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

MIDDLE NAME MACACUA

3. DATE OF BIRTH
(mm/dd/yyyy) 5/25/1965 16. CITIZENSHIP
✘ Filipino Dual Citizenship
✘ by birth by naturalization
4. PLACE OF BIRTH CALOOCAN CITY If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male ✘ Female

6 CIVIL STATUS Single ✘ Married 17. RESIDENTIAL ADDRESS TUBARAN AVENUE

Widowed Separated House/Block/Lot No. Street
CURAHAB
Other/s:
Subdivision/Village Barangay

7. HEIGHT (m) 1.55 M MALABANG LANAO DEL SUR

City/Municipality Province
8. WEIGHT (kg) 73 KG. ZIP CODE 9300

9. BLOOD TYPE A
18. PERMANENT ADDRESS TUBARAN AVENUE
House/Block/Lot No. Street

10. GSIS ID NO. CRN-006-0028-7319-0 CURAHAB

Subdivision/Village Barangay

11. PAG-IBIG ID NO. 195000404708 MALABANG LANAO DEL SUR

City/Municipality Province

12. PHILHEALTH NO. 15-000066150-5 ZIP CODE 9300

13. SSS NO. N/A 19. TELEPHONE NO. N/A

14. TIN NO. 921-897-615 20. MOBILE NO. 09394204138

15. AGENCY EMPLOYEE NO. 1040007 21. E-MAIL ADDRESS (if any) faridah_bmjamil@yahoo.com

II. FAMILY BACKGROUND

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

NAME EXTENSION (JR., SR) ARIFAH MACACUA JAMIL

FIRST NAME ABDULLAH N/A 8/7/1982

MIDDLE NAME AMATONDING ABU RAFE MACACUA JAMIL 9/23/1988

OCCUPATION BUSINESSMAN (SELF-EMPLOYED/PROPRIETOR) ABDULLAH MACACUA JAMIL, JR. 2/25/1992

EMPLOYER/BUSINESS NAME EZDI CONSTRUCTION ALRAHJI MACACUA JAMIL 12/7/1994

BUSINESS ADDRESS TUBARAN AVENUE, BRGY, CURAHAB, MALABANG, LANAO DEL SUR BAI FARIDAH MACACUA JAMIL 11/2/1997

TELEPHONE NO. N/A BAI LAWAN MACACUA JAMIL 2/12/1999

24. FATHER'S SURNAME MACACUA AMIR JAMEEL MACACUA JAMIL 5/16/2001

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

MIDDLE NAME POKIATAO

25. MOTHER'S MAIDEN NAME

SURNAME BALINDONG

FIRST NAME LAWANBAI

MIDDLE NAME BALINDONG (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

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

MALABANG CENTRAL ELEMENTARY HONORABLE

ELEMENTARY PRIMARY 1971 1977 N/A 1977 MENTION
PILOT SCHOOL

SECONDARY
VOCATIONAL / MALABANG NATIONAL HIGH SCHOOL HIGH SCHOOL 1977 1981 N/A 1981 VALEDICTORIAN

DATAPRO COMPUTER CORPORATION/ INTERFACE

COMPUTER LEARNING CENTER
BCS COBOL PROGRAMMING/ LANGUAGES 1982 1984 N/A N/A N/A
TRADE BACHELOR OF SCIENCE IN COMMERCE/
51 UNITS (FOR
COURSE
COLLEGE LANAO EDUCATIONAL INSTITUTE BACHELOR OF SCIENCE IN EDUCATION (EARNED 1986/ 2010 2000/ 2011 EARNED UNITS)
2000/ 2011 N/A
UNITS)

GRADUATE STUDIES N/A N/A N/A N/A N/A N/A N/A

(Continue on separate sheet if necessary)

SIGNATURE DATE
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

N/A N/A N/A N/A N/A N/A

(Continue on separate sheet if necessary)

ICE
(Include private employment. Start from your recent work) Description of duties should be indicated in the attached Work Experience sheet. GOV'T
SERVICE
28. INCLUSIVE DATES SALARY/ JOB/ PAY
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)
3/15/2017 PRESENT ADMINISTRATIVE OFFICER IV MALABANG NATIONAL HIGH SCHOOL P27,565 SG-15-1 TEMPORARY YES

1/1/2017 3/14/2017 ADMINISTRATIVE OFFICER IV MALABANG NATIONAL HIGH SCHOOL P27,565 SG-15-1 TEMPORARY YES

7/1/2016 12/31/2016 ADMINISTRATIVE OFFICER IV MALABANG NATIONAL HIGH SCHOOL P26,192 SG-15-1 TEMPORARY YES

1/1/2016 6/30/2016 ADMINISTRATIVE OFFICER IV MALABANG NATIONAL HIGH SCHOOL P26,192 SG-15-1 TEMPORARY YES

7/1/2015 12/31/2015 ADMINISTRATIVE OFFICER IV MALABANG NATIONAL HIGH SCHOOL P24,887 SG-15-1 TEMPORARY YES

7/1/2014 6/30/2015 ADMINISTRATIVE OFFICER IV MALABANG NATIONAL HIGH SCHOOL P24,887 SG-15-1 TEMPORARY YES

7/1/2013 6/30/2014 ADMINISTRATIVE OFFICER IV MALABANG NATIONAL HIGH SCHOOL P24,887 SG-15-1 TEMPORARY YES

6/1/2012 6/30/2013 ADMINISTRATIVE OFFICER IV MALABANG NATIONAL HIGH SCHOOL P24,887 SG-15-1 TEMPORARY YES

6/1/2011 5/31/2012 ADMINISTRATIVE OFFICER IV MALABANG NATIONAL HIGH SCHOOL P22,688 SG-15-1 TEMPORARY YES

6/24/2010 5/31/2011 ADMINISTRATIVE OFFICER IV MALABANG NATIONAL HIGH SCHOOL P20,490 SG-15-1 TEMPORARY YES

7/1/2009 6/23/2010 ADMINISTRATIVE OFFICER IV MALABANG NATIONAL HIGH SCHOOL P18,292 SG-15-1 TEMPORARY YES

7/1/2008 6/30/2009 ADMINISTRATIVE OFFICER IV MALABANG NATIONAL HIGH SCHOOL P16,093 SG-15-1 TEMPORARY YES

7/1/2007 6/30/2008 ADMINISTRATIVE OFFICER IV MALABANG NATIONAL HIGH SCHOOL P14,630 SG-15-1 TEMPORARY YES

6/1/2007 6/30/2007 ADMINISTRATIVE OFFICER IV MALABANG NATIONAL HIGH SCHOOL P13,274 SG-15-1 TEMPORARY YES

1/1/2007 5/31/2007 ADMINISTRATIVE OFFICER II MALABANG NATIONAL HIGH SCHOOL P13,274 SG-15-1 TEMPORARY YES

1/1/2006 12/31/2006 ADMINISTRATIVE OFFICER II MALABANG NATIONAL HIGH SCHOOL P13,274 SG-15-1 TEMPORARY YES

1/1/2005 12/31/2005 ADMINISTRATIVE OFFICER II MALABANG NATIONAL HIGH SCHOOL P13,274 SG-15-1 TEMPORARY YES

1/1/2004 12/31/2004 ADMINISTRATIVE OFFICER II MALABANG NATIONAL HIGH SCHOOL P13,274 SG-15-1 TEMPORARY YES

1/1/2003 12/31/2003 ADMINISTRATIVE OFFICER II MALABANG NATIONAL HIGH SCHOOL P13,274 SG-15-1 TEMPORARY YES

12/3/2002 12/31/2002 ADMINISTRATIVE OFFICER II MALABANG NATIONAL HIGH SCHOOL P13,274 SG-15-1 TEMPORARY YES
 (Continue on separate sheet if necessary)

SIGNATURE 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

YOUTH LEADERSHIP SUMMIT 11/25/2011 11/27/2011 24 CONSULTANT/ SOCIO-CIVIC

110TH ARAW NG MALABANG CELEBRATION WORKING COMMITTEE,

5/1/2009 5/1/2005 152 CHAIRPERSON FOR COMMITTEE ON PROGR
MUNICIPALITY OF MALABANG, LANAO DEL SUR
112TH ARAW NG MALABANG CELEBRATION WORKING COMMITTEE,
5/1/2005 5/1/2005 152 CHAIRPERSON FOR COMMITTEE ON PROGR
MUNICIPALITY OF MALABANG, LANAO DEL SUR

(Continue on separate sheet if necessary)

VII. LEARNING AND DEVELOPMENT (L&D) INTERVENTIONS/TRAINING PROGRAMS ATTENDED
(Start from the most recent L&D/training program and include only the relevant L&D/training taken for the last five (5) years for Division Chief/Executive/Managerial positions)
INCLUSIVE DATES OF
ATTENDANCE Type of LD
30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS ( Managerial/
NUMBER OF HOURS
(Write in full) (mm/dd/yyyy) Supervisory/
Technical/etc)
From To

ORIENTATION WORKSHOP ON THE ENHANCED SCHOOL IMPROVEMENT PLAN 1/18/2017 1/19/2017 16 TECHNICAL
 WORKSHOP ON EDUCATION IN EMERGENCY AND CONFLICT SENSITIVE EDUCATION
1/13/2017 1/14/2017 16 TECHNICAL
FOCUS ON PSYCHOSOCIAL SERVICES

K TO 12 BASIC EDUCATION REFORM REGIONAL PRE-SUMMIT CONFERENCE 1/16/2012 1/16/2012 8 TECHNICAL

K TO 12 PRE-SUMMIT CONFERENCE 12/9/2011 12/9/2011 8 TECHNICAL

DEPED DBM WORKHOP ON RECONCILIATION AND CLEARING UP OF PSI-

2/12/2009 12/13/2009 16 TECHNICAL
POP DATA

LIVELIHOOD TRAINING SEMINAR ON FISH PROCESSING 9/24/2008 9/24/2008 8 TECHNICAL

STUDENT MULTI-MEDIA PRESENTATION ON PAYING AND SAVING ELECTRICAL ENERGY

3/1/2007 3/1/2007 4 TECHNICAL
UNIT OF SCIENCE

COMPUTER BASIC OPERATION 1/23/2007 1/24/2007 16 TECHNICAL

MICROSOFT OFFICE SPECIALIST, ICT LITERACY TRAINING ON CLIC

8/9/2006 8/10/2006 16 TECHNICAL
PARTNERS SCHOOL

TEACHERS ENHANCEMENT SEMINAR 1/18/2005 1/19/2005 16 TECHNICAL

DEPED-STI TEACH PROGRAM 5/27/2003 5/28/2003 16 TECHNICAL

REGIONAL TRAINING ON MORAL RECOVERY 10/12/2002 10/12/2002 8 TECHNICAL

REGIONAL TRAINING ON MORAL RECOVERY 10/19/2002 10/19/2002 8 TECHNICAL

REGIONAL TRAINING ON MORAL RECOVERY 10/26/2002 10/26/2002 8 TECHNICAL

REGIONAL TRAINING ON MORAL RECOVERY 11/2/2002 11/2/2002 8 TECHNICAL

REGIONAL TRAINING ON MORAL RECOVERY 11/9/2002 11/9/2002 8 TECHNICAL

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

NON-ACADEMIC DISTINCTIONS / RECOGNITION
31. SPECIAL SKILLS and HOBBIES 32.
(Write in full)

VICE PRESIDENT, PARENTS TEACHERS ASSOCIATION OF

CULINARY ARTS - BAKING MALABANG NATIONAL HIGH SCHOOL
PRESIDENT, FACULTY AND STAFF ASSOCIATION OF
COOKING
MALABANG NATIONAL HIGH SCHOOL
BOARD OF DIRECTOR, SCHOOL GOVERNING COUNCIL -
READING
MALABANG NATIONAL HIGH SCHOOL
RESPONDENT, ADMINISTRATION OF LEARNING AND DEVELOPMENT NEEDS
ASSESSMENTSURVEY OF DEPED - ARMM

(Continue on separate sheet if necessary)

SIGNATURE DATE
/ NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S

POSITION / NATURE OF WORK

CONSULTANT/ SOCIO-CIVIC

CHAIRPERSON FOR COMMITTEE ON PROGRAMS/ SOCIO-CIVIC

CHAIRPERSON FOR COMMITTEE ON PROGRAMS/ SOCIO-CIVIC

(Continue on separate sheet if necessary)

NTIONS/TRAINING PROGRAMS ATTENDED
ant L&D/training taken for the last five (5) years for Division Chief/Executive/Managerial positions)

DIVISION OF LANAO DEL SUR II

 DIVISION OF LANAO DEL SUR II

DEPARTMENT OF EDUCATION - ARMM

DEPARTMENT OF EDUCATION

DEPARTMENT OF EDUCATION AND DEPARTMENT OF

BUDGET AND MANAGEMENT
CONGRESSIONAL SPOUSES FOUNDATION AND
TECHNOLOGY AND RESEARCH CENTER
SCIENCE DEPARTMENT - MALABANG NATIONAL
HIGH SCHOOL
GROWTH WITH EQUITY IN MINDANAO CLIC-
GLOBALCHIPS TECHNOLOGY
DEPED - MICROSOFT PARTNERS IN LEARNING
COMMUNITY

CIVIL SERVICE COMMISSION - ARMM

DEPARTMENT OF EDUCATION AND STI

DEPARTMENT OF EDUCATION - ARMM

DEPARTMENT OF EDUCATION - ARMM

DEPARTMENT OF EDUCATION - ARMM

DEPARTMENT OF EDUCATION - ARMM

DEPARTMENT OF EDUCATION - ARMM

(Continue on separate sheet if necessary)

MEMBERSHIP IN ASSOCIATION/ORGANIZATION
33. (Write in
full)
SCHOOL COMMUNITY PLANNING TEAM -
MALABANG NATIONAL HIGH SCHOOL
PARENTS TEACHERS ASSOCIATION -
MALABANG NATIONAL HIGH SCHOOL
SCHOOL GOVERNING COUNCIL -
MALABANG NATIONAL HIGH
SCHOOL

(Continue on separate sheet if necessary)

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,
Bureau or Department where you will be apppointed,
a. within the third degree? YES ✘ NO
b. within the fourth degree (for Local Government Unit - Career Employees)? YES ✘ NO
If YES, give details:

35. a. Have you ever been found guilty of any administrative offense? YES ✘ NO
If YES, give details:
________________________________
________________________________
b. Have you been criminally charged before any court? YES ✘ 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 YES ✘ 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, ✘ YES 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? ________________________________
END OF TERM

________________________________
38. a. Have you ever been a candidate in a national or local election held within the last year (except YES ✘ NO
Barangay election)? If YES, give details:

b. Have you resigned from the government service during the three (3)-month period before the last YES ✘ 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? YES ✘ 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? YES ✘ NO
If YES, please specify:
b. Are you a person with disability? YES ✘ NO
If YES, please specify ID No:
c. Are you a solo parent? YES ✘ 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
HEART AND LUNG DIAGNOSTIC the last 6 months
DR. JOSE A. YULDE CENTER, QUEZON CITY
02-4330037 3.5 cm. X 4.5 cm
(passport size)

ROLANDO DELA ROSA MALABANG, LANAO DEL SUR N/A With full and handwritten
name tag and signature over
printed name
DR. NASSER ALIMODA MALABANG, LANAO DEL SUR N/A
Computer generated
42. or photocopied picture
I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and is not acceptable
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: GSIS
ID/License/Passport No.: CRN-006-0028-7319-0
Signature (Sign inside the box)

Date/Place of Issuance: ILIGAN CITY

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