CS Form No.

212
Revised 2017

PERSONAL DATA SHEET

WARNING: Any misrepresentation made in the Personal Data Sheet and the Work Experience Sheet shall cause the filing of administrative/criminal case/s against the person
concerned.
READ THE ATTACHED GUIDE TO FILLING OUT THE PERSONAL DATA SHEET (PDS) BEFORE ACCOMPLISHING THE PDS FORM.
Print legibly. Tick appropriate boxes ( ) and use separate sheet if necessary. Indicate N/A if not applicable. DO NOT ABBREVIATE. 1. CS ID No. (Do not fill up. For CSC use only)

I. PERSONAL INFORMATION
2. SURNAME ABOGA-A
NAME EXTENSION (JR., SR)
FIRST NAME BILLY JOE

MIDDLE NAME REX

3. DATE OF BIRTH
(mm/dd/yyyy) 5/21/1997 16. CITIZENSHIP FILIPINO

4. PLACE OF BIRTH QUEZON CITY If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX MALE

17. RESIDENTIAL ADDRESS BLOCK 145 LOT 12

6 CIVIL STATUS SINGLE
House/Block/Lot No. Street
ST. MARTHA ESTATE HOMES BATIA
Subdivision/Village Barangay
BOCAUE BULACAN
7. HEIGHT (m) 1.6256 m
City/Municipality Province
8. WEIGHT (kg) 64 kg ZIP CODE

18. PERMANENT ADDRESS BLOCK 145 LOT 12

9. BLOOD TYPE 0+
House/Block/Lot No. Street
ST. MARTHA ESTATE HOMES BATIA
10. GSIS ID NO.
Subdivision/Village Barangay

11. PAG-IBIG ID NO.

BOCAUE BULACAN
City/Municipality Province

12. PHILHEALTH NO. 030260156612 ZIP CODE

13. SSS NO. 3462001796 19. TELEPHONE NO.

14. TIN NO. 330835259 20. MOBILE NO. 09057952264

15. AGENCY EMPLOYEE NO. 21. E-MAIL ADDRESS (if any) [email protected]

II. FAMILY BACKGROUND

22. SPOUSE'S SURNAME N/A 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
NAME EXTENSION (JR., SR) N/A
FIRST NAME N/A N/A

MIDDLE NAME N/A

OCCUPATION N/A

EMPLOYER/BUSINESS NAME N/A

BUSINESS ADDRESS N/A

TELEPHONE NO. N/A

24. FATHER'S SURNAME ABOGA-A

NAME EXTENSION (JR., SR)
FIRST NAME LEONARDO

MIDDLE NAME MOSTAJO

25. MOTHER'S MAIDEN NAME

SURNAME REX

FIRST NAME MARIVIL

MIDDLE NAME DOMANICO (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

NAME OF SCHOOL HIGHEST LEVEL/ SCHOLARSHIP/
26. BASIC EDUCATION/DEGREE/COURSE PERIOD OF ATTENDANCE UNITS
YEAR
ACADEMIC
LEVEL (Write in GRADUATED
(Write in full) EARNED HONORS
full) (if not graduated) RECEIVED
From To

8th
ELEMENTARY OLD BALARA ELEMENTARY SCHOOL-ANNEX 6/1/2006 3/1/2010 2010
Honorable
1st
SECONDARY /
VOCATIONAL FLORA A. YLAGAN HIGH SCHOOL 6/1/2010 3/1/2014 2014 Honorable
Mention
MAGSAYSAY CENTER FOR HOSPITALITY AND
CULINARY ARTS
HOUSEKEEPING SERVICES 5/20/2019 1/10/2020 2020
TRADE
COURSE
COLLEGE POLYTECHNIC UNIVERSITY OF THE PHILIPPINES BACHELOR OF ARTS IN HISTORY 6/3/2014 5/16/2018 2018

GRADUATE STUDIES

(Continue on separate sheet if necessary)

SIGNATURE BILLY JOE R. ABOGA-A DATE September 21, 2020

CS FORM 212 (Revised 2017), Page 1 of 4

IV. CIVIL SERVICE ELIGIBILITY
27. CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER DATE OF LICENSE (if applicable)
RATING
SPECIAL LAWS/ CES/ CSEE EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
(If Applicable) NUMBER Date of
BARANGAY ELIGIBILITY / DRIVER'S LICENSE CONFERMENT
Validity

(Continue on separate sheet if necessary)

V. WORK EXPERIENCE
(Include private employment. Start from your recent work) Description of duties should be indicated in the attached Work Experience sheet.
GOV'T
28. INCLUSIVE DATES SALARY/ JOB/ PAY SERVICE
POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY GRADE (if
(mm/dd/yyyy) MONTHLY STATUS OF
(Write in full/Do not (Write in SALARY
applicable)& STEP
APPOINTMENT
(Format "00-0")/
abbreviate) full/Do not abbreviate) INCREMENT
From To
(Y/ N)
CONTRACTUA
7/16/2019 4/29/2020 SENIOR HIGH SCHOOL INSTRUCTOR SKILL-POWER INSTITUTE, INC.
L
PROBATIONAR
10/15/2016 5/21/2017 SERVICE CREW McDONALD'S Del Monte
Y

(Continue on separate sheet if necessary)

SIGNATURE BILLY JOE R. ABOGA-A DATE

CS FORM 212 (Revised 2017), Page 2 of 4
VI. VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S
INCLUSIVE DATES
29. NAME & ADDRESS OF ORGANIZATION
(Write in full) (mm/dd/yyyy) NUMBER OF HOURS POSITION / NATURE OF WORK
From To

(Continue on separate sheet if necessary)

VII. LEARNING AND DEVELOPMENT (L&D) INTERVENTIONS/TRAINING PROGRAMS ATTENDED
INCLUSIVE DATES OF
ATTENDANCE Type of LD
30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS ( Managerial/ CONDUCTED/ SPONSORED BY
NUMBER OF HOURS
(Write in full) Supervisory/ (Write in full)
(mm/dd/yyyy)
Technical/etc)
From To
MAGSAYSAY CENTER FOR HOSPITALITY AND
HOUSEKEEPING NC II 5/20/2019 1/10/2020 TECHNICAL
CULINARY ARTS

BASIC TRAINING 2/2/2020 2/13/2020 64.0

MAGSAYSAY TRAINING CENTER
SECURITY AWARENESS TRAINING AND SEAFARERS WITH DESIGNATED SECURITY
2/13/2020 2/14/2020 8.0
DUTIES MAGSAYSAY TRAINING CENTER
SAFETY TRAINING FOR PERSONNEL PROVIDING DIRECT SERVICES TO PASSENGERS IN
2/17/2020 2/17/2020 8.0
PASSENGER SPACES MAGSAYSAY TRAINING CENTER

PASSENGER SHIP CROWD MANAGEMENT TRAINING 5/18/2020 5/19/2020 10.0

MAGSAYSAY TRAINING CENTER

BEAUTY CARE-NAIL CARE NC II

HOUSEKEEPING SERVICES INTERNSHIP (EXTERNAL) 600.0

SEDA VERTIS NORTH

HOUSEKEEPING SERVICES INTERNSHIP (INTERNAL) 300.0

MIHCA MANILA

WORKSHOP ON BASIC CONSERVATION OF MUSEUM ARTIFACTS (METAL OBJECTS) MUSEO VALENZUELA FOUNDATION, INC.

BALIK-TANAW: SEMINAR-WORKSHOP SA MGA KATUTUBONG KULTURA SA PILIPINAS DE LA SALLE UNIVERSITY

BA HISTORY PRACTICUM 1/8/2018 3/22/2018 221.0 NATIONAL ARCHIVES OF THE PHILIPPINES

INFORMATION AND COMMUNICATION

6/1/2013 3/1/2014
TECHNOLOGY-WEB DEVELOPMENT INCOME - CREATING OPPORTUNITIES THROUGH

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

MEMBERSHIP IN ASSOCIATION/ORGANIZATION
NON-ACADEMIC DISTINCTIONS / RECOGNITION
31. SPECIAL SKILLS and HOBBIES 32. 33. (Write in
(Write in full)
full)

S SAMAHAN NG MAG-AARAL SA KASAYSAYAN

(Continue on separate sheet if necessary)

SIGNATURE BILLY JOE R. ABOGA-A DATE SEPTEMBER 21, 2020

CS FORM 212 (Revised 2017), Page 3 of 4
 34. Are you related by consanguinity or affinity to the appointing or recommending authority, or to the
chief of bureau or office or to the person who has immediate supervision over you in the Office, NO
Bureau or Department where you will be apppointed,
a. within the third degree?
b. within the fourth degree (for Local Government Unit - Career Employees)? NO
If YES, give details:
________________________________

35. a. Have you ever been found guilty of any administrative offense? NO
If YES, give details:
________________________________
________________________________
b. Have you been criminally charged before any court? NO
If YES, give details:
________________________________
Date Filed:
________________________________
Status of Case/s:

36. Have you ever been convicted of any crime or violation of any law, decree, ordinance or regulation NO
by any court or tribunal?
If YES, give details:
________________________________
________________________________
37. Have you ever been separated from the service in any of the following modes: resignation, NO
retirement, dropped from the rolls, dismissal, termination, end of term, finished contract or phased If YES, give details:
out (abolition) in the public or private sector? ________________________________
________________________________
38. a. Have you ever been a candidate in a national or local election held within the last year (except NO
Barangay election)?
If YES, give details:
b. Have you resigned from the government service during the three (3)-month period before the last NO
election to promote/actively campaign for a national or local candidate? If YES, give details:
39. Have you acquired the status of an immigrant or permanent resident of another country? NO
If YES, give details (country):

40. Pursuant to: (a) Indigenous People's Act (RA 8371); (b) Magna Carta for Disabled Persons (RA
7277); and (c) Solo Parents Welfare Act of 2000 (RA 8972), please answer the following items:
a. Are you a member of any indigenous group? NO
If YES, please specify:
b. Are you a person with disability? NO
If YES, please specify ID No:
c. Are you a solo parent? NO
If YES, please specify ID No:

41. REFERENCES (Person not related by consanguinity or affinity to applicant /appointee)

NAME ADDRESS TEL. NO. ID picture taken within

the last 6 months
4.5 cm. X 3.5 cm
GENEVA URIZAR MANDALUYONG 0977-616-2219 (passport size)

JOBELYN REVIDIZO-MAMARLAO MANDALUYONG 0918-581-0078 Computer generated

or photocopied picture
is not acceptable
DR. JONAS DOMINGO SAN JUAN 0917-574-9575
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and
complete statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the
Philippines. I authorize the agency head/authorized representative to verify/validate the contents stated herein.
I agree that any misrepresentation made in this document and its attachments shall cause the filing of PHOTO
administrative/criminal case/s against me.

Government Issued ID (i.e.Passport, GSIS, SSS, PRC, Driver's License, etc.)

PLEASE INDICATE ID Number and Date of Issuance
Government Issued ID: PASSPORT

ID/License/Passport No.: P3961147B

Signature (Sign inside the box)
SEPTEMBER 21, 2020
Date/Place of Issuance: NOVEMBER 25, 2019
Date Accomplished Right Thumbmark

SUBSCRIBED AND SWORN to before me this , affiant exhibiting his/her validly issued government ID as indicated above.

Person Administering Oath

CS FORM 212 (Revised 2017), Page 4 of 4