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PDS 2017

This document is a personal data sheet that collects an individual's personal and employment information. It requests information such as name, date of birth, citizenship, civil status, physical attributes, family background, educational attainment, work experience, training and scholarships/academic honors received. The form warns that any misrepresentation made could result in administrative or criminal cases filed against the person.

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patricia
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912 views4 pages

PDS 2017

This document is a personal data sheet that collects an individual's personal and employment information. It requests information such as name, date of birth, citizenship, civil status, physical attributes, family background, educational attainment, work experience, training and scholarships/academic honors received. The form warns that any misrepresentation made could result in administrative or criminal cases filed against the person.

Uploaded by

patricia
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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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 c

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. F

I. PERSONAL INFORMATION
2. SURNAME
NAME EXTENSION (JR., SR)
FIRST NAME

MIDDLE NAME

3. DATE OF BIRTH
16. CITIZENSHIP Dual Citizenship
(mm/dd/yyyy) Filipino
by birth by naturaliz

4. PLACE OF BIRTH 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)

II. FAMILY BACKGROUND


22. SPOUSE'S SURNAME 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRT
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

26. PERIOD OF ATTENDANCE HIGHEST LEVEL/


NAME OF SCHOOL BASIC EDUCATION/DEGREE/COURSE YEAR
LEVEL UNITS EARNED
(Write in full) (Write in full) (if not graduated)
GRADUATED
From To

ELEMENTARY

SECONDARY
VOCATIONAL /
TRADE COURSE

COLLEGE

GRADUATE STUDIES

(Continue on separate sheet if necessary)

SIGNATURE DATE
CS FORM 212 (Revised
concerned.

For CSC use only)

ization

TH (mm/dd/yyyy)

SCHOLARSHIP/
ACADEMIC
HONORS
RECEIVED
d 2017), Page 1 of 4

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