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    11.08.23 Annex A BOIS Form Revised 2023 1

    Uploaded by

    Ronnie Manao
    1) Kyna Diaz Solano is running for re-election as the Punong Barangay of Barangay Lusong for the 2023-2025 term. 2) She has held the position of Punong Barangay for the past term and will assume office again on November 22, 2023 after being re-elected in the October 30, 2023 elections. 3) The document collects her personal and political information such as her birthdate, address, education history, contact details, and information about beneficiaries as required for her position as Punong Barangay.

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    © All Rights Reserved
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    11.08.23 Annex A BOIS Form Revised 2023 1

    Uploaded by

    Ronnie Manao
    208 views2 pages
    1) Kyna Diaz Solano is running for re-election as the Punong Barangay of Barangay Lusong for the 2023-2025 term. 2) She has held the position of Punong Barangay for the past term and will assume office again on November 22, 2023 after being re-elected in the October 30, 2023 elections. 3) The document collects her personal and political information such as her birthdate, address, education history, contact details, and information about beneficiaries as required for her position as Punong Barangay.

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    11.08.23-Annex-A-BOIS-Form-Revised-2023-1[1]

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    1) Kyna Diaz Solano is running for re-election as the Punong Barangay of Barangay Lusong for the 2023-2025 term. 2) She has held the position of Punong Barangay for the past term and will assume office again on November 22, 2023 after being re-elected in the October 30, 2023 elections. 3) The document collects her personal and political information such as her birthdate, address, education history, contact details, and information about beneficiaries as required for her position as Punong Barangay.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    208 views2 pages

    11.08.23 Annex A BOIS Form Revised 2023 1

    Uploaded by

    Ronnie Manao
    1) Kyna Diaz Solano is running for re-election as the Punong Barangay of Barangay Lusong for the 2023-2025 term. 2) She has held the position of Punong Barangay for the past term and will assume office again on November 22, 2023 after being re-elected in the October 30, 2023 elections. 3) The document collects her personal and political information such as her birthdate, address, education history, contact details, and information about beneficiaries as required for her position as Punong Barangay.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    BOIS Revised 2023

    ANNEX “A”

    Republic of the Philippines Passport Size


    Department of the Interior and Local Government Photo

    BARANGAY OFFICIAL’S INFORMATION SHEET


    2023-2025 Term of Office

    NOTE: PLEASE ACCOMPLISH THIS FORM AND WRITE LEGIBLY ALL THE INFORMATION REQUIRED IN CAPITAL LETTERS.

    REGION* : MIMARO0PA IV-B CITY/MUNICIPALITY* : San Agustin

    PROVINCE* : Romblon BARANGAY* : Lusong

    ELECTIVE AND APPOINTIVE POSITION


    (Instruction: Check the acquired position)

    DATE OF ASSUMPTION TO OFFICE/APPOINTMENT * : _______November 22, 2023_____________ DATE OF ELECTION: October 30, 2023

    Punong Barangay Barangay Treasurer BADAC Cluster Leader


    Sangguniang Barangay Member Barangay Secretary Barangay Health Worker
    Encircle Rank (1, 2, 3, 4, 5, 6, 7) SK Treasurer Accredited/Registered by the Local Health Board
    SK Chairperson SK Secretary Appointed by the Barangay (Barangay Health
    Aide/Health Care Assistant)
    SK Member (Encircle Rank 1, 2, 3, 4, 5, 6, 7) Barangay Nutrition Scholar
    IPMR Barangay Tanod
    Day Care Worker
    TERM IN THE PRESENT POSITION: Accredited per ECCD Council Resolution No. 15-03
    1st 2nd 3rd Appointive/Replacement dated Sept. 10, 2015
    Lupon Member
    VAW Desk Officer
    If related with the Appointing Authority, please indicate the
    degree of consanguinity/affinity: _______________________

    PERSONAL AND POLITICAL INFORMATION


    - -
    (PhilSys Card No.)

    Solano Kyna Diaz


    (Last Name) * (First Name) * (Suffix e.g. Jr., II, III) (Middle Name) *

    121-11-2004 Barangay Lusong F Single Roman Catholic


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

    Barangay Lusong, SAR N/A N/A


    (Residence Address) * (Contact Number) * (Official E-mail Address)

    Barangay Lusong 09185008213 Blgulusong@gmail.com


    (Barangay Hall Address) * (Barangay Hall Contact Number) * (Barangay E-mail Address)

    HIGHEST EDUCATIONAL ATTAINMENT*: ELEMENTARY HIGH SCHOOL COLLEGE POST GRAD VOCATIONAL

    Graduate ________________________ Under Graduate


    (Course)
    OTHER OCCUPATION,
    IF ANY: HONORARIUM AS BARANGAY OFFICIAL*:
    Private Government
    BENEFICIARIES*: (for Punong Barangay, Sangguniang Barangay Member, SK Chairperson, IPMR, Barangay Secretary, and Barangay Treasurer only)

    NAME DATE OF BIRTH RELATIONSHIP


    (Last Name, First Name, Middle Initial) (mm/dd/yyyy)
    1.

    2.

    3.

    4.

    5.
    (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.

    KYNA D. SOLANO November 28, 2023


    (Signature over Printed Name) (Date Accomplished)
    Verified and validated by:
    CD/CLGOO/MLGOO Date
    (Signature over Printed Name)

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