)

February 9, 2016 Aparri Cagayan Female Single

(Birth Date) (Birth Place) (Sex) (Civil Status) (Religion)

Filipino Z4-124, Aglugob Street, Baraoidan, Gattaran, Cagayan, Region II (Cagayan Valley), 3508

(Citizenship) (Residence Address)

Student 09972464276

(Profession / Occupation) (Contact Number) (Email Address)

HIGHEST EDUCATIONAL ATTAINMENT: [ ] ELEMENTARY [ ] HIGH SCHOOL [ ] COLLEGE [ ] POST GRAD [ ] VOCATIONAL

Please specify: [ ] Graduate [ ] Undergraduate

I hereby certify that the above information is 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.

- PRECIOUS SHAMMAH M. OCAMPO


Date Accomplished Name/Signature of Person Accomplishing the Form

Attested By:

MARICEL M. OCAMPO
Barangay Secretary Left Thumbmark Right Thumbmark

Household Number:
Note: The household number shall be filled up by the Barangay Secretary

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