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 agai
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. F

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

MIDDLE NAME EBESA

3. DATE OF BIRTH
(mm/dd/yyyy) 2/4/1995 16. CITIZENSHIP
✘ Filipino Dual Citizenship

by birth by naturalizatio
4. PLACE OF BIRTH SURIGAO CITY If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male ✘ Female

17. RESIDENTIAL ADDRESS 04312 PUROK 9 NAVARRO STREET

6 CIVIL STATUS ✘ Single Married
House/Block/Lot No. Street
Widowed Separated
BRGY TAFT
Other/s:
Subdivision/Village Barangay
SURIGAO CITY SURIGAO DEL NORTE
7. HEIGHT (m) 1.524 m
City/Municipality Province
8. WEIGHT (kg) 62 kg ZIP CODE 8400
18. PERMANENT ADDRESS 04312 PUROK 9 NAVARRO STREET
9. BLOOD TYPE B+
House/Block/Lot No. Street
TAFT
10. GSIS ID NO.
Subdivision/Village Barangay
SURIGAO CITY SURIGAO DEL NO
11. PAG-IBIG ID NO. 916116763573
City/Municipality Province
12. PHILHEALTH NO. 180251985586 ZIP CODE 8400

13. SSS NO. 0824271798 19. TELEPHONE NO.

14. TIN NO. 20. MOBILE NO. +639 093 237 563

15. AGENCY EMPLOYEE NO. 21. E-MAIL ADDRESS (if any) reycel1995@gmail.com
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (m
NAME EXTENSION (JR., SR)
FIRST NAME

MIDDLE NAME

OCCUPATION

EMPLOYER/BUSINESS NAME

BUSINESS ADDRESS

TELEPHONE NO.

24. FATHER'S SURNAME COMANDANTE

NAME EXTENSION (JR., SR)
FIRST NAME REYNALDO

MIDDLE NAME PELINTA

25. MOTHER'S MAIDEN NAME

SURNAME EBESA

FIRST NAME CECILIA

MIDDLE NAME CABUSAS (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

HIGHEST
NAME OF SCHOOL BASIC EDUCATION/DEGREE/COURSE LEVEL/
26. PERIOD OF ATTENDANCE YEAR
UNITS
LEVEL (Write in full) EARNED
GRADUATE
(Write in full) D
From To (if not
graduated)
ELEMENTARY MARIANO ESPINA MEMORIAL ELEMENTARY SCHOOL ELEMENTARY 2001 2007 graduated 2007
VOCATIONAL / SURIGAO DEL NORTE NATIONAL HIGH
SECONDARY SCHOOL
HIGH SCHOOL 2007 2011 graduated 2011

TRADE SURIGAO STATE COLLEGE OF BACHELOR OF SCIENCE IN INFORMATION

COLLEGE
COURSE TECHNOLOGY SYSTEM 2011 2015 graduated 2015
GRADUATE STUDIES

(Continue on separate sheet if necessary)

SIGNATURE DATE January 29, 2020

CS FORM 212 (Revised

ase/s against the

o not fill up. For CSC use only)

naturalization
ntry:

RO STREET
Street
GY TAFT
rangay
O DEL NORTE
ovince

RO STREET
Street
TAFT
rangay
DEL NORTE
ovince

OF BIRTH (mm/dd/yyyy)

SCHOLARSHIP/
ACADEMIC HONORS
RECEIVED

CITY GOVERNMENT
SCHOLAR
 y 29, 2020

M 212 (Revised 2017), Page 1 of 4

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

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

11/24/2013 5/24/2014 SERVICE CREW GOLDEN LION PIZZA CORP. (GREENWICH SURIGAO) 4000.00 CONTRACTUAL

7/8/2015 12/30/2015 ADMINISTRATIVE AIDE SURIGAO STATE COLLEGE OF TECHNOLOGY 5000.00 CONTRACTUAL

OFFICE CLERK PGEA 5000.00 CONTRACTUAL

5/28/2016 present TELLER MLHUILLIER FINANCIAL SERVICES 10000.00 REGULAR

(Continue on separate sheet if necessary)

SIGNATURE DATE January 29, 2020

CS FORM 212 (Revised 2017)
 LICENSE (if applicable)

Date of
Validity

eparate sheet if necessary)

GOV'T
SERVICE

(Y/
N)
N

eparate sheet if necessary)

January 29, 2020
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

ORGANIZATIONAL PRODUCTIVITY ENHANCEMENT COMMITTEE PRO

ORGANIZATIONAL PRODUCTIVITY ENHANCEMENT COMMITTEE VICE PRESIDENT - CRS

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

INTERNATIONAL EMPLOYMENT ACCELERATE TRAINING 6/15/2013 4/18/2014 12 JEEP USAID - SSCT

6TH CARAGA IT CONGRESS W/THE THEME : "INNOVATIONS FOR
EDUCATION ON MOBILE GENERATION." 3/7/2014 3/7/2014 12 COMMISSION ON HIGHER EDUCATION

PHILIPPINE SOCIETY FOR INFORMATION TECHNOLOGY

SEMINAR & WORKSHOP ON THE FUNDAMENTALS OF HTML5 EDUCATORS (PSITE) CARAGA CHAPTER CARAGA
DESIGN & APPLICATION 3/7/2014 3/7/2014 12 COUNCIL OF DEANS FOR INFORMATION TECHNOLY
EDUCATION

WORLD CONSUMER RIGTHS DAY CONSUMPTIONS 3/15/2014 3/15/2014 12 DEPARTMENT OF TRADE & INDUSTRY (DTI)

ONE-DAY GENDER SENSITIVITY TRAINING FOR SSCT FACULTY 8/9/2015 8/9/2015 12 SURIGAO STATE COLLEGE OF TECHNOLOGY

CIVIL SERVICE COMMISSION- CARAGA REGIONAL

ONE-DAY ORIENTATION ON RA 6713 & EMPLOYEE DISCIPLINE 11/21/2015 11/21/2015 8 OFFICE

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

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

(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 theof bureau or office or to the person who has immediate supervision over you in the
chief
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
YES ✘ NO
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, YES ✘ NO
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
YES ✘ NO
(except Barangay election)?
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
a.
items:
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
TIMES BRGY WASHINGTON the last 6 months
DONNA MAY DILOY PINGUIT SURIGAO CITY 3.5 cm. X 4.5 cm
(passport size)

ERIC DOLERA GARCES CEBU CITY With full and handwritten

name tag and signature over
DEL CASTILLO BLDG RIZAL ST printed name
CHERYLOU A. ALCESO SURIGAO CITY
Computer generated
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct or photocopied picture
is not acceptable
and 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 PHOTO
filing of 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:

ID/License/Passport No.:
Signature (Sign inside the box)

Date/Place of Issuance:
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