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Dilg Bois

This document is a Barangay Official's Information Sheet that collects personal and professional information about a barangay official in the Philippines. It includes their name, position, contact details, education history, occupation, beneficiaries, and signature certifying the accuracy of the information provided. The form is used by the Department of the Interior and Local Government to process personal data as part of carrying out their mandate.

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Phil Castillo Mar
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We take content rights seriously. If you suspect this is your content, claim it here.
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1K views1 page

Dilg Bois

This document is a Barangay Official's Information Sheet that collects personal and professional information about a barangay official in the Philippines. It includes their name, position, contact details, education history, occupation, beneficiaries, and signature certifying the accuracy of the information provided. The form is used by the Department of the Interior and Local Government to process personal data as part of carrying out their mandate.

Uploaded by

Phil Castillo Mar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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BOIS Form Revised 2022

ANNEX “A”

Republic of the Philippines


Department of the Interior and Local Government
DILG-NAPOLCOM Center, EDSA corner Quezon Avenue, Quezon City

BARANGAY OFFICIAL’S INFORMATION SHEET 1X1


ID Picture
BARMM
REGION : CITY/MUN : BONGAO
PROVINCE : TAWI-TAWI BARANGAY : PAG-ASA

ELECTIVE AND APPOINTIVE POSITION


Punong Barangay Barangay Treasurer
Sangguniang Barangay Member Barangay Secretary
Rank (1,2,3,4,5,6,7) SK Treasurer
SK Chairperson SK Secretary
SK Member(Rank 1, 2, 3, 4, 5, 6, 7) IPMR
Relationship with the Appointing Authority: __________________
TERM IN THE PRESENT POSITION: Other Appointive Barangay Official:
1st 2nd 3rd ___________________________________
* If Barangay Health Worker, check the box, if:
Ac credited/Registered by the Local Health Board
Ap pointed by the Barangay

PERSONAL INFORMATION

(PhilSys Card No.)

ABEJO LODELIZA FELISARTA


(Last Name) (Suffix e.g. Jr., I, II,III) (First Name) (MiddleName)

(Birth Date: mm/dd/yyyy) (Birth Place) (Sex) (Civil Status) (Religion)

(Residence Address) (Residence Telephone No.)

(Mobile Number) (Barangay Hall Telephone Number) (E-mail Address)

HIGHEST EDUCATIONAL ATTAINMENT: ELEMENTARY HIGH SCHOOL COLLEGE POST GRAD VOCATIONAL

Please specify: Graduate Under Graduate

OCCUPATION: HONORARIUM:

BENEFICIARIES:(optional for the other appointive barangay officials)


NAME DATE OF BIRTH RELATIONSHIP

1.

2.

3.

4.
(Please use additional Sheet if necessary)

I hereby certify that the above information are true and correct to the best of my knowledge. I understand that for the DILG to carry out its mandate they must
necessarily process my personal information. Therefore, I grant my consent and recognize the authority of the DILG to process my personal information, pursuant
to the Philippine Data Privacy Act of 2012.

(Signature over Printed Name) (Date Accomplished)

Verified and validated by:

CD/CLGOO/MLGOO Date
(Signature over Printed Name)

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