PMIS Form

#002

Individual Form No.

INDIVIDUAL MEMBER’S PROFILE

Place
Latest
ABOUT THE MEMBER
2x2 Photo
1. Name DUMO HAROLD CARIASO Here
Last Name Given Name Middle Name

2. Nickname RHOLD 3. Are you differently abled Yes No

4. Complete Address BLACK 28 LOT 7
No. Street Village/Subdivision/Barangay
AGL HEIGHTS II, CAALIBANGBANGAN 5. Contact No. _09238499951
City/Municipality CABANATUAN CITY Province NUEVA ECIJA
6. Email Address:harolddumo@yahoo.com
7. Birthday 02-23-1976 8. Birthplace TALUGTUG, NUEVA ECIJA
m md d y y
9. Gender Male Female 10. Civil Status Single
Married
11. Religion EVANGELICAL CHRISTIAN 12. Blood Type O Widow/er
Separated
13. Highest Educational Attainment 14. Name of Spouse THEISA P
DUMO
COLLEGE GRADUATE 15. Father’s Name DERRY R
DUMO
16. Mother’s Name JENIE C DUMO
17. Name/s of Dependent/s: (Please use extra sheet, if necessary.)
HAROLD JR. P. DUMO
______________________________________________________________________________
______________________________________________________________________________
18. Membership Type Individual Retiree Union Member
19. Union Name (in full, please) 20. Position in the Union
_____________________
____________________________________ 21. Date Elected | | | | | | |
______________________________________ mm d d y y

MEMBER’S EMPLOYMENT
22. Name of the Agency PHILIPPINE NATIONAL POLICE
23. Complete Address
No. Street Village/Subdivision/Barangay
M. DE LEON AVE, CITY HALL COMPOUND, KAPITAN PEPE 24. Contact
No. 09206112000
City/Municipality CABANATUAN CITY Province: NUEVA ECIJA 25. Fax
Number 044-463-1111
26. Website Address N/A 27. Occupation NON-UNIFORMED PERSONNEL
28. Position in the Agency RADIO OPERATOR 29. Basic Salary
Php14,961.00
30. Salary Grade: 6-2 31. Gross Annual Income
Php179,532.00
32. Job Status: Regular Probationary Contractual Casual
Co-terminus
IN CASE OF EMERGENCY
33. Contact Person THEISA P. DUMO Relationship WIFE
23. Complete Address
BLACK 28 LOT 7 AGL HIEGHTS II, CAALIBANGBANGAN, CABANATUAN CITY,
NUEVA ECIJA
No. Street Village/Subdivision/Barangay City/Municipality
Province

24. Contact No. 09331790765

MORE AT THE BACK

 SKILLS:

Writing Communication Community/Labor

Organizing
Computer-related Financial Management Cooperative
Management
Graphic Arts Counseling Conduct of Trainings/Meetings
Performing Arts Care-giving/Health Care Others (please
specify)
_____________________
_____________________
_____________________

List of All Trainings Attended Date Venue No. of

(Please use extra sheet, if necessary.) Hours
1. DISCIPLESHIP TRAINING JULY – GOD IS ALIVE 40
AUG. 2019 CHURCH
TEMPLE
DS. GARCIA,
CABANATUAN
CITY

2. ANTI-ROBBERY AUGUST CABANATUAN 3

25, 2019 CITY POLICE
STATION

3. CASE INFORMATION AND DATABASE APRIL NEPPO HOSTEL 32

MANAGEMENT SYSTEM(CIDMS) 4,5,11,12, CABANATUAN
2019 CITY

4. TRAINING OF TRAINERS(TOT)FOR FEB. 2-7, HARVEST 24

ONLINE CASE INFORMATION AND 2017 HOTEL
DATABASE MANAGEMENT SYSTEM CABANATUAN
(CIDMS) CITY

5. COMMUNICATION TECHNOLOGY JULY 10, REGIONAL 3

TRAINING/SEMINAR 2015 COMMUNICATI
ON &
ELECTRONICS
OFFICE 3
CAMP OLIVAS
, SAN
FERNANDO
PAMPANGA

6. TEACHERS AND PREACHERS TRAINING OCTOBER GOD IS ALIVE

SCHOOL 14, 2007 CHURCH
TEMPLE
DS. GARCIA,
CABANATUAN
CITY

7.

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18.

Thank you!
Instructions in Filling Up the PSLINK INDIVIDUAL MEMBER’S PROFILE
Form

1. Please submit a clear photograph and do not staple nor paste on the
form. Please write your name legibly at the back of the photograph.
2. Please type or write legibly.
3. Contact numbers could be cellular phone or landline phone.
4. For item # 5, please put the area code inside the parenthesis “( )”.
5. For item # 6, if you don’t have an email address, leave space blank.
6. For items # 14, #15, and #16, if deceased, please indicate.
7. For item # 17, dependents include children below 21 years old and
parents above 65 years old.
8. For item # 19, please state the full name of your Union.
9. For item # 20, please state your elected position in the Union.
10.For items #7 and #21, dates should be in month month day day year year
format for example October 7, 1968, the date should be 10/07/68
11.For item #22, please state the full name of your Agency.
12.For items # 24 and # 25, please put the area code inside the parenthesis
“( )”.
13.For item #26, if your Agency doesn’t have a URL or website address,
leave space blank.
14.For item #29, please do not include other sources of income.
15.For item #31, please include allowances and other benefits received from
your Agency such as PERA, clothing allowance, rice subsidy, etc.
16.For Trainings Attended, please indicate all trainings from the start of
your employment including PSLINK trainings.

VERY IMPORTANT: Please fill in the blanks with the necessary

information.

Principal beneficiary: THEISA P DUMO Relationship: WIFE

Secondary beneficiary: HAROLD JR. P. DUMO Relationship: SON
Contact Address: BLK 28 LOT 7 AGL HIEGHTS II,
CAALIBANGBANGN,CABANATUAN CITY
Contact Number: 09331790765