HOUSEHOLD

RECORD OF BARANGAY INHABITANTS (RBI)

REGION lll A. 1 PSGC__________
PROVINCE TARLAC B. 1 PSGC__________
MUNICIPALITY MONCADA C. 1 PSGC__________
BARANGAY POBLACION 1 D. 1 PSGC __________
HOUSEHOLD NO._____________

LEGEND:
NAME ADDRESS PLACE OF DATE OF SEX CIVIL CITEZENSHIP OCCUPATION RELATIONSHIP
BIRTH BIRTH STATUS TO
HOUSEHOLD
HEAD
1 2 3 4 5 6 7 8
LAST FIRST MIDDLE QUALIFIER NUMBER STREET NAME NAME OF
SUBDIVISION/
SITIO/PUROK(IF
APPLICABLE)
1.1 1.2 1.3 1.4 2.1 2.2. 2.3

PSGC: Philippine Standard Geographic Code shall be made available by the DILG City/ Municipal Office.
HOUSEHOLD is a social unit consisting of a person living alone or a group of persons who
1) sleeps in the same housing unit, and 2) have a common arrangement in the preparation and consumption of food on
QUALIFIER in the addition and or/ inclusion “JR” “SR”/ atc. As the cases maybe after the person’s surname(s).

Prepared by:_________________ Certified by: ____________________ Verified by: ___________________

Barangay Secretary Punong Barangay