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 BARON
NAME EXTENSION (JR., SR)
FIRST NAME KRIZZA JOY

MIDDLE NAME PAULE

3. DATE OF BIRTH
(mm/dd/yyyy) 09/26/1997 16. CITIZENSHIP
✘ Filipino Dual Citizenship
by birth by
naturalization
4. PLACE OF BIRTH PASACAO, CAMARINES SUR If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male ✘ Female

6 CIVIL STATUS ✘ Single Married 17. RESIDENTIAL ADDRESS LOOBAN ZONE 2A

Widowed Separated House/Block/Lot No. Street
STA. ROSA DEL NORTE
Other/s:
Subdivision/Village Barangay

7. HEIGHT (m) 1.6 PASACAO CAMARINES SUR

City/Municipality Province
8. WEIGHT (kg) 57 ZIP CODE 4417
18. PERMANENT ADDRESS LOOBAN ZONE 2A
9. BLOOD TYPE AB+
House/Block/Lot No. Street
STA. ROSA DEL NORTE
10. GSIS ID NO. N/A
Subdivision/Village Barangay

11. PAG-IBIG ID NO. 121277700313 PASACAO CAMARINES SUR

City/Municipality Province
12. PHILHEALTH NO. 102532929072 ZIP CODE 4417
13. SSS NO. 3499762590 19. TELEPHONE NO. N/A

14. TIN NO. N/A 20. MOBILE NO. 09517501641

15. AGENCY EMPLOYEE NO. N/A 21. E-MAIL ADDRESS (if any) krizzajoybaron32@gmail.com
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)

FIRST NAME N/A

NAME EXTENSION (JR., SR) 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 BARON
NAME EXTENSION (JR., SR)
FIRST NAME DANTE
MIDDLE NAME SUTAN
25. MOTHER'S MAIDEN NAME ANALYN B. PAULE
SURNAME BARON
FIRST NAME ANALYN
MIDDLE NAME PAULE (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) GRADUATED HONORS
(Write in full) EARNED
(if not RECEIVED
From To
graduated)
ELEMENTARY PASACAO CENTRAL SCHOOL 2004 2010 2010 WITH HONORS
FOURTH
VOCATIONAL
SECONDARY / PASACAO ACADEMY 2010 2014 2014 HONORABLE
MENTION
N/A
TRADE ACADEMIC
COURSE CENTRAL BICOL STATE UNIVERSITY BACHELOR OF SECONDARY EDUCATION COLLEGE AWARDEE,
COLLEGE OF AGRICULTURE- PASACAO MAJOR IN BIOLOGICAL SCIENCE 2015 2020 DEGREE 2020 TERTIARY
CAMPUS EDUCATION
SUBSIDY (TES)
GRADUATE STUDIES N/A

(Continue on separate sheet if necessary)

SIGNATURE DATE
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

PROFESSIONAL TEACHER 84.4 OCTOBER 02, 2022 LEGAZPI CITY 2139536 09/26/2027

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

1/7/2023 05/31/2024 CLASSROOM TEACHER ROSARY SCHOOL, INC. ₱8,400.00 N/A CONTRACTUAL N/A

07/15/2024 PRESENT CLASSROOM TEACHER, SCHOOL PUBLICATION PASACAO ACADEMY, INC. ₱9,000.00 N/A CONTRACTUAL N/A
MODERATOR

(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
NAME & ADDRESS OF ORGANIZATION INCLUSIVE DATES
29. (Write in
full) (mm/dd/yyyy) NUMBER OF HOURS POSITION / NATURE OF WORK
From To

N/A N/A N/A N/A 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)

BASIC COMPUTER LITERACY 01/13/2025 01/24/2025 80 TECHNICAL INFINITECH TRAINING CENTER

SPECIAL BATCH ROLL-OUT ON COACHING AND 1/3/2024 3/3/2024 24 COACHING SDO CAMSUR
OFFICIATING
DIVISION DECENTRALIZED TRAINING 11/24/2023 11/26/2023 24 COACHING SDO CAMSUR

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

MEMBERSHIP IN
3ASSOCIATION/ORGANIZATION
31. SPECIAL SKILLS and HOBBIES NON-ACADEMIC DISTINCTIONS / RECOGNITION 3
(Write in full) . (Write in full)

COACHING IN BOXING WINNING COACH (BOXING) OPSCSI DISTRICT MEET

FIFTH DISTRICT
PLAYING GUITAR AND PIANO WINNING COACH (BOXING) OPSCSI DIVISION MEET
(CAMARINES SUR)
SINGING

BASIC COMPUTER SKILLS

COMMUNICATION SKILLS (HOSTING)

(Continue on separate sheet if necessary)

SIGNATURE DATE
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 by any court or tribunal? YES ✘ NO
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 YES ✘ NO
phased out (abolition) in the public or private sector? If YES, give details:
________________________________
________________________________
38. a. Have you ever been a candidate in a national or local election held within the last year
(except Barangay election)? YES ✘ NO
If YES, give details:
b. Have you resigned from the government service during the three (3)-month period before YES ✘ NO
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?
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
the last 6 months
NANCY C. GARCIA SAN FERNANDO, CAMARINES SUR 09634567132 3.5 cm. X 4.5 cm
(passport size)
STA. ROSA DEL SUR PASACAO,
GUILLERMO P. ABELLERA JR. CAMARINES SUR 09213426572 With full and handwritten
name tag and signature over
CARANAN, PASACAO, CANARINES printed name
JONATHAN O. BARDE SUR 09127121316
Computer generated
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and or photocopied picture
complete statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the is not acceptable
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 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

ID/License/Passport No.: 2139536

Signature (Sign inside the box)

Date/Place of Issuance: 02/02/2024

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