RBI FORM B (Revised 2024)
INDIVIDUAL RECORDS OF BARANGAY INHABITANT
REGION: Region VIII (Eastern CITY/MUNICIPALITY: Santa Fe
PROVINCE: Visayas) BARANGAY: Katipunan
Leyte
PERSONAL INFORMATION
(PhilSys Card No.)
MARCOS RODOLFO
(Last Name) (Suffix) (First Name) (Middle Name)
April 1, 1985 Male Married
(Birth Date) (Birth Place) (Sex) (Civil Status) (Religion)
Filipino Katipunan, Santa Fe, Leyte, Region VIII (Eastern Visayas)
(Citizenship) (Residence Address)
(Profession / Occupation) (Contact Number) (Email Address)
HIGHEST EDUCATIONAL ATTAINMENT: [ ] ELEMENTARY [ ] HIGH SCHOOL [ ] COLLEGE [ ] POST GRAD [ ] VOCATIONAL
Please specify: [ ] Graduate [ ] Undergraduate
I hereby certify that the above information is true and correct to the best of my knowledge. I understand that for the
Barangay to carry out its mandate pursuant to Section 394 (d)(6) of the Local Government Code of 1991, they must
necessarily process my personal information for easy identification of inhabitants, as a tool in planning, and as an updated
reference in the number of inhabitants of the Barangay. Therefore, I grant my consent and recognize the authority of the
Barangay to process my personal information, subject to the provision of the Philippine Data Privacy Act of 2012.
- RODOLFO MARCOS
Date Accomplished Name/Signature of Person Accomplishing the Form
Attested By:
LOIDA M. MABAIT
Barangay Secretary Left Thumbmark Right Thumbmark
Household Number:
Note: The household number shall be filled up by the Barangay Secretary
