Republic of the Philippines

Province of the Northern Samar

Municipality of Laoang
Barangay _________________

REGISTRY OF BARANGAY INHABITANTS (RBI)

(Base on Section 394 (d) (6) of RA7160)

Name ADDRESS PLACE OF DATE SE CIVIL OCCUPAT RELATIO REMAR

(1) (2) BIRTH OF X STATU I N (OTHE
LAST FIRST MIDDLE QU NUMBE STREET NAME OF BIRTH S ON SHIP TO INFO
A R SUBD/ZONE/S HOUSEH
NAME
LIFI HH # I O
E
TIO/ PUROK if LD HEAD
R
applicable
(1.1) (1.2) (1.3) (2.2) (4) (7) (10)
(2.1) (2.3) (5) (6 (8)
(1.

SIGNATURE: SUBMITTED:

______________________________ _______________________________
SECRETARY PUNONG BARANGAY