Last Name First Name City Barangay Aguso Alvindia Amucao Armenia Asturias Atioc Balanti Balete Balibago I Balibago II Balingcanaway Banaba Bantog Baras-baras Batang-batang Binauganan Bora Buenavista Buhilit Burot Calingcuan Capehan Carangian Care Central Culipat Cut-cut I Cut-cut II Dalayap Dela Paz Dolores Laoang Ligtasan Lourdes Mabini Maligaya Maliwalo Mapalacsiao Mapalad Matatalaib Paraiso Poblacion Salapungan San Carlos San Francisco San Isidro San Jose San Jose de Urquico San Juan Bautista San Juan de Mata San Luis San Manuel San Miguel San Nicolas San Pablo San Pascual San Rafael San Roque San Sebastian San Vicente Santa Cruz Santa Maria Santo Cristo Santo Domingo Santo Niño Sapang Maragul Sapang Tagalog Sepung Calzada Sinait Suizo Tariji Tibag Tibagan Trinidad Ungot Villa Bacolor Street Address Zip Code Phone Your primary contact number Email Date of Birth