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RBI FORM A (Revised 2024)
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RECORDS OF BARANGAY INHABITANTS BY HOUSEHOLD
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REGION :
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PROVINCE:HOUSEHOLD NUMBER:
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CITY/MUNICIPALITY:
(to be filled by Barangay Secretary)
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BARANGAY :
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HOUSEHOLD ADDRESS :
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NO. OF HOUSEHOLD MEMBERS:
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NAMEPLACE OF BIRTHDATE OF BIRTH
(MM-DD-YYYY)		AGESEXCIVIL STATUSCITIZENSHIPOCCUPATIONIndicate if Labor/employed, Unemployed (E/UE), PWD, OFW, Solo Parent (SP), Out of School Youth (OSY), Out of School Children (OSC) and/or IP
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LAST NAME FIRST NAME MIDDLE NAMEEXT
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Prepared by:Certified Correct:
Validated by:
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Name of Household/Head MemberBarangay SecretaryPunong Barangay
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(Signature over Printed Name)(Signature over Printed Name)(Signature over Printed Name)
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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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