CS Form No. ***
Revised ****
PERSONAL DATA SHEET
WARNING: Any misrepresentation 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 AQUINO
NAME EXTENSION (JR., SR)
FIRST NAME MIGUEL ANGELICO
MIDDLE NAME DEOCAMPO
3. DATE OF BIRTH
MARCH 22 1997 16. CITIZENSHIP
(mm/dd/yyyy) Filipino Dual Citizenship
by by
birth naturalization
4. PLACE OF BIRTH DAVAO CITY If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male Female
6 CIVIL STATUS Single Married 17. RESIDENTIAL ADDRESS 26 JUNA AVENUE
House/Block/Lot No. Street
Widowed Separate
JUNA SUBDIVISION MATINA
Other/s: d
Subdivision/Village Barangay
DAVAO CITY
7. HEIGHT (m) 1.64M
City/Municipality Province
8. WEIGHT (kg) 51KG ZIP CODE 8000
18. PERMANENT ADDRESS N/A N/A
9. BLOOD TYPE O
House/Block/Lot No. Street
N/A N/A
10. GSIS ID NO. N/A
Subdivision/Village Barangay
11. PAG-IBIG ID NO. N/A
N/A N/A
City/Municipality Province
12. PHILHEALTH NO. 162********* ZIP CODE N/A
13. SSS NO. 34-843****-*-**. TELEPHONE NO. (082-***-****
14. TIN NO. N/A 20. MOBILE NO. +639*********
15. AGENCY EMPLOYEE NO. N/A 21. E-MAIL ADDRESS (if any) ***********@*****.***
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 N/A N/A
OCCUPATION N/A N/A N/A
EMPLOYER/BUSINESS NAME N/A N/A N/A
BUSINESS ADDRESS N/A N/A N/A
TELEPHONE NO. N/A N/A N/A
24. FATHER'S SURNAME AQUINO N/A 02/19/1975
FIRST NAME JONATHAN
NAME EXTENSION (JR., SR) N/A N/A
MIDDLE NAME DE CASTRO N/A N/A
25. MOTHER'S MAIDEN NAME N/A 12/14/1975
SURNAME DEOCAMPO N/A N/A
FIRST NAME ANGELLE MARIE N/A N/A
MIDDLE NAME MAGBANUA (Continue on separate sheet if necessary)
III. EDUCATIONAL BACKGROUND
NAME OF SCHOOL HIGHEST LEVEL/ SCHOLARSHIP/
26. BASIC EDUCATION/DEGREE/COURSE PERIOD OF ATTENDANCE YEAR
LEVEL (Write in UNITS ACADEMIC
(Write in full) GRADUATED
full) EARNED HONORS
(if not graduated) RECEIVED
From To
ELEMENTARY ATENEO DE DAVAO UNIVERSITY ELEMENTARY 2004 2010 N/A 2010 N/A
SECONDARY
VOCATIONAL /
ATENEO DE DAVAO UNIVERSITY HIGH SCHOOL 2010 2014 N/A 2014 N/A
N/A N/A N/A N/A N/A N/A N/A
TRADE
COURSE
BACHELOR OF SCIENCE IN
COLLEGE ATENEO DE DAVAO UNIVERSITY ENTREPRENEURSHIP MAJOR IN 2014 2018 N/A 2018 N/A
AGRIBUSINESS
GRADUATE STUDIES N/A N/A N/A N/A N/A N/A 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
NON-PROFESSIONAL DRIVER'S LICENSE 89% 11/10/2018 LAND TRANSPORTATION OFFICE XI L0218011595 03/22/2022
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N/A N/A N/A N/A N/A N/A
(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 (mm/dd/ SALARY/ JOB/ PAY SERVICE
yyyy) POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY GRADE (if
MONTHLY STATUS OF
(Write in full/Do not (Write in SALARY
applicable)& STEP
APPOINTMENT
abbreviate) full/Do not abbreviate) (Format "00-0")/
INCREMENT
From To
(Y/ N)
INTERNATIONAL PROPERTY
06/2019 6/1/2020 ALIANZA PMC 15,000.00 N/A REGULAR NO
CONSULTANT
4/2018 8/2018 SOLE PROPREITOR JICO'S POULTRY 10,000.00 N/A OWNER NO
2000 2014 CASHIER FARMACIA BATANGUENA DRUG STORE N/A N/A PART TIME NO
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(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
INCLUSIVE DATES
29. NAME & ADDRESS OF ORGANIZATION
(Write in full) (mm/dd/yyyy) NUMBER OF HOURS POSITION / NATURE OF WORK
From To
ATENEO GREEN-AGRIPRENEURS FO RENEWABLE & ECO-FRIENDLY
ENTERPRISES SOCIETY 06/23/2014 03/16/2018 400+ COMMITTEE ON COMMUNITY ENGAGEMENT AND ADVOCACY CHAIRMAN
N/A N/A N/A N/A N/A
N/A N/A N/A N/A N/A
N/A N/A N/A N/A N/A
N/A N/A N/A N/A N/A
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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
ATTENDANCE Type of LD
30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS ( Managerial/
(Write in full)
NUMBER OF HOURS
Supervisory/ CONDUCTED/ SPONSORED BY (Write in full)
(mm/dd/yyyy)
Technical/etc)
From To
03/2018 03/2018 6 TECHNICAL COL FINANCIAL
PHILIPPINE FINANCIAL SUMMIT
FORUM ON SUSTAINABLE AGRICULTURE AND AGRIBUSINESS 02/01/2018 02/01/2018 6 TECHNICAL ATENEO DE DAVAO UNIVERSITY
FINANCIAL LITERACY FOR YOUNG LEADERS 12/12/2018 12/12/2018 6 TECHNICAL ATENEO DE DAVAO UNIVERSITY
SEMINAR ON ECOLOGICAL AGRICULTURE, LIVELIHOOD AND AGRIBUSINESS
OPPORTUNITIES (SEALAO) 11/07/2017 11/07/2017 6 TECHNICAL ATENEO DE DAVAO UNIVERSITY
#IAMHAMPASLUPA: REGIONAL FORUM ON THE ROLE OF THE FILIPINO YOUTH 10/23/2017 10/23/2017 6 TECHNICAL ATENEO DE DAVAO UNIVERSITY
IN SHAPING THE COUNTRY'S FOOD AND AGRICULTURE
PRACTICUM ACTIVITY ON AGRICULTURAN ENTREPRENEURSHIP 9/28/2017 9/28/2017 6 TECHNICAL ATENEO DE DAVAO UNIVERSITY
FORUM ON COMPETITIVE ORGANIC AGRICULTURE INDUSTRY FOR ASIAN
MARKET 8/28/17 8/28/17 6 TECHNICAL ATENEO DE DAVAO UNIVERSITY
SIMA ASEAN THAILAND 2017 9/07/2017 09/09/2017 24 TECHNICAL SIMA ASEAN THAILAND
REAL ESTATE TRAINING PROGRAM 06/18/2019 06/19/19 16 TECHNICAL PHILIPPINE ASSOCIATION OF REALTORS BOARDS
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(Continue on separate sheet if necessary)
VIII. OTHER INFORMATION
NON-ACADEMIC DISTINCTIONS / RECOGNITION MEMBERSHIP IN ASSOCIATION/ORGANIZATION
31. SPECIAL SKILLS and HOBBIES 32. (Write in full) 33. (Write in full)
SOCCER PLAYER PALARONG PAMBANSA REGION XI
N/A N/A N/A
N/A N/A N/A
N/A N/A N/A
N/A N/A N/A
N/A N/A N/A
N/A N/A N/A
(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
b. within the fourth degree (for Local Government Unit - Career Employees)? YES
If YES, give details:
N/A
35. a. Have you ever been found guilty of any administrative offense?
YES NO
If YES, give details:
N/A
b. Have you been criminally charged before any court? YES NO
If YES, give details:
Date Filed: N/A
Status of Case/s: N/A
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:
N/A
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?
N/A
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: N/A
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: N/A
39. Have you acquired the status of an immigrant or permanent resident of another country?
YES NO
If YES, give details (country):
N/A
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: N/A
b. Are you a person with disability? YES NO
If YES, please specify ID No: N/A
c. Are you a solo parent? YES NO
If YES, please specify ID No: N/A
41. REFERENCES (Person not related by consanguinity or affinity to applicant /appointee)
NAME ADDRESS TEL. NO.
ID picture taken within
the last 6 months
JUDGE OSCAR S. AQUINO JUNA AVENUE, DAVAO CITY 092******** 3.5 cm. X 4.5 cm
(passport size)
JUDGE GLENN D.C AQUINO GSIS, DAVAO CITY 091******** With full and handwritten
name tag and signature over
printed name
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: DRIVER'S LICENSE
ID/License/Passport No.: L0218011595
Signature (Sign inside the box)
Date/Place of Issuance: DAVAO CITY - 10/11/2018
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