Record of Barangay Inhabitants by Household: C O D E S
Record of Barangay Inhabitants by Household: C O D E S
Record of Barangay Inhabitants by Household: C O D E S
E. HOUSEHOLD NO.:
DATE ACCOMPLISHED:
PROVINCE BGY
I. PERSONAL INFORMATION
NAME:
(Last) (First) (Middle) (Ext)
DATE OF BIRTH: PLACE OF BIRTH:
MM DD YYYY
SEX: MALE CIVIL STATUS: SINGLE WIDOW/ ER
FEMALE MARRIED SEPARATED
CITIZENSHIP:
PROFESSION/OCCUPATION:
RESIDENCE ADDRESS:
House No Street Name
Subdivision Name/Zone/Sitio/Purok
I hereby certify that the above information is true and correct to the best of my knowledge.
Attested by:
Left Right
Thumbmark Thumbmark
Barangay Secretary
Household Number
Note: The Household No. shall be filled up by the Barangay Secretary.