CS Form No.

212
Revised 2017
PERSONAL DATA SHEET
WARNING: Any misinterpretation 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 Coste
NAME EXTENSION (JR., SR) N/A
FIRST NAME Cristine
MIDDLE NAME Anguit
3. DATE OF BIRTH
16. CITIZENSHIP
(mm/dd/yyyy) 7/29/1990 ✘

4. PLACE OF BIRTH Lupon, Davao Oriental If holder of dual citizenship,

✘
Pls. indicate country:
please indicate the details.
5. SEX ✘

6 CIVIL STATUS
17. RESIDENTIAL ADDRESS Purok Manlipig
✘ House/Block/Lot No. Street
Maragatas
Subdivision/Village Barangay

7. HEIGHT (m) 1.5 m Lupon Davao Oriental

City/Municipality Province
8. WEIGHT (kg) 49 kg ZIP CODE 8208

9. BLOOD TYPE A+
18. PERMANENT ADDRESS Purok Manlipig
House/Block/Lot No. Street

10. GSIS ID NO. N/A Maragatas

Subdivision/Village Barangay

11. PAG-IBIG ID NO. N/A Lupon Davao Oriental

City/Municipality Province
12. PHILHEALTH NO. N/A ZIP CODE 8207
13. SSS NO. N/A 19. TELEPHONE NO. N/A
14. TIN NO. 63412920800000 20. MOBILE NO. 09634661162
15. AGENCY EMPLOYEE NO. N/A 21. E-MAIL ADDRESS (if any) coste.cristine.a@gmail.com
II. FAMILY BACKGROUND
DATE OF BIRTH
22. SPOUSE'S SURNAME N/A 23. NAME of CHILDREN (Write full name and list all) (mm/dd/yyyy)
NAME EXTENSION (JR., SR)
FIRST NAME

MIDDLE NAME
OCCUPATION
EMPLOYER/BUSINESS NAME
BUSINESS ADDRESS
TELEPHONE NO.
24. FATHER'S SURNAME Coste
NAME EXTENSION (JR., SR)
FIRST NAME Policarpio
MIDDLE NAME Rufin
25. MOTHER'S MAIDEN NAME
SURNAME Anguit
FIRST NAME Lucresia
MIDDLE NAME Carreon (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

HIGHEST
LEVEL/ SCHOLARSHIP/
26. NAME OF SCHOOL BASIC EDUCATION/DEGREE/COURSE PERIOD OF ATTENDANCE UNITS
YEAR
ACADEMIC
LEVEL (Write in full) GRADUAT HONORS
(Write in full) EARNED
ED RECEIVED
From To (if not
graduated)
ELEMENTARY Maragatas Elementary School 1995 2001 2001

VOCATIONAL
SECONDARY / Panabo National High School 2001 2006 2006

TRADE
COLLEGE
COURSE Davao Oriental State University 2014 2021 2021
GRADUATE STUDIES N/A
(Continue on separate sheet if necessary)

SIGNATURE DATE January 8, 2025

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

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

LET Passer 85.4 10/2/2022 Davao City 2050083 7/29/2026

(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 MONTH SALARY/ JOB/ SERVICE
(mm/dd/yyyy) POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY PAY GRADE (if
LY applicable)& STATUS OF
(Write in full/Do STEP
SALAR (Format "00-0")/ APPOINTMENT
not abbreviate) (Write in full/Do not abbreviate) Y INCREMENT
From To (Y/ N)

(Continue on separate sheet if necessary)

SIGNATURE DATE January 8, 2025

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

N/A

(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
30. TITLE OF LEARNING AND DEVELOPMENT ATTENDANCE Type of LD
INTERVENTIONS/TRAINING PROGRAMS NUMBER OF HOURS
( Managerial/ CONDUCTED/ SPONSORED BY
(Write in full) (mm/dd/yyyy) Supervisory/ (Write in full)
From To Technical/etc)

Animal/Poultry Production 11/5/2023 12/5/2023 760 hours trainee

TESDA - Lupon

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

MEMBERSHIP IN
31. SPECIAL SKILLS and HOBBIES NON-ACADEMIC DISTINCTIONS / RECOGNITION 33. ASSOCIATION/ORGANIZATION
(Write in full) (Write in
full)
Computer Literate None None
Communication Skills None None

(Continue on separate sheet if necessary)

SIGNATURE DATE January 8, 2025

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? ✘
b. within the fourth degree (for Local Government Unit - Career Employees)? ✘
If YES, give details:
________________________________
35. a. Have you ever been found guilty of any administrative offense? ________________________________
✘
If YES, give details:
________________________________
________________________________
b. Have you been criminally charged before any court? ✘
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 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, ________________________________
retirement, dropped from the rolls, dismissal, termination, end of term, finished contract or If YES, give details:
✘

phased 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 Barangay election)? ✘

If YES, give details:

b. Have you resigned from the government service during the three (3)-month period before
the last 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?
✘
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?
✘
If YES, please specify:
b. Are you a person with disability? ✘
If YES, please specify ID No:
c. Are you a solo parent?
✘
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
Beverly L. Rebalde ( Brgy. Captain) Maragatas, Lupon Davao Oriental 9533673827 3.5 cm. X 4.5 cm
(passport size)
Renante Prudente ( Agriculturist) Maragats, Lupon davao Oriental
With full and handwritten
name tag and signature over
Roland A. Deligero ( MIS Principal I) Clado, Lupon Davao oriental printed name
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and Computer generated
complete statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the or photocopied picture
Philippines. I authorize the agency head/authorized representative to verify/validate the contents stated is not acceptable
herein. I agree that any misrepresentation made in this document and its attachments shall cause the
filing of administrative/criminal case/s against me. PHOTO

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

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

ID/License/Passport No.:
Signature (Sign inside the box)
January 8, 2025
Date/Place of Issuance: PRC ROBINSON'S PLACE, GENSAN
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