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    Personal Data Sheet: Please Take Note of The Correct Word - Misrepresentation, Not Misinterpretation

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    Carl Golingay Jun

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    Personal Data Sheet: Please Take Note of The Correct Word - Misrepresentation, Not Misinterpretation

    Uploaded by

    Carl Golingay Jun
    12 views1 page

    Original Title

    PDS PAGE 1

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    Copyright:

    © All Rights Reserved
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    12 views1 page

    Personal Data Sheet: Please Take Note of The Correct Word - Misrepresentation, Not Misinterpretation

    Uploaded by

    Carl Golingay Jun

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    CS Form No.

    212

    PERSONAL DATA SHEET


    Revised 2017

    PLEASE TAKE NOTE OF THE CORRECT WORD - MISREPRESENTATION, NOT MISINTERPRETATION


    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
    NAME EXTENSION (JR., SR) N/A
    FIRST NAME

    MIDDLE NAME

    3. DATE OF BIRTH
    PLEASE TAKE NOTE OF THE 16. CITIZENSHIP Filipino Dual Citizenship
    (mm/dd/yyyy)
    CORRECT FORMAT - MM/DD/YY
    by birth by naturalization

    4. PLACE OF BIRTH MUST COINCIDE WITH BIRTH CERTIFICATE If holder of dual citizenship, Pls. indicate country:
    please indicate the details.
    5. SEX Male Female

    6 CIVIL STATUS Single Married 17. RESIDENTIAL ADDRESS


    Widowed Separated House/Block/Lot No. Street

    Other/s:
    Subdivision/Village Barangay

    7. HEIGHT (m)
    City/Municipality Province
    8. WEIGHT (kg) ZIP CODE

    9. BLOOD TYPE 18. PERMANENT ADDRESS


    House/Block/Lot No. Street

    10. GSIS ID NO.


    Subdivision/Village Barangay

    11. PAG-IBIG ID NO.


    City/Municipality Province

    12. PHILHEALTH NO. ZIP CODE

    13. SSS NO. 19. TELEPHONE NO.

    14. TIN NO. 20. MOBILE NO.

    15. AGENCY EMPLOYEE NO. 21. E-MAIL ADDRESS (if any) DEPED EMAIL

    II. FAMILY BACKGROUND


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

    MIDDLE NAME

    OCCUPATION

    EMPLOYER/BUSINESS NAME

    BUSINESS ADDRESS

    TELEPHONE NO.

    24. FATHER'S SURNAME


    NAME EXTENSION (JR., SR)
    FIRST NAME

    MIDDLE NAME

    25. MOTHER'S MAIDEN NAME

    SURNAME

    FIRST NAME

    MIDDLE NAME (Continue on separate sheet if necessary)

    III. EDUCATIONAL BACKGROUND


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

    ELEMENTARY ELEMENTARY YEAR YEAR N/A YEAR NONE

    SECONDARY HIGH SCHOOL YEAR YEAR N/A YEAR NONE

    VOCATIONAL /
    TRADE COURSE

    COLLEGE COMPLETE COURSE YEAR YEAR N/A YEAR NONE

    NUMBER OF UNITS
    GRADUATE STUDIES
    IF NOT GRADUATED N/A NONE
    (Continue on separate sheet if necessary)

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

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