Legal Assistant (LTO Central Office)

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 FOJAS

NAME EXTENSION (JR., SR)

FIRST NAME MICHAEL

MIDDLE NAME TUASON

3. DATE OF BIRTH

16. CITIZENSHIP

(mm/dd/yyyy) 3/9/1967 Filipino Dual Citizenship

by

by naturalization

birth

4. PLACE OF BIRTH MANILA If holder of dual citizenship, Pls. indicate country:

please indicate the details.

5. SEX Male Female

6 CIVIL STATUS Single Married 17. RESIDENTIAL ADDRESS 25 Coronado

House/Block/Lot No. Street

Widowed Separated

Vista Verde Exec. Village San Isidro

Other/s: Subdivision/Village Barangay

7. HEIGHT (m) 1.75 Cainta Rizal

City/Municipality Province

8. WEIGHT (kg) 79 ZIP CODE 1900

9. BLOOD TYPE B 18. PERMANENT ADDRESS Same As Above

House/Block/Lot No. Street

10. GSIS ID NO. 200*******

Subdivision/Village Barangay

11. PAG-IBIG ID NO. 005*********

City/Municipality Province

12. PHILHEALTH NO. 190********** ZIP CODE

13. SSS NO. 330-***-**** 19. TELEPHONE NO. None

14. TIN NO. 191******-**. MOBILE NO. 093******** 091********

4016 (LTO-Law Enforcement Unit Legal 21. E-MAIL ADDRESS (if any)

15. AGENCY EMPLOYEE NO.

Division) *******@*****.***.**

II. FAMILY BACKGROUND

DATE OF BIRTH

22. SPOUSE'S SURNAME GARBANZOS 23. NAME of CHILDREN (Write full name and list all) (mm/dd/yyyy)

NAME EXTENSION (JR., SR)

FIRST NAME GOGI ISABELLA MA. KATRINA G. FOJAS 3/30/1999

MIDDLE NAME BANDOQUILLO MARCUS IÑIGO G. FOJAS 2/11/1999

OCCUPATION SELF-EMPLOYED (VITAMINS RETAILER)

EMPLOYER/BUSINESS NAME NOT APPLICABLE

BUSINESS ADDRESS 25 Coronado St., Vista Verde, Cainta, Rizal 1900

TELEPHONE NO. 099********

24. FATHER'S SURNAME FOJAS

NAME EXTENSION (JR., SR)

FIRST NAME IÑIGO

MIDDLE NAME SILVESTRE

25. MOTHER'S MAIDEN NAME

SURNAME TUASON

FIRST NAME AURORA

MIDDLE NAME CRUZ (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

HIGHEST LEVEL/

NAME OF SCHOOL BASIC EDUCATION/DEGREE/COURSE SCHOLARSHI

26. PERIOD OF ATTENDANCE YEAR P/ ACADEMIC

LEVEL (Write (Write in full) UNITS EARNED GRADUATED HONORS

in full) RECEIVED

From To (if not graduated)

ELEMENTARY PACO CATHOLIC SCHOOL ELEMENTARY 06/13/1974 03/22/1980 1980

SECONDARY

VOCATIONAL / SAN BEDA COLLEGE HIGH SCHOOL 8/6/1980 03/21/1984 1984

None

None

TRADE

COURSE

COLLEGE SAN BEDA COLLEGE LIBERAL ARTS (Economics) 06/14/1984 03/14/1988 1988

GRADUATE STUDIES MANUEL L. QUEZON UNIVERSITY BACHELOR OF LAWS 06/15/1994 10/18/1998 1998

(Continue on separate sheet if necessary)

SIGNATURE DATE January 5, 2022

CS FORM 212 (Revised 2017), Page 1 of 4

IV. CIVIL SERVICE ELIGIBILITY

27. LICENSE (if applicable)

CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER DATE OF

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 0.9 Nov. 24, 1999 Quezon City

(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 SALARY

applicable)& STEP

APPOINTMENT

abbreviate) in full/Do not abbreviate) (Format "00-0")/

INCREMENT

From To

(Y/ N)

10/1/2020 Present Legal Officer Land Transportation Ofice - Law P18,000.00 Contractual Y

Enforcement Service

8/1/2017 7/31/2020 Admin/Operations Asst. Manager Selective Security Agency P45,000.00 Regular N

8/4/2018 10/31/2018 Substitute Teacher Pamanatasang Lungsod ng Marikina P22,000.00 Contractual Y

2/1/2001 7/31/2016 City Election Officer Commission On Elections P43,439.00 19 Contractual Y

6/4/1994 1/31/2001 Paralegal Javier, Fojas & Associates Law Office P20,000.00 Regular N

(Continue on separate sheet if necessary)

SIGNATURE DATE January 05, 2022

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

NONE

(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. ATTENDANCE Type of LD

TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING NUMBER OF HOURS

( Managerial/ CONDUCTED/ SPONSORED BY

PROGRAMS (Write in full) (mm/dd/yyyy) Supervisory/ (Write in full)

Technical/etc)

From To

Security Trainors Training 12/6/2019 12/8/2019 24 Hrs Technical GE-SUN Consultancy (DOLE Accr)

Certified Security Trainer 11/8/2019 11/8/2019 08 Hrs. Technical PARSTSI

Board

- Security Trainers Cert/

Technical,

Security Professional Trainers' Course 11/4/2019 11/8/2019 48 Hrs Supervisory PNP Civil Security Group

Campaign Finance Field Training 3/6/2016 3/6/2016 08 Hrs. Technical COMELEC

Leadership Training 2/17/2019 2/19/2016 24 Hrs. Managerial COMELEC - DepEd

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

NON-ACADEMIC DISTINCTIONS / RECOGNITION MEMBERSHIP IN ASSOCIATION/ORGANIZATION

31. SPECIAL SKILLS and HOBBIES 32. 33. (Write in

(Write in full)

full)

(Continue on separate sheet if necessary)

SIGNATURE DATE January 05, 2022

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:

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 phased YES NO

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

Barangay election)? YES NO

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

LTO - LES Deputy Director Roberto A. Valera 918-***-**** 3.5 cm. X 4.5 cm

(passport size)

Vice Mayor Jeannie Sandoval 917-***-**** With full and handwritten

name tag and signature over

printed name

Congressman Romulo V. Peňa (1st Distr, Makati City) 916-***-****

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: GSIS 200*******

ID/License/Passport No.: Driver's License NO185024903 Signature (Sign inside the box)

January 05, 2022

Date/Place of Issuance: Marikina City/ Exp, 03/09/23 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

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