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 SAUD

FIRST NAME DANTE NAME EXTENSION (JR., SR) JR

MIDDLE NAME ARTISTA

3. DATE OF BIRTH
16. CITIZENSHIP
(mm/dd/yyyy) 9/29/1987 ✘ Filipino Dual Citizenship
by birth by naturalization
4. PLACE OF BIRTH COTABATO CITY If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX ✘ Male Female
✘ Single Married 17. RESIDENTIAL ADDRESS 9-21th
6 CIVIL STATUS
House/Block/Lot No. Street
Widowed Separated
NAZARETH
Other/s:
Subdivision/Village Barangay

CAGAYAN DE ORO MISAMIS ORIENTAL

7. HEIGHT (m) 5'5
City/Municipality Province

8. WEIGHT (kg) 75.8 ZIP CODE 9000

9. BLOOD TYPE "O"

18. PERMANENT ADDRESS 9-21th
House/Block/Lot No. Street
NAZARETH
10. GSIS ID NO. N/A
Subdivision/Village Barangay

11. PAG-IBIG ID NO. N/A CAGAYAN DE ORO MISAMIS ORIENTAL

City/Municipality Province

12. PHILHEALTH NO. 17-025445241-9 ZIP CODE 9000

13. SSS NO. 08-1799508-1 19. TELEPHONE NO. N/A

14. TIN NO. 497-767-263-000 20. MOBILE NO. 09772587740/ 09094196882

15. AGENCY EMPLOYEE NO. R12-1025 21. E-MAIL ADDRESS (if any) dantesaud@yahoo.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)
NAME EXTENSION (JR., SR) N/A
FIRST NAME 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 SAUD, ALHADJ

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

MIDDLE NAME UMPA

25. MOTHER'S MAIDEN NAME

SURNAME ARTISTA

FIRST NAME LEAH

MIDDLE NAME SALGADO (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
From To

ELEMENTARY Southern Baptist College ELEMENTARY 1994 2000 GRADUATED 2000 N/A

SECONDARY /
VOCATIONAL Lourdes College High School HIGH SCHOOL 2000 2004 GRADUATED 2004 N/A

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

TRADE
COURSE BACHELOR OF SCIENCE IN
COLLEGE Capitol University 2004 2009 GRADUATED 2009 N/A
COMMERCE MAJOR IN CUSTOMS

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

(Continue on separate sheet if necessary)

SIGNATURE DATE 12/31/2017 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

CIVIL SERVICE PROFESSIONAL PASSER 81.17% 4/17/2016 Capitol University, Cagayan de Oro City 386121 7/4/2016

CIVIL SERVICE SUB-PROFESSIONAL PASSER 80.39% 7/27/2008 Pilgrim Christian College, Cagayan de Oro City 682356 9/29/2008

(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.
28. INCLUSIVE DATES
SALARY/ JOB/ PAY
(mm/dd/yyyy) POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY GRADE (if
STATUS OF GOV'T SERVICE
(Write in full/Do not (Write in MONTHLY SALARY applicable)& STEP
APPOINTMENT (YES/ NO)
(Format "00-0")/
abbreviate) full/Do not abbreviate) INCREMENT
From To

Department of Social Welfare and Memorandum of

7/1/2017 12/31/2017 Project Development Officer II P30,321.50 SG 15 Agreement NO
Development Region XII

Department of Social Welfare and Memorandum of

3-16-2017 6-30-2017 Project Development Officer II P30,321.50 SG 15 Agreement NO
Development Region XII

Department of Social Welfare and Memorandum of

7/1/2015 12/31/2015 Project Development Officer II P24,887.00 SG 15 Agreement NO
Development Region XII

Department of Social Welfare and Memorandum of

1/1/2015 6/30/2015 Project Development Officer II P24,887.00 SG 15 Agreement NO
Development Region XII

Department of Social Welfare and Memorandum of

7/1/2014 12/31/2014 Project Development Officer II P24,887.00 SG 15 Agreement NO
Development Region XII

Department of Social Welfare and Memorandum of

1/1/2014 6/30/2014 Project Development Officer II P24,887.00 SG 15 Agreement NO
Development Region XII

Department of Social Welfare and Memorandum of

11/16/2013 12/31/2013 Project Development Officer II P24,887.00 SG 15 Agreement NO
Development Region XII

Department of Social Welfare and Memorandum of

8/15/2013 11/15/2013 Project Development Officer II P24,887.00 SG 15 Agreement NO
Development Region XII

(Continue on separate sheet if necessary)

SIGNATURE DATE 12/31/2017 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

Mindanao Allied Forces, Inc.- NGO 9/12/2011 3/1/2012 136 Social Program Assistant

(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/
(mm/dd/yyyy) NUMBER OF HOURS CONDUCTED/ SPONSORED BY (Write in full)
(Write in full) Supervisory/
Technical/etc)
From To

Capacity Building on documentation of PAMANA-SLP case narratives for Field DSWD-Central Office and DSWD-CARAGA
10/23/2017 10/26/2017 32 Technical
implementers and SLP-PAMANA Program Participants Region

Raymundo G. Agravante- Regional Director,

DOLE RO X,Josephine G. Go, MD, MBA,
Basic Occupational Safety and Health Training (BOSH) 2/29/2016 3/4/2016 40 Supervisory
FPCOM- President, OSHNet-10, Inc. and Ma.
Teresita S. Cucueco, MD, CESO III, Executive

Training on SLP Simplified Process (2.0) for Project Development Officers 4/20/2015 4/25/2015 40 Technical DSWD Field Office XII

PAMANA-SLP Year-End Project Review and Evaluation Workshop 10/20/2014 10/24/2014 40 Technical DSWD Central Office and Asec. Camilo Gudmalin

SLP-PAMANA Capacity Building on Project Management for Monitoring, Controlling DSWD Central Office and Ms. Joyce
8/18/2014 8/22/2014 40 Technical
and Evaluation Gonzaga

Capacity Building for PAMANA PDO on basic skills in community facilitation in CAA/ DSWD Central Office and Office of the
5/5/2014 5/9/2014 40 Technical
CVA areas. Presidential Adviser on Peace Process

Teambuilding workshop for SLP PDO and PAMANA 2/19/2014 2/20/2014 16 Technical DSWD Field Office XII

Procurement and Financial Management Training 2/6/2014 2/7/2014 16 Technical DSWD Field Office XII KALAHI-CIDSS

CDED Training for LGU livelihood workers with newly hired PDO's and BUB's 12/3/2013 12/6/2013 32 Technical DSWD Field Office XII

Program Review and Evaluation Workshop (PREW) 10/30/2013 10/31/2013 16 Technical DSWD Field Office XII

Community Driven Enterprises Development Training 9/9/2013 9/10/2013 16 Technical DSWD Field Office XII

On-Job-Training 4/6/2009 5/28/2009 200 Managerial Bureau of Customs, Port of Cagayan de Oro City

Capitol Univertsity Business Administration-

Work Readiness Seminar 1/24/2009 1/24/2009 8 Managerial
Student Council
Capitol Univertsity Business Administration-
Time Management Seminar 12/6/2008 12/6/2008 8 Managerial
Student Council

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

MEMBERSHIP IN ASSOCIATION/ORGANIZATION
NON-ACADEMIC DISTINCTIONS / RECOGNITION
31. SPECIAL SKILLS and HOBBIES 32. 33. (Write
(Write in full)
in full)

Can speak with english, bisaya, ilonggo, Social Welfare Employee Association of the
N/A
tagalog and maranao. Philippines (SWEAP)

Computer Literate

Reading Sports News and Articles

Playing Basketball, Badminton, Billiards and

Chess.

Watching NBA, MLB, NHL, NFL, ATP, and

PBA television channels.

(Continue on separate sheet if necessary)

SIGNATURE DATE 12/31/2017 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? ________________________________
________________________________
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
the last 6 months
Director Aminodin D. Guro, LTFRB X Cagayan de Oro City N/A 3.5 cm. X 4.5 cm
(passport size)

Elizabeth E. Figueroa, Dean-BSBA Capitol University Cagayan de Oro City N/A With full and handwritten
name tag and signature over
printed name
Hon. Shariefullah A. Tanog, Municipal Mayor Pualas, 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: PASSPORT

ID/License/Passport No.: EC3318456

Signature (Sign inside the box)
12-31-2017
Date/Place of Issuance: Jan. 30, 2015/ General Santos 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