I.

Family Background

A. Family Type

B. Household Size (number of usual members in a private household)

C. Years of Residency

D. Source of Income

II. Housing Background

A. Historical Background of Lot

1. Tenure Status of Lot

a) If owned specify if inherited or acquired

b) If rented specify the amount of rent per month (exclude utility bills if
possible).

B. Physical Attributes of Lot

1. Lot Size

2. Type of Lot

C. Historical Background of Residence

1. Tenure Status of the House

a) If owned specify if inherited or acquired

b) If rented specify the amount of rent per month (exclude utility bills if
possible).

2. State of Repair of the Building/House

D. Dwelling Unit Attributes

1. Type

2. Stories

3. Materials

4. Architectural style

5. Number of facilities

a) Living quarters (rooms)

6. Floor Area

III. Barangay Background (for barangay officials)

A. Total no. of residence

B. Total no. of residential building

C. Total no. of commercial building D. Total no. of institutional building