CBMS FORM 4 Republic of the Philippines

PSA Approval Number: PSA-2225-04

Expiry Date: 30 April 2023 Philippine Statistics Authority 4A
2022 COMMUNITY-BASED MONITORING SYSTEM
BARANGAY PROFILE QUESTIONNAIRE
Dear Sir/Madam,

The Philippine Statistics Authority (PSA) is conducting the Community-Based Monitoring System (CBMS). CBMS, as defined by the law,
refers to an organized technology-based system of collecting, processing, and validating necessary disaggregated data that may be used
for planning, program implementation, and impact monitoring at the local level while empowering communities to participate in the
process.
The conduct of the CBMS is pursuant to Republic Act No. 11315, otherwise known as the CBMS Act, which authorizes the PSA to
prepare and conduct periodic compendium of localized facts, figures, and maps on the different dimensions of poverty such as health,
nutrition, water, sanitation, shelter, education, income, employment, security, and participation every three years. All barangay Local
Government Units (LGUs) are requested to respond to this Barangay Profile Questionnaire (BPQ).
By responding to this questionnaire, you are voluntarily providing information to the PSA and you are authorizing the PSA to collect data
about your barangay, in which such data may also be shared to the national government agencies for monitoring purposes and for
possible assistance that may be extended to your LGU. The data that you will provide in this BPQ will also be stored and archived in the
PSA's National CBMS Databank.
Rest assured that the data that you will furnish in this data collection activity shall be considered PRIVILEGED COMMUNICATION and as
such shall be inadmissible as evidence in any legal proceeding. Moreover, please be informed that Section 4(e) of RA 10173
(Data Privacy Act of 2012) states that data privacy does not apply to “information necessary in order to carry out the functions of public
authority which includes the processing of personal data for the performance by the independent agencies of their constitutionally and
statutorily mandated functions.” We appreciate your utmost cooperation and support for the success of the enhancement of the CBMS.
If you have inquiries, you may contact PSA at (02) 8376-1909. You may also send us a message through the following e-mail addresses:
cbms@psa.gov.ph and psacbms@gmail.com.
Thank you very much.

CLAIRE DENNIS S. MAPA, Ph.D.

Undersecretary
National Statistician and Civil Registrar General

GEOGRAPHIC IDENTIFICATION

REGION BARANGAY

PROVINCE ENUMERATION AREA

CITY/MUNICIPALITY BUILDING SERIAL NUMBER

GEOPOINTS OF THE BRGY. HALL LATITUDE LONGITUDE

NAME OF PUNONG
BARANGAY
LAST NAME FIRST NAME SUFFIX MIDDLE NAME
COMPLETE ADDRESS
OF THE BARANGAY HALL
FLOOR NO. BLDG NAME/NO. BLOCK/LOT NO. STREET NAME ZONE VILLAGE/PUROK/SITIO
EMAIL ADDRESS
CONTACT NUMBER OF THE BARANGAY
INTERVIEW RECORD
DATE OF VISIT TIME BEGAN TIME ENDED
MONTH/DAY (mm/dd) HOUR:MINUTE AM/PM HOUR:MINUTE AM/PM

MODE OF DATA COLLECTION

1 - COMPUTER-ASSISTED WEB INTERVIEW (CAWI) 3 - SELF-ADMINISTERED QUESTIONNAIRE (SAQ)

2 - COMPUTER-ASSISTED PERSONAL INTERVIEW (CAPI)

CERTIFICATION FROM THE BARANGAY

RESPONDENT PUNONG BARANGAY BARANGAY PERSONNEL (RECORD THE NAME)

BARANGAY PERSONNEL
LAST NAME FIRST NAME SUFFIX MIDDLE NAME POSITION

BARANGAY PERSONNEL
LAST NAME FIRST NAME SUFFIX MIDDLE NAME POSITION
I hereby certify that the data provided are true and complete based on my knowledge and records of the barangay.

PUNONG BARANGAY DATE OF COMPLETION

SIGNATURE OVER PRINTED NAME
CERTIFICATION
I hereby certify that the data set forth herein were personally obtained/reviewed by me and in accordance with the instructions given by the PSA.

TS CAS CO/RSSO/PSO SUPERVISOR/HEAD CAS

SIGNATURE OVER PRINTED NAME SIGNATURE OVER PRINTED NAME SIGNATURE OVER PRINTED NAME

.
CBMS Form 4 1 of 28
 COMMUNITY-BASED MONITORING SYSTEM
4B BARANGAY PROFILE QUESTIONNAIRE
GENERAL INSTRUCTIONS
1 Boxes are found all throughout the questionnaire. Each box corresponds to alpha/numeric response/s. Make sure that each
number/letter is written inside the box.
2 Use the prescribed alpha numeric characters. If number-coded, only one answer is allowed. If letter-coded, multiple answers are allowed.
3 If lines are provided, write the specific answer. Always use capital letters for write-in entries.
4 Follow the skipping instructions.
5 Use pencil when filling out the questionnaire. Never use pen, ballpen, or marker.
6 Use eraser in case there is need to correct an entry. Do not use liquid eraser or correction fluid.
Make sure that each wrong entry is properly erased.
7 Complete all the information to maintain data accuracy and consistency.
8 Write neatly and legibly.
9 If an answer needs further explanation or clarification, write it down in the “Remarks” portion of the questionnaire.
Do not forget to indicate the section and item number being referred to.
PART I. BARANGAY CHARACTERISTICS AND COMMUNITY FACILITIES

A. Physical Characteristics of the Barangay

We would like to know about the physical characteristics of your barangay.
1 What are the general descriptions and characteristics of the barangay? Does this barangay have…
Plains? YES …..…..…..…..…..…..…..…..1
NO …..…..…..…..…..…..…..…..2
Upland areas? YES …..…..…..…..…..…..…..…..1
NO …..…..…..…..…..…..…..…..2
Mountainous areas? YES …..…..…..…..…..…..…..…..1
NO …..…..…..…..…..…..…..…..2
Coastal areas? YES …..…..…..…..…..…..…..…..1
NO …..…..…..…..…..…..…..…..2
Others, specify
2 Are there puroks in the barangay? YES …..…..…..…..…..…..…..…..1
NO …..…..…..…..…..…..…..…..2 4
3 What are the puroks in the barangay?
ADD ALL NAMES OF PUROKS.

4 Are there sitios in the barangay? YES …..…..…..…..…..…..…..…..1

NO …..…..…..…..…..…..…..…..2 6
5 What are the sitios in the barangay?
ADD ALL NAMES OF SITIOS.

6 What is the land area (in square meters) of the barangay used for the following purposes?
Residential . 6a Reference Period
Commercial .
Agricultural . 6b Source of Document
Industrial .
Mineral . 6c Data source agency/unit/office in the barangay
Timberland .
Special classes .
Vacant lot .
Others, specify .
TOTAL LAND AREA .
7 What are the boundaries of the barangay? Please indicate the barangay and/or landmark.
North 7a Reference Period
East
West 7b Source of Document
South
7c Data source agency/unit/office in the barangay

CBMS Form 4 2 of 28
 B. Service Institutions and Infrastructure 4C
In this section, we would like to get information about the different health facilities available in your barangay. Kindly list down all government-operated and privately-owned health facilities in your barangay.
HF1. Does this barangay HF2. What is the distance of HF3. What is the name HF4. What is the HF5. Are there other HF6. What are HF7. Is the facility HF8. What type of
I. HEALTH FACILITY have at least one ___? the brgy hall to the nearest facility? of the (HEALTH FACILITY)? address of the services/ facilities the other services/ a government institution operates
(SEE CODES BELOW) (HEALTH FACILITY)? present in the ___? facilities present project completed the facility?
in the ___? in the last 3 years?
IF CODES 3 OR 4, YES…1 NO….2 (SEE CODES BELOW)
SPECIFY PROV, CITY/MUN NO GO TO HF7 YES…1 NO….2
a. Barangay Health YES ……......
1 HF3 HF8 5
Center NO …….. 2

b. Hospital YES …....... 1 HF3 HF8

NO …..... 2

c. Rural Health Unit (RHU) YES …....... 1 HF3 HF8

/Urban Health Center NO …..... 2

d. Maternity/Lying-in YES …....... 1 HF3 HF8

Clinic/Birthing Home NO …..... 2

e. Pediatric/Child Clinic YES …....... 1 HF3 HF8

NO …..... 2

f. Medical YES …....... 1 HF3 HF8

Clinic/Diagnostic/ NO …..... 2
Dialysis Center

g. Dental Clinic YES …....... 1 HF3 HF8

NO …..... 2

CODES FOR HF2 1 WITHIN 2 KMS (INSIDE THE CITY/MUNICIPALITY) 3 WITHIN 2 KMS (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY CODES FOR HF8 4 CITY/MUNICIPAL GOVERNMENT 8 DON'T KNOW
2 MORE THAN 2 KMS (INSIDE THE CITY/MUNICIPALITY) 4 MORE THAN 2 KMS (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY 1 PRIVATE (BUSINESS/PROFIT ORIENTED) 5 BARANGAY GOVERNMENT 9 NONE
8 DON’T KNOW 2 NATIONAL GOVERNMENT 6 GOVERNMENT-OWNED AND CONTROLLED CORPORATION
3 PROVINCIAL GOVERNMENT 7 NGOs/NON-PROFIT INSTITUTION SERVING HOUSEHOLD

CBMS Form 4 3 of 28
 B. Service Institutions and Infrastructure 4D
In this section, we would like to get information about the different health facilities available in your barangay. Kindly list down all government-operated and privately-owned health facilities in your barangay.
HF1. Does this barangay HF2. What is the distance of HF3. What is the name HF4. What is the HF5. Are there other HF6. What are HF7. Is the facility HF8. What type of
I. HEALTH FACILITY have at least one ___? the brgy hall to the nearest facility? of the (HEALTH FACILITY)? address of the services/ facilities the other services/ a government institution operates
(SEE CODES BELOW) (HEALTH FACILITY)? present in the ___? facilities present project completed the facility?
in the ___? in the last 3 years?
IF CODES 3 OR 4, YES…1 NO….2 (SEE CODES BELOW)
SPECIFY PROV, CITY/MUN NO GO TO HF7 YES…1 NO….2
h. Mobile Clinic YES ……......
1 HF3 HF8
NO …….. 2

i. Botika ng Barangay YES …....... 1 HF3 HF8

NO …..... 2

j. Botika ng Bayan YES …....... 1 HF3 HF8 1

NO …..... 2

k. Pharmacy/Drugstore YES …....... 1 HF3 HF8

NO …..... 2

l. COVID-19 Quarantine/ YES …....... 1 HF3 HF8

Isolation Facility NO …..... 2

m. COVID-19 YES …....... 1 HF3 HF8

Testing Center/ NO …..... 2
Vaccination Site

n. Habilitation Facility YES …....... 1 HF3 HF8

NO …..... 2

CODES FOR HF2 1 WITHIN 2 KM (INSIDE THE CITY/MUNICIPALITY) 3 WITHIN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY CODES FOR HF8 4 CITY/MUNICIPAL GOVERNMENT 8 DON'T KNOW
2 MORE THAN 2 KM (INSIDE THE CITY/MUNICIPALITY) 4 MORE THAN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY 1 PRIVATE (BUSINESS/PROFIT ORIENTED) 5 BARANGAY GOVERNMENT 9 NONE
8 DON’T KNOW 2 NATIONAL GOVERNMENT 6 GOVERNMENT-OWNED AND CONTROLLED CORPORATION
3 PROVINCIAL GOVERNMENT 7 NGOs/NON-PROFIT INSTITUTION SERVING HOUSEHOLD

CBMS Form 4 4 of 28
 B. Service Institutions and Infrastructure 4E
In this section, we would like to get information about the different health facilities available in your barangay. Kindly list down all government-operated and privately-owned health facilities in your barangay.
HF1. Does this barangay HF2. What is the distance of HF3. What is the name HF4. What is the HF5. Are there other HF6. What are the HF7. Is the facility HF8. What type of
I. HEALTH FACILITY have at least one ___? the brgy hall to the nearest facility? of the (HEALTH FACILITY)? address of the services/ facilities other services/ a government institution operates
(SEE CODES BELOW) (HEALTH FACILITY)? present in the ___? facilities present in project completed the facility?
the ___? in the last 3 years?
IF CODES 3 OR 4, YES…1 NO….2 (SEE CODES BELOW)
SPECIFY PROV, CITY/MUN NO GO TO HF7 YES…1 NO….2
o. Rehabilitation Center YES …....... 1 HF3 HF8
NO …..... 2

p. Others, specify_____ YES ……......

1 HF3
NO …….. 2 EF1

In this section, we would like to get information about the different educational facilities available in your barangay. Kindly list down all government-operated and privately-owned education facilities in your barangay.
EF1. Does this barangay EF2. What is the distance of EF3. What is the name EF4. What is the EF5. Are there other EF6. What are the EF7. Is the facility EF8. What type of
II. EDUCATION FACILITY have at least one ___? the brgy hall to the nearest facility? of the (EDUCATION FACILITY)? address of the services/ facilities other services/ a government institution operates
(SEE CODES BELOW) (EDUCATION FACILITY)? present in the ___? facilities present in project completed the facility?
the ___? in the last 3 years?
IF CODES 3 OR 4, YES…1 NO….2 (SEE CODES BELOW)
SPECIFY PROV, CITY/MUN NO GO TO EF7 YES…1 NO….2
a. Day Care Center YES …...... 1 EF3 EF8
NO …..... 2

b. College/University YES …...... 1 EF3 EF8

NO …..... 2

c. Senior High School YES …...... 1 EF3 EF8

NO …..... 2

d. Junior High School YES …...... 1 EF3 EF8

NO …..... 2

CODES FOR 1 WITHIN 2 KM (INSIDE THE CITY/MUNICIPALITY) 3 WITHIN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY CODES FOR HF8 & EF8 4 CITY/MUNICIPAL GOVERNMENT 8 DON'T KNOW
HF2 & EF2 2 MORE THAN 2 KM (INSIDE THE CITY/MUNICIPALITY) 4 MORE THAN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY 1 PRIVATE (BUSINESS/PROFIT ORIENTED) 5 BARANGAY GOVERNMENT 9 NONE
8 DON’T KNOW 2 NATIONAL GOVERNMENT 6 GOVERNMENT-OWNED AND CONTROLLED CORPORATION
3 PROVINCIAL GOVERNMENT 7 NGOs/NON-PROFIT INSTITUTION SERVING HOUSEHOLD

CBMS Form 4 5 of 28
 B. Service Institutions and Infrastructure 4F
In this section, we would like to get information about the different education facilities available in your barangay. Kindly list down all government-operated and privately-owned education facilities in your barangay.
EF1. Does this barangay EF2. What is the distance of EF3. What is the name EF4. What is the EF5. Are there other EF6. What are the EF7. Is the facility EF8. What type of
II. EDUCATION FACILITY have at least one ___? the brgy hall to the nearest facility? of the (EDUCATION FACILITY)? address of the services/ facilities other services/ a government institution operates
(SEE CODES BELOW) (EDUCATION FACILITY)? present in the ___? facilities present project completed the facility?
in the ___? in the last 3 years?
IF CODES 3 OR 4, YES…1 NO….2 (SEE CODES BELOW)
SPECIFY PROV, CITY/MUN NO GO TO EF7 YES…1 NO….2
e. Elementary School YES …...... 1 EF3 EF8
NO …..... 2

f. Preschool YES …...... 1 EF3 EF8

NO …..... 2

g. SPED School/ YES …...... 1 EF3 EF8

Center NO …..... 2

h. TVET Institution/ YES …...... 1 EF3 EF8

Training Institute NO …..... 2

i. Alternative Learning YES …...... 1 EF3 EF8

System (ALS) Center NO …..... 2

j. Others, specify _____ YES …...... 1 EF3

NO …..... 2 SF1
In this part, we would like to gather information about the service facilities that are present in your barangay.
SF1. Does this barangay SF2. What is the distance of SF3. What is the name SF4. What is the SF5. Are there other SF6. What are the SF7. Is the facility SF8. What type of
III. SERVICE FACILITY have at least one ___? the brgy hall to the nearest facility? of the (SERVICE FACILITY)? address of the services/ facilities other services/ a government institution operates
(SEE CODES BELOW) (SERVICE FACILITY)? present in the ___? facilities present project completed the facility?
in the ___? in the last 3 years?
IF CODES 3 OR 4, YES…1 NO….2 (SEE CODES BELOW)
SPECIFY PROV, CITY/MUN NO GO TO SF7 YES…1 NO….2
a. Multi-purpose YES …...... 1 SF3 SF8
Hall NO …..... 2

CODES FOR 1 WITHIN 2 KM (INSIDE THE CITY/MUNICIPALITY) 3 WITHIN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY CODES FOR EF8 & SF8 4 CITY/MUNICIPAL GOVERNMENT 8 DON'T KNOW
EF2 & SF2 2 MORE THAN 2 KM (INSIDE THE CITY/MUNICIPALITY) 4 MORE THAN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY 1 PRIVATE (BUSINESS/PROFIT ORIENTED) 5 BARANGAY GOVERNMENT 9 NONE
8 DON’T KNOW 2 NATIONAL GOVERNMENT 6 GOVERNMENT-OWNED AND CONTROLLED CORPORATION
3 PROVINCIAL GOVERNMENT 7 NGOs/NON-PROFIT INSTITUTION SERVING HOUSEHOLD

CBMS Form 4 6 of 28
 B. Service Institutions and Infrastructure 4G
In this part, we would like to gather information about the service facilities that are present in your barangay.
SF1. Does this barangay SF2. What is the distance of SF3. What is the name SF4. What is the SF5. Are there other SF6. What are SF7. Is the facility SF8. What type of
III. SERVICE FACILITY have at least one ___? the brgy hall to the nearest facility? of the (SERVICE FACILITY)? address of the services/ facilities other services/ a government institution operates
(SEE CODES BELOW) (SERVICE FACILITY)? present in the ___? facilities present project completed the facility?
in the ___? in the last 3 years?
IF CODES 3 OR 4, YES…1 NO….2 (SEE CODES BELOW)
SPECIFY PROV, CITY/MUN NO GO TO SF7 YES…1 NO….2
b. Police Station/ YES ……......
1 SF3 SF8
Substation NO …….. 2

c. Jail YES …....... 1 SF3 SF8

NO …..... 2

d. Fire Station YES …....... 1 SF3 SF8

NO …..... 2

e. Trial Court House YES …....... 1 SF3 SF8

NO …..... 2

f. Public Plaza/Parks/ YES …....... 1 SF3 SF8

Garden/Sports NO …..... 2
Facility (gymnasium,
court, etc.)

g. Disaster Risk Reduction YES …....... 1 SF3 SF8

Desk/Office NO …..... 2

h. Women’s Crisis Center YES …....... 1 SF3 SF8

NO …..... 2

CODES FOR SF2 1 WITHIN 2 KM (INSIDE THE CITY/MUNICIPALITY) 3 WITHIN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY CODES FOR SF8 4 CITY/MUNICIPAL GOVERNMENT 8 DON'T KNOW
2 MORE THAN 2 KM (INSIDE THE CITY/MUNICIPALITY) 4 MORE THAN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY 1 PRIVATE (BUSINESS/PROFIT ORIENTED) 5 BARANGAY GOVERNMENT 9 NONE
8 DON’T KNOW 2 NATIONAL GOVERNMENT 6 GOVERNMENT-OWNED AND CONTROLLED CORPORATION
3 PROVINCIAL GOVERNMENT 7 NGOs/NON-PROFIT INSTITUTION SERVING HOUSEHOLD

CBMS Form 4 7 of 28
 B. Service Institutions and Infrastructure 4H
In this part, we would like to gather information about the service facilities that are present in your barangay.
SF1. Does this barangay SF2. What is the distance of SF3. What is the name SF4. What is the SF5. Are there other SF6. What are the SF7. Is the facility SF8. What type of
III. SERVICE FACILITY have at least one ___? the brgy hall to the nearest facility? of the (SERVICE FACILITY)? address of the services/ facilities other services/ a government institution operates
(SEE CODES BELOW) (SERVICE FACILITY)? present in the ___? facilities present project completed the facility?
in the ___? in the last 3 years?
IF CODES 3 OR 4, YES…1 NO….2 (SEE CODES BELOW)
SPECIFY PROV, CITY/MUN NO GO TO SF7 YES…1 NO….2
i. Violence against YES ……......
1 SF3 SF8
Women and their NO …….. 2
Children (VAWC)
Desk/Office

j. Go Negosyo Center YES …....... 1 SF3 SF8

NO …..... 2

k. Persons with Disabilities YES …....... 1 SF3 SF8

Affairs Office (PDAO) NO …..... 2

l. Office of Senior YES …....... 1 SF3 SF8

Citizens Affairs NO …..... 2

m. Local Council for YES …....... 1 SF3 SF8

Protection of Children NO …..... 2
Office

n. Post Office/ YES …....... 1 SF3 SF8

Postal Service NO …..... 2

o. Evacuation Center YES …....... 1 SF3 SF8

NO …..... 2

CODES FOR SF2 1 WITHIN 2 KM (INSIDE THE CITY/MUNICIPALITY) 3 WITHIN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY CODES FOR SF8 4 CITY/MUNICIPAL GOVERNMENT 8 DON'T KNOW
2 MORE THAN 2 KM (INSIDE THE CITY/MUNICIPALITY) 4 MORE THAN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY 1 PRIVATE (BUSINESS/PROFIT ORIENTED) 5 BARANGAY GOVERNMENT 9 NONE
8 DON’T KNOW 2 NATIONAL GOVERNMENT 6 GOVERNMENT-OWNED AND CONTROLLED CORPORATION
3 PROVINCIAL GOVERNMENT 7 NGOs/NON-PROFIT INSTITUTION SERVING HOUSEHOLD

CBMS Form 4 8 of 28
 B. Service Institutions and Infrastructure 4H
In this part, we would like to gather information about the service facilities that are present in your barangay.
SF1. Does this barangay SF2. What is the distance of SF3. What is the name SF4. What is the SF5. Are there other SF6. What are SF7. Is the facility SF8. What type of
III. SERVICE FACILITY have at least one ___? the brgy hall to the nearest facility? of the (SERVICE FACILITY)? address of the services/ facilities the other services/ a government institution operates
(SEE CODES BELOW) (SERVICE FACILITY)? present in the ___? facilities present project completed the facility?
in the ___? in the last 3 years?
IF CODES 3 OR 4, YES…1 NO….2 (SEE CODES BELOW)
SPECIFY PROV, CITY/MUN NO GO TO SF7 YES…1 NO….2
p. Library YES ……......
1 SF3 SF8
NO …….. 2

q. Public Market YES …....... 1 SF3 SF8

NO …..... 2

r. Communal Toilet YES …....... 1 SF3 SF8

NO …..... 2

s. Cemetery/ YES …....... 1 SF3 SF8

Memorial Park NO …..... 2

t. Others, specify YES …....... 1 SF3

NO …..... 2 AF1

We would like to acquire sufficient information on the agricultural facilities that are operating in your barangay.
AF1. Does this barangay AF2. What is the distance of AF3. What is the name AF4. What is the AF5. Are there other AF6. What are the AF7. Is the facility AF8. What type of
IV. AGRICULTURAL have at least one ___? the brgy hall to the nearest facility? of the ( AGRICULTURAL FACILITY)? address of the services/ facilities other services/ a government institution operates
FACILITY (SEE CODES BELOW) (AGRICULTURAL FACILITY)? present in the ___? facilities present project completed the facility?
in the ___? in the last 3 years?
IF CODES 3 OR 4, YES…1 NO….2 (SEE CODES BELOW)
SPECIFY PROV, CITY/MUN NO GO TO AF7 YES…1 NO….2
a. Rice Mill YES ……......
1 AF3 AF8
(fixed and mobile) NO …….. 2

CODES FOR 1 WITHIN 2 KM (INSIDE THE CITY/MUNICIPALITY) 3 WITHIN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY CODES FOR SF8 & AF8 4 CITY/MUNICIPAL GOVERNMENT 8 DON'T KNOW
SF2 & AF2 2 MORE THAN 2 KM (INSIDE THE CITY/MUNICIPALITY) 4 MORE THAN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY 1 PRIVATE (BUSINESS/PROFIT ORIENTED) 5 BARANGAY GOVERNMENT 9 NONE
8 DON’T KNOW 2 NATIONAL GOVERNMENT 6 GOVERNMENT-OWNED AND CONTROLLED CORPORATION
3 PROVINCIAL GOVERNMENT 7 NGOs/NON-PROFIT INSTITUTION SERVING HOUSEHOLD

CBMS Form 4 9 of 28
 B. Service Institutions and Infrastructure 4I
We would like to acquire sufficient information on the agricultural facilities that are operating in your barangay.
AF1. Does this barangay AF2. What is the distance of AF3. What is the name AF4. What is the AF5. Are there other AF6. What are AF7. Is the facility AF8. What type of
IV. AGRICULTURAL have at least one ___? the brgy hall to the nearest facility? of the ( AGRICULTURAL FACILITY)? address of the services/ facilities the other services/ a government institution operates
FACILITY (SEE CODES BELOW) (AGRICULTURAL FACILITY)? present in the ___? facilities present project completed the facility?
in the ___? in the last 3 years?
IF CODES 3 OR 4, YES…1 NO….2 (SEE CODES BELOW)
SPECIFY PROV, CITY/MUN NO GO TO AF7 YES…1 NO….2
b. Corn Mill YES ……......
1 AF3 AF8
(fixed and mobile) NO …….. 2

c. Feed Mill YES …....... 1 AF3 AF8

(fixed and mobile) NO …..... 2

d. Sugar Mill? YES …....... 1 AF3 AF8

(fixed and mobile) NO …..... 2

e. Mechanical/Electrical YES …....... 1 AF3 AF8

/Solar Dryer NO …..... 2
(coconut, rice, etc.)

f. Fish Landing Center YES …....... 1 AF3 AF8

NO …..... 2

g. Agriculture Produce YES …....... 1 AF3 AF8

Market (permanent/ NO …..... 2
bagsakan, and
periodic/talipapa/
weekend market)

h. Slaughterhouse/ YES …....... 1 AF3 AF8

Dressing Plant NO …..... 2

CODES FOR AF2 1 WITHIN 2 KM (INSIDE THE CITY/MUNICIPALITY) 3 WITHIN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY CODES FOR AF8 4 CITY/MUNICIPAL GOVERNMENT 8 DON'T KNOW
2 MORE THAN 2 KM (INSIDE THE CITY/MUNICIPALITY) 4 MORE THAN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY 1 PRIVATE (BUSINESS/PROFIT ORIENTED) 5 BARANGAY GOVERNMENT 9 NONE
8 DON’T KNOW 2 NATIONAL GOVERNMENT 6 GOVERNMENT-OWNED AND CONTROLLED CORPORATION
3 PROVINCIAL GOVERNMENT 7 NGOs/NON-PROFIT INSTITUTION SERVING HOUSEHOLD

CBMS Form 4 10 of 28
 B. Service Institutions and Infrastructure 4J
We would like to acquire sufficient information on the agricultural facilities that are operating in your barangay.
AF1. Does this barangay AF2. What is the distance of AF3. What is the name AF4. What is the AF5. Are there other AF6. What are AF7. Is the facility AF8. What type of
IV. AGRICULTURAL have at least one ___? the brgy hall to the nearest facility? of the ( AGRICULTURAL FACILITY)? address of the services/ facilities the other services/ a government institution operates
FACILITY (SEE CODES BELOW) (AGRICULTURAL FACILITY)? present in the ___? facilities present project completed the facility?
in the ___? in the last 3 years?
IF CODES 3 OR 4, YES…1 NO….2 (SEE CODES BELOW)
SPECIFY PROV, CITY/MUN NO GO TO AF7 YES…1 NO….2
i. NFA Warehouse YES ……......
1 AF3 AF8
NO …….. 2

j. Commercial YES …....... 1 AF3 AF8

Agriculture NO …..... 2
Warehouse

k. Layer Farm (poultry) YES …....... 1 AF3 AF8

NO …..... 2

l. Hatchery for YES …....... 1 AF3 AF8

Aquafarm Species NO …..... 2

m. Breeding/Multiplier YES …....... 1 AF3 AF8

Farm for Livestock NO …..... 2

n. Breeding Farm for YES …....... 1 AF3 AF8

Poultry NO …..... 2

o. Nursery/Greenhouse/ YES …....... 1 AF3 AF8

Screen House/ NO …..... 2
Nethouse

CODES FOR AF2 1 WITHIN 2 KM (INSIDE THE CITY/MUNICIPALITY) 3 WITHIN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY CODES FOR AF8 4 CITY/MUNICIPAL GOVERNMENT 8 DON'T KNOW
2 MORE THAN 2 KM (INSIDE THE CITY/MUNICIPALITY) 4 MORE THAN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY 1 PRIVATE (BUSINESS/PROFIT ORIENTED) 5 BARANGAY GOVERNMENT 9 NONE
8 DON’T KNOW 2 NATIONAL GOVERNMENT 6 GOVERNMENT-OWNED AND CONTROLLED CORPORATION
3 PROVINCIAL GOVERNMENT 7 NGOs/NON-PROFIT INSTITUTION SERVING HOUSEHOLD

CBMS Form 4 11 of 28
 B. Service Institutions and Infrastructure 4K
AF1. Does this barangay AF2. What is the distance of AF3. What is the name AF4. What is the AF5. Are there other AF6. What are AF7. Is the facility AF8. What type of
IV. AGRICULTURAL have at least one ___? the brgy hall to the nearest facility? of the ( AGRICULTURAL FACILITY)? address of the services/ facilities the other services/ a government institution operates
FACILITY (SEE CODES BELOW) (AGRICULTURAL FACILITY)? present in the ___? facilities present project completed the facility?
in the ___? in the last 3 years?
IF CODES 3 OR 4, YES…1 NO….2 (SEE CODES BELOW)
SPECIFY PROV, CITY/MUN NO GO TO AF7 YES…1 NO….2
p. Veterinary/ YES ……......
1 AF3 AF8
Para-veterinary Clinic? NO …….. 2

q. Others, specify_____ YES …....... 1 AF3

NO …..... 2 ID1

In this part, we would like to gather information about the input dealers that are present in your barangay.
ID1. Does this barangay ID2. What is the distance of ID3. What is the name ID4. What is the ID5. Are there other ID6. What are ID7. Is the facility ID8. What type of
V. INPUT DEALER have at least one ___? the brgy hall to the nearest facility? of the (INPUT DEALER)? address of the services/ facilities the other service/s a government institution operates
(SEE CODES BELOW) (INPUT DEALER)? present in the ___? facilities present project completed the facility?
in the ___? in the last 3 years?
IF CODES 3 OR 4, YES…1 NO….2 (SEE CODES BELOW)
SPECIFY PROV, CITY/MUN NO GO TO ID7 YES…1 NO….2
a. Agricultural Supplies YES ……......
1 ID3 ID8
Dealer (feeds, fertilizer, NO …….. 2
pesticide, seeds
/seedling)

b. Agriculture/Fishery YES …....... 1 ID3 ID8

Machine/ NO …..... 2
Equipment Dealer

c. Boat/Fishing YES …....... 1 ID3 ID8

Gear Dealer NO …..... 2

d. Veterinary Medicine YES …....... 1 ID3 ID8

Dealer NO …..... 2

e. Others, specify_____ YES …....... 1 ID3

NO …..... 2 WF1
CODES FOR 1 WITHIN 2 KM (INSIDE THE CITY/MUNICIPALITY) 3 WITHIN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY CODES FOR AF8 & ID8 4 CITY/MUNICIPAL GOVERNMENT 8 DON'T KNOW
AF2 & ID2 2 MORE THAN 2 KM (INSIDE THE CITY/MUNICIPALITY) 4 MORE THAN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY 1 PRIVATE (BUSINESS/PROFIT ORIENTED) 5 BARANGAY GOVERNMENT 9 NONE
8 DON’T KNOW 2 NATIONAL GOVERNMENT 6 GOVERNMENT-OWNED AND CONTROLLED CORPORATION
3 PROVINCIAL GOVERNMENT 7 NGOs/NON-PROFIT INSTITUTION SERVING HOUSEHOLD

CBMS Form 4 12 of 28
 B. Service Institutions and Infrastructure 4L
Now, we would like to seek information on the different water facilities that are functioning in your barangay.
WF1. Does this barangay WF2. What is the distance of WF3. What is the name WF4. What is the WF5. Is the WF6. Are there WF7. What are WF8. Is the facility WF9. What type of
VI. WATER have at least one ___? the brgy hall to the nearest facility? of the (WATER FACILITY)? address of the source located services/ facilities the other services/ a government institution operates
FACILITY (SEE CODES BELOW) (WATER FACILITY)? in the barangay? present in the ___? facilities present project completed the facility?
in the ___? in the last 3 years?
IF CODES 3 OR 4, YES…1 NO….2 YES…1 NO….2 (SEE CODES BELOW)
SPECIFY PROV, CITY/MUN NO GO TO WF8 YES…1 NO….2
a. Deep Well YES ……......
1 WF3 WF9
(Level I) NO …….. 2

b. Artesian Well YES …....... 1 WF3 WF9

(Level I) NO …..... 2

c. Shallow Well YES ……......

1 WF3 WF9
(Level I) NO …….. 2

d. Water Refill YES …....... 1 WF3 WF9

Station NO …..... 2

e. Level II Water …....... 1 WF3 WF9

System …..... 2
(Communal
Faucet System
or Standposts)

f. Level III Water YES …....... 1 WF3 WF9

system (reservoir, NO …..... 2
piped distribution
within adequate
network)
g. Others, specify YES …....... 1 WF3
NO …..... 2 E
CODES FOR WF2 1 WITHIN 2 KM (INSIDE THE CITY/MUNICIPALITY) 3 WITHIN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY CODES FOR WF9 CITY/MUNICIPAL GOVERNMENT 8 DON'T KNOW
2 MORE THAN 2 KM (INSIDE THE CITY/MUNICIPALITY) 4 MORE THAN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY 1 PRIVATE (BUSINESS/PROFIT ORIENTED) BARANGAY GOVERNMENT 9 NONE
8 DON’T KNOW 2 NATIONAL GOVERNMENT GOVERNMENT-OWNED AND CONTROLLED CORPORATION
3 PROVINCIAL GOVERNMENT NGOs/NON-PROFIT INSTITUTION SERVING HOUSEHOLD

CBMS Form 4 13 of 28
 B. Service Institutions and Infrastructure 4N
In this part, we would like to know the the different electricity sources that are being used in your barangay.
E.0 Is electricity available within the barangay? YES 1
NO 2 E7.
E1. Does this barangay E2. What is the name E3. What is the E4. Is there an electric E5. What type of E6. Is the facility a
VII. SOURCE OF have at least one ___? of the (Source of Electricity)? address of the substation present institution operates government project completed
ELECTRICITY (Source of Electricity)? in the barangay? the facility? in the last 3 years?
YES…1 NO….2 (SEE CODES BELOW) YES…1 NO….2

a. Electric company YES ……......

1
NO …….. 2 b

b. Hydroelectric Power YES ……......

1
Plant NO …….. 2 c

c. Geothermal Power YES ……......

1
Station NO …….. 2 d

d. Wind Farm YES ……......

1
NO …….. 2 e

e. Non-Renewable Power YES ……...... 1

Plant/Station (Coal, Diesel,NO …….. 2 f
Natural Gas, Nuclear)
f. Others, specify YES ……......
1
NO …….. 2 E7
E7. Are the following sources of electricity available CODES FOR CI2 CODES FOR E5 & CI8
in the barangay hall? YES …..... 1 1 WITHIN 2 KM (INSIDE THE CITY/MUNICIPALITY) 1 PRIVATE (BUSINESS/PROFIT ORIENTED) 6 GOVERNMENT-OWNED AND CONTROLLED CORPORATION
NO …..... 2 2 MORE THAN 2 KM (INSIDE THE CITY/MUNICIPALITY) 2 NATIONAL GOVERNMENT 7 NGOs/NON-PROFIT INSTITUTION SERVING HOUSEHOLD
a. Generator 3 WITHIN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY 3 PROVINCIAL GOVERNMENT 8 DON'T KNOW
b. Solar 4 MORE THAN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY 4 CITY/MUNICIPAL GOVERNMENT 9 NONE
c. Battery 8 DON’T KNOW 5 BARANGAY GOVERNMENT
In this section, we would like learn about the different financial and credit institution that can be found in your barangay.
CI1. Does this barangay CI2. What is the distance of CI3. What is the name CI4. What is the CI5. Are there CI6. What are CI7. Is the facility CI8. What type of
VIII. FINANCIAL & CREDIT have at least one ___? the brgy hall to the nearest facility? of the (CREDIT INSTITUTIONS)? address of the services/ facilities other services/ a government institution operates
INSTITUTIONS (SEE CODES ABOVE) (CREDIT INSTITUTIONS)? present in the ___? facilities present project completed the facility?
in the ___? in the last 3 years?
IF CODES 3 OR 4, YES…1 NO….2 (SEE CODES ABOVE)
SPECIFY PROV, CITY/MUN NO GO TO CI7 YES…1 NO….2
a. Bank YES ……......
1 CI3 CI8
NO …….. 2

b. Community/Barangay YES …....... 1 CI3 CI8

Cooperative NO …..... 2

CBMS Form 4 14 of 28
 B. Service Institutions and Infrastructure 4O
CI1. Does this barangay CI2. What is the distance of CI3. What is the name CI4. What is the CI5. Are there other CI6. What are CI7. Is the facility CI8. What type of
VIII. FINANCIAL & CREDIT have at least one ___? the brgy hall to the nearest facility? of the (CREDIT INSTITUTIONS)? address of the services/ facilities the other services/ a government institution operates
INSTITUTIONS (SEE CODES ABOVE) (CREDIT INSTITUTIONS)? present in the ___? facilities present project completed the facility?
in the ___? in the last 3 years?
IF CODES 3 OR 4, YES…1 NO….2 (SEE CODES BELOW)
SPECIFY PROV, CITY/MUN NO GO TO CI7 YES…1 NO….2
c. Microfinance NGOs YES ……......
1 CI3 CI8
NO …….. 2

d. Pawnshops YES ……......

1 CI3 CI8
NO …….. 2

e. Others, specify YES …....... 1 CI3 CI8

NO …..... 2

In this section, we would like learn about the different tourism sites and destinations that can be found in your barangay.
T1. Are there any of the tourism sites and YES …........... 1
destination present in the barangay? NO ….......... 2 T10
T2. Does this barangay T3. What is the distance of T4. What is the name T5. What is the T6. Are there other T7. What are the T8. Is the facility T9. What type of
IX. TOURISM have at least one ___? the brgy hall to the nearest facility? of the (TOURISM SITES & DESTINATION)? address of the services/ facilities other services/ a government institution operates
SITES AND DESTINATIONS (SEE CODES BELOW) (TOURISM SITES & DESTINATION)? present in the ___? facilities present project completed the facility?
in the ___? in the last 3 years?
IF CODES 3 OR 4, YES…1 NO….2 (SEE CODES BELOW)
SPECIFY PROV, CITY/MUN NO GO TO T8 YES…1 NO….2
a. Natural Sites YES ……......
1 T4 T9
(nature parks, reserves, NO …….. 2
zoos, aquaria, and
botanical garden)

b. Tourist Attraction YES …....... 1 T4 T9

(museums, religious NO …..... 2
sites, historical
landmark)

c. Theme/Amusement YES …....... 1 T4 T9

Parks NO …..... 2

d. Historical
Other YES …....... 1 T4
Tourism Site/ NO …..... 2 T10
Attraction
CODES FOR 1 WITHIN 2 KM (INSIDE THE CITY/MUNICIPALITY) 3 WITHIN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY CODES FOR CI8 & T9 4 CITY/MUNICIPAL GOVERNMENT 8 DON'T KNOW
CI2 & T3 2 MORE THAN 2 KM (INSIDE THE CITY/MUNICIPALITY) 4 MORE THAN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY 1 PRIVATE (BUSINESS/PROFIT ORIENTED) 5 BARANGAY GOVERNMENT 9 NONE
8 DON’T KNOW 2 NATIONAL GOVERNMENT 6 GOVERNMENT-OWNED AND CONTROLLED CORPORATION
3 PROVINCIAL GOVERNMENT 7 NGOs/NON-PROFIT INSTITUTION SERVING HOUSEHOLD

CBMS Form 4 15 of 28
 B. Service Institutions and Infrastructure 4O
T10 Does your barangay engage in tourism activities? YES ….......... 1
NO ….......... 2
We would like to know if there are transportation terminals (airport, seaport, bus, tricycle, jeepney and etc) situated in your barangay.
PT1. What is the name of the PT2. What is the address of the PT3. What type of institution PT4. Is the facility a government project
X. TRANSPORT FACILITY (Transport Facility)? (Transport Facility)? operates the facility? completed in the last 3 years?
(SEE CODES BELOW) YES…1 NO….2

Pta. Is there a seaport located YES …. 1

in the barangay NO …. 2 PTb
Ptb. Is there an airport located YES …. 1
in the barangay NO …. 2 Ptc
Ptc. Is there a terminal (bus, jeepney, YES …. 1
tricycle) located in the barangay NO …. 2 G1

Now, we would like to get information on the different garbage and waste disposal facilities that are running in your barangay.
G1. Does this barangay G2. What is the distance of G3. What is the name G4. What is the G5. Are there other G6. What are the G7. Is the facility G8. What type of
XI.GARBAGE AND have at least one ___? the brgy hall to the nearest facility? of the address of the services/ facilities other services/ a government institution operates
WASTE DISPOSAL (SEE CODES BELOW) (WASTE DISPOSAL FACILITY)? (WASTE DISPOSAL FACILITY)? present in the ___? facilities present project completed the facility?
FACILITY in the ___? in the last 3 years?
IF CODES 3 OR 4, YES…1 NO….2 (SEE CODES BELOW)
SPECIFY PROV, CITY/MUN NO GO TO G7 YES…1 NO….2
a. Open Dump Site YES ……......
1 G3 G8
NO …….. 2
b. Sanitary Landfill YES ……......
1 G3 G8
NO …….. 2
c. Barangay YES …....... 1 G3 G8
Compost Pits NO …..... 2

d. Material Recovery YES …....... 1 G3 G8

Facility (MRF) NO …..... 2

e. Waste-to-Energy YES …....... 1 G3 G8

Facility NO …..... 2

f. Sewage Treatment YES …....... 1 G3 G8

Plant NO …..... 2

g. Treatment, Storage, and YES …....... 1 G3 G8

Disposal (TSD) Facility NO …..... 2

h. Others, specify YES …....... 1 G3

NO …..... 2 WD1

CODES FOR G2 1 WITHIN 2 KM (INSIDE THE CITY/MUNICIPALITY) 3 WITHIN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY CODES FOR PT3 & G8 4 CITY/MUNICIPAL GOVERNMENT 8 DON'T KNOW
2 MORE THAN 2 KM (INSIDE THE CITY/MUNICIPALITY) 4 MORE THAN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY 1 PRIVATE (BUSINESS/PROFIT ORIENTED) 5 BARANGAY GOVERNMENT 9 NONE
8 DON’T KNOW 2 NATIONAL GOVERNMENT 6 GOVERNMENT-OWNED AND CONTROLLED CORPORATION
3 PROVINCIAL GOVERNMENT 7 NGOs/NON-PROFIT INSTITUTION SERVING HOUSEHOLD

CBMS Form 4 16 of 28
 4Q B. Service Institutions and Infrastructure
WD1 Are the following waste collection equipment available WD2. How many units are
in the barangay? being used by the
TYPE OF WASTE COLLECTION EQUIPMENT barangay?
A. Collection Trucks YES …..... 1
NO …..... 2 WD1B
B. Waste Collection Bins YES …..... 1
NO …..... 2 WD1C
C. Incinerators YES …..... 1
NO …..... 2 WD1D
D. Others, specify___________ YES …..... 1
NO …..... 2 WD3
WD3 Who primarily collects the garbage from households? SEE CODES BELOW WD4 How often are garbage
IF CODE '9' PROCEED TO NEXT collected from households?
CLASSIFICATION OF WASTE
CLASSIFICATION OF WASTE
A. Biodegradable/compostable SPECIFY SPECIFY

B. Recyclables SPECIFY SPECIFY

C. Residuals (nonhazardous industrial waste) SPECIFY SPECIFY

D. Special wastes (medical/clinical waste,
electrical waste, chemical waste) SPECIFY SPECIFY
CODES FOR WD3 CODES FOR WD4
MUNICIPAL COLLECTOR …..... 1 "BOTE DYARYO", WASTE PICKERS …. 4 DAILY ….................... 1 ….................. 4
ONCE A WEEK
BARANGAY COLLECTOR …..... 2 OTHERS, SPECIFY _______ ….......... 5 THRICE A WEEK …..... 2 OTHERS, SPECIFY _____ 5
PRIVATE COLLECTOR (ESTABLISHMENT) …..... 3 NONE …............... 9 TWICE A WEEK …..... 3
WD5. Does this barangay collect garbage from households even YES …..…................................... 1
if these are not properly segregated? NO …..…................................... 2
…..…...................................
NOT APPLICABLE 8
WD6. Does this barangay pay the municipal/city/provincial LGU for YES …..…................................... 1
waste management services? NO PAYMENT FEE ….................... 2 WD8.
WD7. How much does the barangay pay for waste management services
for the whole year? (in PhP) …................................................... .
WD8. Is the current garbage collection system able to YES …..…................................... 1 MT1.
serve the whole barangay? NO …..…................................... 2
…..…...................................
NOT APPLICABLE 8 MT1.
WD9. What specific areas (zone/purok/sitio) are not reached
by the barangay and city/municipal garbage collectors?
In this part, we would like to gather information on the different modes of transportation available in your barangay.
MT1. Is (MODE OF TRANSPORTATION) available or in operation in the barangay?
a. Bus YES …..…................................... 1
NO …..…................................... 2
b. Regular Taxi YES …..…................................... 1
NO …..…................................... 2
c. TNVS car (Grab, MiCab, etc.) YES …..…................................... 1
NO …..…................................... 2
d. TNVS motorcycle (JoyRide, Angkas, etc.) YES …..…................................... 1
NO …..…................................... 2
e. Van/FX YES …..…................................... 1
NO …..…................................... 2
f. Jeepney YES …..…................................... 1
NO …..…................................... 2
g Tricycle YES …..…................................... 1
NO …..…................................... 2
h Pedicab YES …..…................................... 1
NO …..…................................... 2
i Boat/Motorized Banca YES …..…................................... 1
NO …..…................................... 2
j Train YES …..…................................... 1
NO …..…................................... 2
k Motorcycle (Habal-habal, skylab etc) YES …..…................................... 1
NO …..…................................... 2
l Others, specify _____________ YES …..…................................... 1
NO …..…................................... 2
MT2. What is the distance of the barangay hall to the nearest public
land transport or railroad terminal? (in kms) .
C. Information and Communications Technology
Now, we would like to know the different information and communication technology facility and its uses in your barangay.
IT1. Is cellphone network signal available in the barangay? YES …..…................................... 1
NO …..…................................... 2 IT4.
IT1.1 What is the available cellphone network signal in the barangay? 2G (E or G) ….......................... 1
3G (H or 3G+ or H+) ….......... 2
4G (LTE or 4G+ or LTE-A) …..3
5G …..…..…..…..…..…..…..…..…..4
CBMS Form 4
17 of 28
 C. Information and Communications Technology 4R
IT2. Is there an existing telecommunication/cellular tower/s YES …........................................ 1
in the barangay? NO …........................................ 2 IT4.
IT3. How many are the existing telecommunication/cellular tower/s
in the barangay? …...............................................................
IT4. Is free Wi-Fi available in the barangay? YES …........................................ 1
NO …........................................ 2 IT6.
IT4.1 What is the coverage of the free Wi-Fi? WHOLE BARANGAY ….........1
SELECTED AREAS IN THE
BARANGAY ….…................... 2
BARANGAY HALL..................................
ONLY 3
..................................
..................................
OTHERS, SPECIFY … 4

IT5. Who provides the free Wi-Fi in the barangay? PRIVATELY-OWNED ….............. A
GOVERNMENT-OWNED …..... B
IT6. Which of the following ICT equipment in the barangay TELEPHONES/CELLPHONES ….........A
can be used by the public for free? COMPUTERS (DESKTOP,
LAPTOP,TABLET) ….…................... B
FAX MACHINES
..................................
..................................
.................................. C
..................................
..................................
..................................
PRINTERS ….............................. D
AUDIO-VISUAL EQUIPMENT
(PROJECTOR, MICROPHONE,
SPEAKER) ….................................... E
OTHERS, SPECIFY … F
NONE …................................................ Z
.
IT7. Are there Fiber Optic Cables installed in the barangay hall? YES …........................................ 1
NO …........................................ 2
IT8. Does this barangay use computers (desktop, laptop, tablet, etc.) YES …........................................ 1
in providing government services such as barangay clearance, NO …........................................ 2
community tax certificate, etc.?
IT9. How do barangay clients usually fill out their forms MANUAL ACCOMPLISHMENT
for their transactions in the barangay? OF FORMS …........................ A
DIRECT ENCODING TO A
COMPUTER BY BARANGAY
PERSONNEL ….................... B
DIRECT ENCODING TO A
COMPUTER BY CLIENT … C
OTHERS, SPECIFY ____________ D
IT10. Does this barangay maintain a computerized database? YES …........................................ 1
NO …........................................ 2
IT11. Does this barangay have a hired IT personnel? YES …........................................ 1
NO …........................................ 2 IT13.
IT12. How many IT personnel are working in the barangay
performing IT functions? …....................................................................
IT13. Does this barangay have an official website (gov.ph) YES …........................................ 1
(to disseminate news, provide barangay services, etc.)? NO …........................................ 2 IT15.
IT14. What is the official website Uniform Resource Locator (URL)
of the barangay?
IT15. Does this barangay have a social media account YES …........................................ 1
operated by the LGU? NO …........................................ 2 IT17.
IT16. What is the social media account page URL
of the barangay?
IT17. Does this barangay have a specific local strategy on YES …........................................ 1
new technologies such as the use of social media to disseminate NO …........................................ 2 IT19.
information, online selling and buying of goods, and use of online
facilities to request services from the barangay, etc.?
IT18. Please provide the URL to the document containing the
local strategy on new technologies.
OR Please attach a photo copy of the file

IT19. Does this barangay implement an e-Government Strategy? YES …........................................ 1

NO …........................................ 2 IT21.
IT20. Please provide the URL to the document containing the
e-government strategy.
OR Please attach a photo copy of the file
IT21. Does this barangay use ICT equipment/ facilities for YES …........................................ 1
security purposes? (e.g., CCTV) NO …........................................ 2
D. Significant Events of the Barangay
Now, we would like to gather information on the significant events that had occurred in your barangay.
S1. From 01 July 2019 to 30 June 2021, how many times did the event occur and/or negatively affected the barangay?
PUT NUMBERS IN THE BOX PROVIDED
a. Climate-related and geologic events
typhoon flooding storm dry spell/ earth- landslide/ volcanic tsunami forest
surge drought quake mudslide eruption fire
b. Economic Events
closure of closure of opening of opening of mass opening of opening of
small firms large firm/s large firm/s small firm/s lay-off shopping malls fastfood
restaurant/s
c. Health and agriculture-related events
epidemic pest livestock/poultry fish kill
pandemic infestation diseases
d. Peace and order events OTHERS, SPECIFY
fire armed
conflict

CBMS Form 4 18 of 28
 4S D. Significant Events of the Barangay
S2. Based on report to barangay, what are the reasons
for the closure of (small/large) firms during the period
(01 July 2019 to 30 June 2021)? SPECIFY
CODES FOR S2, S4, S5 RETRENCHMENT TO PREVENT LOSSES … D EPIDEMIC/PANDEMIC …......... H
CHANGE IN MANAGEMENT/MERGER A COMMISSION OF CRIME/OFFENSES ….......... E GOVERNMENT DECISION …..... I
FINANCIAL LOSSES …............................ B NATURAL CALAMITY …................................... F OTHERS, SPECIFY …J
LACK OF CAPITAL …............................ C MAN-MADE CALAMITY ….............................. G
S3. From 01 July 2021 to 30 June 2022, how many times did the event occur and/or negatively affected the barangay?
PUT NUMBERS IN THE BOX PROVIDED
a. Climate-related and geologic events
typhoon flooding storm dry spell/ earth- landslide/ volcanic tsunami forest
surge drought quake mudslide eruption fire
b. Economic Events
closure of closure of opening of opening of mass opening of opening of
small firms large firm/s large firm/s small firm/s lay-off shopping malls fastfood
c. Health and agriculture-related events restaurant/s
epidemic pest livestock/poultry fish kill
pandemic infestation diseases
d. Peace and order events OTHERS, SPECIFY
fire armed
conflict

S4. Based on report to barangay, what are the main reasons

for the closure of small firms during the period
01 July 2021 to 30 June 2022? SPECIFY
S5. Based on report to barangay, what are the main reasons
for the closure of large firms during the period
01 July 2021 to 30 June 2022? SPECIFY
E. Disaster Risk Reduction and Management
Now, we would like to talk about the disaster preparedness of the barangay.

DP1. Does this barangay have a written disaster YES …........................................ 1

risk reduction and management plan? NO …........................................ 2
DP2. Does this barangay have a disaster YES …........................................ 1
management committee? NO …........................................ 2
DP3. Does this barangay have a disaster/emergency response team? YES …........................................ 1
NO …........................................ 2
DP4. Does this barangay have an organization’s plan of succession YES …........................................ 1
during an emergency? NO …........................................ 2
DP5. Does this barangay have a disaster/emergency hotline? YES …........................................ 1
NO …........................................ 2 DP7.
DP6. What is the barangay's disaster/emergency hotline?
…...............................
DP7. Does this barangay have disaster preparedness guide YES …........................................ 1
for persons with disabilities (PWDs)? NO …........................................ 2
DP8. Are you aware of government digital platforms for YES …........................................ 1
Disaster Risk Reduction and Climate Change NO …........................................ 2
Adaptation (DRR-CCA) that may be used in the
formulation of this barangay's DRR-CCA plans?

DP9. Does this barangay have a DP10. Does this barangay have a
TYPE OF DISASTER localized early warning system disaster contingency plan
for (TYPE OF DISASTER)? for (TYPE OF DISASTER)?
YES …............................ 1
NO …............................ 2
NOT APPLICABLE …... 3
a Typhoon

b Flooding

c Drought

d Earthquake

e Volcanic eruption

f Landslide

g Tsunami

h Storm surge

i Epidemic/pandemic

j Others, specify

CBMS Form 4 19 of 28
 E. Disaster Risk Reduction and Management 4T
DP11. Does this barangay have an evacuation map? YES …........................................ 1
NO …........................................ 2 DP13.
DP12. For what hazard was the evacuation map used? FLOOD ...................................... A
LANDSLIDE ............................ B
STORM SURGE …................... C
EARTHQUAKE …................... D
TSUNAMI …............................. E
VOLCANIC ERUPTION ….......... F
OTHERS, SPECIFY __________… G
DP13. Does this barangay have a hazard map? YES …........................................ 1
NO …........................................ 2 DP15.
DP14. For what hazards was the hazard map used? FLOOD ...................................... A
LANDSLIDE ............................ B
STORM SURGE …................... C
EARTHQUAKE …................... D
TSUNAMI …............................. E
VOLCANIC ERUPTION ….......... F
OTHERS, SPECIFY __________… G
DP15. In the past 12 months ( 01 July 2021 to 30 June 2022), did YES …........................................ 1
this barangay LGU conduct disaster preparedness seminars NO …........................................ 2
(maybe funded by LGU or Non-Government Agency (NGA))?
DP16. In the past 12 months ( 01 July 2021 to 30 June 2022), were YES …........................................ 1
there disaster kits provided (maybe funded by LGU or NGA) NO …........................................ 2
to the barangay LGU?
DP17. Does this barangay have an evacuation facility? YES …........................................ 1
NO …........................................ 2 Part II

DP18. DP19. DP20. DP21. DP22. DP23. DP24 DP25 DP26.

Enumerate the location/s How What is the capacity In which Does the Does the Does the Does the Does the
of evacuation centers would you of the evacuation types facility have facility have facility have facility facility
in the barangay. categorize center? of disasters access to access to an operational have a have
this was this safe drinking sanitary handwashing disinfection medical
evacuation How many persons evacuation water? toilets? area? area? kits?
center? can fit inside the center has
evacuation center? been used?
(SEE (SEE
1 - YES 2 - NO
CODES CODES
BELOW) BELOW)

SPECIFY SPECIFY

SPECIFY SPECIFY

SPECIFY SPECIFY

SPECIFY SPECIFY
CODES FOR DP19 CODES FOR DP21
1 SCHOOL BUILDING 4 BARANGAY HALL A TYPHOON D EARTHQUAKE G TSUNAMI J EPIDEMIC/PANDEMIC
2 DEDICATED EVACUATION 5 OTHERS, B FLOODING E VOLCANIC ERUPTION H FOREST FIRE K ARMED CONFLICT
CENTER SPECIFY ______ C DROUGHT F LANDSLIDE I FIRE L OTHERS, SPECIFY ____
3 GYM/COVERED COURT M - NOT USED

CBMS Form 4 20 of 28
 4U PART II. BARANGAY LGU AND RECORD-BASED DATA
At this juncture, we would like to obtain general information that are related to your Barangay Local Government Unit.
A. General Information about the Barangay Local Government Unit
A1. How many are males aged _____ as of A2. How many are females aged _____ as of
Barangay Officials/ 01 July 2022? 01 July 2022?
Appointees/Workers 15 to 30 years old 31 to 59 years old 60 and above 15 to 30 years old 31 to 59 years old 60 and above

a. Captain

b. Kagawad

c. Secretary

d. Treasurer

e. Tanod
f. Health worker (BHW, Doctor,
Nurse, Midwife)
g. Nutrition scholar

h. Purok leader

i. ENR officer

j. SK Chairman

k. Day care worker

l. Utility worker

m. Others (e.g. Clerk), specify:

Title of Source document: Data source agency/unit:

AA. Business Units in the Barangay
We would like to get information on the business units that are operating in your barangay.
A3. How many business units are in the barangay as of 01 July 2022?
Sector Number of business units Sector Number of business units

a. Agriculture, forestry, and fishing l. Real estate activities

m. Professional, scientific, and technical

b. Mining and quarrying
services
n. Administrative and support
c. Manufacturing
service activities
d. Electricity, gas, steam, and air o. Education
conditioning supply
e. Water supply, sewerage, waste
p. Human health and social work activities
management and remediation activities

f. Construction q. Arts, entertainment, and recreation

g. Wholesale and retail trade; repair of

motor vehicles and motorcycles r. Activities of extraterritorial organizations
and bodies
h. Transportation and storage

i. Accommodation and food service

s. Other service activities
activities

j. Information and communication REMARKS:

k. Financial and insurance activities

Title of Source document: Data source agency/unit:

We would like to get information on the volunteerism in your barangay.
B. Volunteerism in the Barangay
B1. What were the volunteer service organizations/Volunteer Involving Organizations which extended help to the barangay in the past 12 months?
Name of Volunteer Service Organization/
B2. Sector/ Thematic Area B3. Number of Volunteers
Volunteer Involving Organizations

SPECIFY

SPECIFY

SPECIFY

SPECIFY
CODES FOR SECTOR/THEMATIC AREA
Agriculture …............. A Peace and Security …........... D Education …........................................
G Social Services …........... J
Environment …....... B Industry …..................................
E Governance ….................................. H Others, Specify …........... K
Health …................. C Services …..................................
F Job creation/income generation … I

CBMS Form 4 21 of 28
 PART II. BARANGAY LGU AND RECORDS-BASED DATA 4V
We would like to obtain information about the road networks that are seen in your barangay.
C. Road Networks
C1. Are there C2. What is the name of the ______ C3. What is the C4. What type of C5. What is the
(type of road surface) road? length of the road/ institution present condition
roads/streets present street? maintains the of the road?
in the barangay? (in km.) road/street? (SEE CODES
(SEE CODES BELOW) BELOW)

I. Paved Concrete YES … 1 a.

NO … 2 b.
if NO go to next type c.
of road d.
e.
f.
II. Paved Asphalt YES … 1 a.
NO … 2 b.
if NO go to next type c.
of road d.
e.
f.
III. Unpaved Gravel YES … 1 a.
NO … 2 b.
if NO go to next type c.
of road d.
e.
f.
IV. Unpaved Earth YES … 1 a.
NO … 2 b.
if NO go to D1 c.
d.
e.
f.
CODES FOR C4 1 PRIVATE 5 BARANGAY GOVERNMENT CODES FOR C5 1 GOOD 4 BAD
2 NATIONAL GOVERNMENT 6 OTHERS, SPECIFY _____ 2 FAIR 5 NO ASSESSMENT
3 PROVINCIAL GOVERNMENT 7 NONE 3 POOR
4 MUNICIPAL/CITY GOVERNMENT 8 DON’T KNOW

In this section, we would like to discuss about the crimes/cases that were reported in your barangay.
D. Crime
D1. Does this barangay have D2. How many D3. How many
reported cases on the following cases were cases were
crimes/cases during the past reported to resolved with the
D4. How many were male D5. How many were female D6.Total number of
12 months (01 July 2021 the police? assistance of the
victims of crime? victims of crime? victims
to 30 June 2022)? barangay LGU?
1 - YES 2 - NO
IF NO GO TO NEXT CRIME
a. Theft of personal
property (pickpocketing
other thefts)
b. Robbery (theft by
using violence)
c. Psychological
(mobbing, stalking)
violence
d. Sexual offenses
(sexual assault, rape)
e. Fraud (cheating,
credit card,
internet fraud)

CBMS Form 4 22 of 28
 PART II. BARANGAY LGU AND RECORDS-BASED DATA 4W
D. Crime
D1. Does this barangay have D2. How many D3. How many
reported cases on the following cases were cases were
crimes/cases during the past reported to resolved with the D5. How many were
D4. How many were D6. Total number of
12 months (01 July 2021 the police? assistance of the female victims of
to 30 June 2022)? barangay LGU?
male victims of crime? victims
crime?
1 - YES 2 - NO
if NO go to next crime
f. Corruption/ bribery

g. Exposure to illegal
drugs
h. Vehicle theft (motor
vehicle, car, motorcycle,
bicycle; theft from vehicles)
i. Housebreaking
(domestic burglary,
attempted burglary)
j. Vandalism (damage
to cars, graffiti)

k. Assault and threat

l. Others, specify_____

Now, we would like to record the disaster supplies and equiment that are available in your barangay.
E. Disaster Supplies/Equipment
DE1. How many of the following disaster/ emergency response equipment does the barangay own as of 01 July 2022?

a. first aid kits (piece) l. searchlights (piece) u. barricade (piece)

m. protective gear
b. vaccines (piece) v. tent, divider (piece)
(helmet, life vest) (piece)
c. cadaver bags (piece) n. medical grade PPE sets w. basic medicines (piece)
(face mask, face shield, gloves,
d. boats/vans/buses (unit) surgical/ isolation gown, etc.) (piece) x. gasoline (liter)
e. ambulance/ amphibian/ o. reflectorized vest (piece) y. portable generator,
vehicle/ backhoe/ dumptruck/ solar powered generator,
crawler/ tractor/ scoop loader (unit) flashlights, and extra batteries
p. extrication kit
f. siren (piece) z. potable water (liter)
(spine board, shovel, jack
hammer, or alternative aa. food packs (rice,
g. megaphone (piece)
digging device) (piece) canned goods, noodles,
q. chainsaw, bolo, shovel, ready-to-eat meals)
h. whistle (piece)
water pump (piece) (piece)
i. two-way radio and other r. ladder (piece) bb. sanitation supplies (piece)
communication equipment (alcohol, disinfectant, etc.)
(including satellite phone) (piece)
j. GPS/ GIS device, s. caution tape (piece) cc. hygiene kits (piece) (soap,
drone (piece) toothbrush, toothpaste, etc.)
k. ropes and throw bags
t. K9 unit (unit) dd. others, specify ______
(piece)

In this part, we would like to obtain information about the budget, revenue, and expenditure in your barangay
F. BUDGET, REVENUE, and EXPENDITURE
E1. How much was the budget
E2. How much was the revenue of the E3. How much did the barangay LGU
YEAR allocated for the barangay LGU
barangay LGU in ___________? spend in __________?
operations in _________?
2019

2020

2021
( January - June 2022) ( January - June 2022)
2022

E4. Title of source document _______________________________ E5. Data source agency/unit: _________________________

CBMS Form 4 23 of 28
 4X PART II. BARANGAY LGU AND RECORDS-BASED DATA
G. Programs, Projects, and Activities (Based on the Barangay Annual Investment Program)
Now, we would like to gain information on the different programs, activities, and projects that are being implemented in your barangay.

I. NON-INFRASTRUCTURE (SOCIAL, ECONOMIC, AND AGRICULTURAL) DEVELOPMENT DURING THE PAST YEAR ( 01 July 2021 to 30 June 2022)

Line SE1. What is the title SE2. Please provide a brief SE3. How much was allotted SE4. What is the status SE5. Who/what sector/s SE6. Did the PPA SE7. What is the title of SE8. Which barangay unit
no of the PPA? description of the PPA? for the PPA (in PhP)? of the PPA as of benefited from engage volunteers? source document that keeps/maintains the
01 July 2022? the PPA? contains information information/source
about the PPA? document about the PPA?
(SEE CODES BELOW)

YES … 1
01 . NO … 2

YES … 1
02 . NO … 2

YES … 1
03 . NO … 2

YES … 1
04 . NO … 2

YES … 1
05 . NO … 2

YES … 1
06 . NO … 2

YES … 1
07 . NO … 2

YES … 1
08 . NO … 2

CODES FOR SE4 1 PROPOSED 4 COMPLETED

2 FUNDED 5 DISCONTINUED
3 ONGOING

CBMS Form 4 24 of 28
 PART II. BARANGAY LGU AND RECORDS-BASED DATA 4Y
G. Programs, Projects, and Activities (Based on the Barangay Annual Investment Program)
Now, we would like to gain information on the different government infrastructure projects that are being planned/constructed in your barangay.

II. INFRASTRUCTURE DEVELOPMENT DURING THE PAST 3 YEARS (01 July 2019 to 30 June 2022)

Line I1. What is the title I2. In which I3. Where is the government I4. How much was allotted I5. When did the I6. What is the status I7. When was the I8. When is the I9. What is the title of I10. Which barangay unit
no. of the government sector is the infrastructure project for the government government of the government government expected source document that keeps/maintains the
infrastructure government located? infrastructure project (in PhP)? infrastructure infrastructure project as of infrastructure project completion of the contains information information/source
project? infrastructure project 01 July 2022? completed (mm/yyyy)? government about the government document about the
project expected (Indicate street address.) construction (SEE CODES BELOW) infrastructure infrastructure government
to contribute to? start IF CODES 1, 2, 3 & 5 project (mm/yyyy)? project? infrastructure
(SEE CODES (mm/yyyy)? GO TO I8 project?
BELOW)

01 .
SPECIFY
`

02 .
SPECIFY

03 .
SPECIFY

04 .
SPECIFY

05 .
SPECIFY

06 .
SPECIFY
CODES FOR I2 1 HEALTH 4 AGRICULTURE 7 TOURISM CODES FOR I6 1 PROPOSED 4 COMPLETED
2 EDUCATION 5 WATER 8 OTHERS, SPECIFY ____________ 2 FUNDED 5 DISCONTINUED
3 SERVICE 6 GARBAGE AND WASTE DISPOSAL 3 ONGOING 6 NOT FUNCTIONAL

CBMS Form 4 25 of 28
 B. Service Institutions and Infrastructure 4Z
In case of multiple entries in the service institutions and infrastructures, you may use this additional sheet.
1. Does this barangay 2. What is the distance of 3. What is the name 4. What is the 5. Are there other 6. What are the 7. Is the facility 8. What type of
TYPE OF FACILITY have at least one ___? the brgy hall to the nearest facility? of the (TYPE OF FACILITY)? address of the services/ facilities other services/ a government institution operates
(SEE CODES BELOW) (TYPE OF FACILITY)? present in the ___? facilities present project completed the facility?
IF CODES 3 OR 4, YES…1 NO….2 in the ___? in the last 3 years? (SEE CODES BELOW)
SPECIFY PROV, CITY/MUN NO GO TO 7 YES…1 NO….2
YES ……......
1 3 8
NO …….. 2

YES …....... 1 3 8
NO …..... 2

YES …....... 1 3 8
NO …..... 2

YES …....... 1 3 8
NO …..... 2

YES …....... 1 3 8
NO …..... 2

YES …....... 1 3 8
NO …..... 2

YES …....... 1 3 8
NO …..... 2

CODES FOR 2 1 WITHIN 2 KM (INSIDE THE CITY/MUNICIPALITY) 3 WITHIN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY CODES FOR 8 4 CITY/MUNICIPAL GOVERNMENT 8 DON'T KNOW
2 MORE THAN 2 KM (INSIDE THE CITY/MUNICIPALITY) 4 MORE THAN 2 KM (OUTSIDE THE CITY/MUNICIPALITY), SPECIFY 1 PRIVATE (BUSINESS/PROFIT ORIENTED) 5 BARANGAY GOVERNMENT 9 NONE
8 DON’T KNOW 2 NATIONAL GOVERNMENT 6 GOVERNMENT-OWNED AND CONTROLLED CORPORATION
3 PROVINCIAL GOVERNMENT 7 NGOs/NON-PROFIT INSTITUTION SERVING HOUSEHOLD

CBMS Form 4 26 of 28
 Reference Code for List of Facilities 4AA
For items HF6, EF6, SF6, AF6, ID6, WF7, CI6, T7, and G6, kindly refer to this list of services and/or facilities and its corresponding code.
0306 Fire Station 0499 Others, please specify _____
HEALTH FACILITY Tourist Attraction (museums, religious sites,
0307 Trial Court House 0902
INPUT DEALER historical landmark)
0101 Barangay Health Center 0308 Public Plaza/Parks/Garden/Sports Facility (gymnasium, court, etc.) 0903 Theme/Amusement Parks
0102 Rural Health Unit (RHU)/ Urban Health Center 0311 Disaster Risk Reduction Desk/Office 0501 Agricultural Supplies Dealer (feeds, fertilizer, pesticide, seeds/seedling) 0999 Others, please specify ______
0103 Hospital 0312 Women’s Crisis Center 0502 Agriculture/fishery machine/equipment dealer
TRANSPORT FACILITY
0104 Maternity/Lying-in Clinic/Birthing Home 0313 Violence against Women and their Children (VAWC) Desk/Office 0503 Boat/fishing gear dealer
0105 Pediatric/Child Clinic 0314 Go Negosyo Center 0504 Veterinary medicine dealer 1001 Airport
0106 Medical Clinic/Diagnostic/Dialysis Center 0315 Persons with Disabilities Affairs Office (PDAO) 0599 Others, please specify _____ 1002 Seaport
0107 Dental Clinic 0316 Office of Senior Citizens Affairs 1003 Terminal (bus, jeepney, tricycle)
WATER FACILITY
0108 Mobile Clinic 0317 Local Council for Protection of Children Office 1099 Others, please specify ____
0109 Botika ng Barangay 0318 Post Office/Postal Service 0601 Deep Well (Level I)
GARBAGE AND WASTE DISPOSAL FACILITY
0110 Botika ng Bayan 0319 Evacuation Center 0602 Artesian Well (Level I)
0111 Pharmacy/Drugstore 0320 Library 0603 Shallow Well (Level I) 1101 Open Dump Site
0112 COVID-19 Quarantine/Isolation Facility 0321 Public Market 0604 Level II Water system (communal faucet system or standposts) 1102 Sanitary Landfill
Level III Water system (reservoir, piped distribution within adequate
0113 COVID-19 Testing Center/ Vaccination Site 0322 Communal Toilet 0605 1103 Barangay Compost Pits
network)
0114 Habilitation Facility 0323 Cemetery/Memorial Park 0606 Water Refill Station 1104 Material Recovery Facility (MRF)
0115 Rehabilitation Center 0399 Others, please specify _____ 0699 Others, please specify _____ 1105 Treatment, storage, & disposal (TSD) Facility
0199 Others, please specify ____ AGRICULTURAL FACILITY 1106 Waste-to-energy facility
ENERGY FACILITY
EDUCATION FACILITY 0401 Rice Mill (fixed and mobile) 1107 Sewage Treatment Plant
0201 Day Care Center 0402 Corn Mill (fixed and mobile) 0701 Electric Company 1199 Others, please specify _____
0202 College/ University 0403 Feed Mill (fixed and mobile) 0702 Hydroelectric Power Plant
0203 Senior High School 0404 Sugar Mill (fixed and mobile) 0703 Geothermal Power Station
0204 Junior High School 0405 Mechanical/Electrical/Solar Dryer (coconut, rice, etc.) 0704 Wind Farm
Non-Renewable Power Plant/Station (Coal, Diesel, Natural Gas,
0205 Elementary School 0406 Fish Landing Center 0705
Nuclear)
Agriculture produce market (permanent/bagsakan, and
0206 Preschool 0407 0799 Others, please specify _____
periodic/talipapa/weekend market)
0207 SPED school/center 0408 Slaughterhouse/dressing plant
FINANCIAL AND CREDIT INSTITUTION
0208 TVET institution/training institute 0409 NFA warehouse
0209 Alternative Learning System (ALS) Center 0410 Commercial agriculture warehouse 0801 Bank
0299 Others, please specify _____ 0411 Layer farm (poultry) 0802 Community/Barangay Cooperative
0412 Hatchery for aquafarm species 0803 Microfinance NGOs
SERVICE FACILITY
0413 Breeding/multiplier farm for livestock 0899 Others, please specify ____
0302 Multi-purpose Hall 0414 Breeding farm for poultry
TOURISM SITES & DESTINATION FACILITY
0304 Police Station/Substation 0415 Nursery/greenhouse/screen house/nethouse
Natural Sites (nature parks, reserves, zoos, aquaria, and botanical
0305 Jail 0416 Veterinary/para-veterinary clinic 0901
garden)

CBMS Form 4 27 of 28
 Republic of the Philippines
4AB PHILIPPINE STATISTICS AUTHORITY
SUPERVISOR'S NOTE

CBMS Form 4 28 of 28