Professional Profile Summary
Resume:
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 if accomplished through own handwriting. Tick appropriate boxes and use separate sheet if necessary. Indicate N/A if not applicable. DO NOT ABBREVIATE.
I. PERSONAL INFORMATION
1. SURNAME DOMINGO
NAME EXTENSION (JR., SR) N/A
2. FIRST NAME DIVINA
MIDDLE NAME CADUNGOG
3. DATE OF BIRTH
01/6/1974 16. CITIZENSHIP Dual
(dd/mm/yyyy) Filipino
Citizenship
by by
birth naturalization
4. PLACE OF BIRTH BUTUAN CITY If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX AT BIRTH Male
Female
6 CIVIL STATUS Single 17. RESIDENTIAL ADDRESS N/A PUROK 5
Married
Widowe Separa House/Block/Lot No. Street
OCHOA AVE., LAURAVILLE SUBD. 14-LIMAHA
d ted
Other/s: Subdivision/Village Barangay
BUTUAN CITY AGUSAN DEL NORTE
7. HEIGHT (m) 1.53
City/Municipality Province
8. WEIGHT (kg) 68 ZIP CODE 8600
18. PERMANENT ADDRESS N/A PUROK 5
9. BLOOD TYPE O+
House/Block/Lot No. Street
OCHOA AVE., LAURAVILLE SUBD. 14-LIMAHA
10. UMID ID NO. B74M1DCD018
Subdivision/Village Barangay
BUTUAN CITY AGUSAN DEL NORTE
11. PAG-IBIG ID NO. 310*********
City/Municipality Province
12. PHILHEALTH NO. 18-000042440-2 ZIP CODE 8600
13. PhilSys Number (PSN): 081*******-**. TELEPHONE NO. 085-***-****
14. TIN NO. 190-***-***-**. MOBILE NO. 090********
15. AGENCY EMPLOYEE NO. 130*******-**. E-MAIL ADDRESS (if any) ****************@*****.***
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME DOMINGO 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (dd/mm/yyyy)
NAME EXTENSION (JR., SR) KATE TRISHIA C. DOMINGO
FIRST NAME CHRISTIAN MARK ANTHONY 18/11/1997
FLORENCE SONJA C. DOMINGO
MIDDLE NAME AGUILAR 13/01/2001
CHRIS IAN C. DOMINGO
OCCUPATION NONE 18/08/2008
EMPLOYER/BUSINESS NAME NONE XXX XXX
BUSINESS ADDRESS NONE
TELEPHONE NO. NONE
24. FATHER'S SURNAME CADUNGOG (DECEASED)
NAME EXTENSION (JR., SR)
FIRST NAME PORFERIO
MIDDLE NAME MATAS
25. MOTHER'S MAIDEN NAME
SURNAME PELIN (DECEASED)
FIRST NAME MILAGROS
MIDDLE NAME ABELLANA (Continue on separate sheet if necessary)
III. EDUCATIONAL BACKGROUND
NAME OF SCHOOL HIGHEST LEVEL/
26. PERIOD OF ATTENDANCE YEAR SCHOLARSHIP/
LEVEL (Write in BASIC EDUCATION/DEGREE/COURSE UNITS
GRADUATED ACADEMIC HONORS
full)
(Write in full) EARNED RECEIVED
(if not graduated)
From To
ELEMENTARY BUTUAN CENTRAL ELEMENTARY SCHOOL ELEMENTARY 1981 1987 GRADUATED 1987 4TH HONOR
SECONDARY
VOCATIONAL /
AGUSAN NATIONAL HIGH SCHOOL HIGH SCHOOL 1987 1991 GRADUATED 1991 3RD HONOR
N/A N/A N/A N/A N/A N/A N/A
TRADE
COURSE BACHELOR OF SCIENCE IN COMPUTER
COLLEGE SAINT JOSEPH INSTITUTE OF TECHNOLOGY SCIENCE 1993 1997 GRADUATED 1997 DEAN'S LISTER
GRADUATE STUDIES MEDINA COLLEGE MASTER IN PUBLIC ADMINISTRATION 2003 2005 GRADUATED 2005 N/A
(Continue on separate sheet if necessary)
SIGNATURE DATE January 13, 2026
CS FORM 212 (Revised 2025), Page 1 of 4
IV. CIVIL SERVICE ELIGIBILITY
27. LICENSE (if applicable)
CES/CSEE/CAREER SERVICE/RA 1080 (BOARD/ DATE OF
BAR)/UNDER SPECIAL LAWS/CATEGORY II/ IV ELIGIBILITY RATING EXAMINATION / PLACE OF EXAMINATION /
and ELIGIBILITIES FOR UNIFORMED PERSONNEL (If Applicable) CONFERMENT CONFERMENT NUMBER Valid Until
CAREER SERVICE SUB-PROFESSIONAL 81.13 6/29/1997 BUTUAN CITY N/A N/A
xxx nothing follows xxx
(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 (dd/mm/ GOV'T SERVICE
yyy) POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY STATUS OF
(Write in full/Do not (Write in
abbreviate) full/Do not abbreviate) APPOINTMENT
From To (Y/ N)
DEPARTMENT OF AGRARIAN REFORM
16/08/2025 TO DATE ADMINISTRATIVE AIDE VI REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
01/01/2025 15/08/2025 ADMINISTRATIVE AIDE VI REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
01/01/2024 31/12/2024 ADMINISTRATIVE AIDE VI REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
01/01/2023 31/12/2023 ADMINISTRATIVE AIDE VI REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
01/01/2022 31/12/2022 ADMINISTRATIVE AIDE VI REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
16/08/2021 31/12/2021 ADMINISTRATIVE AIDE VI REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
01/01/2021 15/08/2021 ADMINISTRATIVE AIDE VI REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
01/01/2020 31/12/2020 ADMINISTRATIVE AIDE VI REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
01/01/2019 31/12/2019 ADMINISTRATIVE AIDE VI REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
16/08/2018 31/12/2018 ADMINISTRATIVE AIDE VI REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
01/01/2018 15/08/2018 ADMINISTRATIVE AIDE VI REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
01/01/2017 31/12/2017 ADMINISTRATIVE AIDE VI REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
01/01/2016 31/12/2016 ADMINISTRATIVE AIDE VI REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
16/08/2025 31/12/2015 ADMINISTRATIVE AIDE VI REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
16/08/2015 15/08//2015 ADMINISTRATIVE AIDE VI REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
01/06/2012 15/08/2012 ADMINISTRATIVE AIDE VI REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
01/06/2011 31/05/2012 ADMINISTRATIVE AIDE VI REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
06/24/2010 31/05/2011 ADMINISTRATIVE AIDE VI REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
16/08/2009 23/06/2010 CLERK III REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
01/07/2009 15/08/2009 CLERK III REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
01/07/2008 30/06/2009 CLERK III REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
01/07/2007 30/06/2008 CLERK III REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
16/08/2006 30/06/2007 CLERK III REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
16/08/2003 15/08/2006 CLERK III REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
01/07/2001 15/08/2003 CLERK III REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM
16/08/2000 30/06/2001 CLERK III REGIONAL OFFICE XIII
PERMANENT Y
DEPARTMENT OF AGRARIAN REFORM CONTRACT OF
16/05/1998 15/08/2000 TECHNICAL STAFF REGIONAL OFFICE XIII SERVICE
N
07/08/1996 30/11/1997 TRAFFIC SECRETARY NMBS-GMA-7 BUTUAN TEMPORARY N
01/04/1993 30/08/1996 UTILITY WORKER ECONOMIC ENTERPRISE (SPES) TEMPORARY N
(Continue on separate sheet if necessary)
SIGNATURE DATE January 13, 2026
CS FORM 212 (Revised 2025), 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) (dd/mm/yyyy) NUMBER OF HOURS POSITION / NATURE OF WORK
From To
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
INCLUSIVE DATES OF
ATTENDANCE Type of L&D
30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS NUMBER OF ( Managerial/ CONDUCTED/ SPONSORED BY
(Write in full) (dd/mm/yyyy) HOURS Supervisory/ (Write in full)
Technical/etc)
From To
ORIENTATION/RE-ORIENATION ON THE CITIZEN'S CHARTER & BASIC GENDER 16/12/2025 16/12/2025 TECHNICAL DEPARTMENT OF AGRARIAN REFORM REGIONAL OFFICE
SENSITIVITY TRAINING 8 XIII
CASCADING OF THE ESSENTIAL SKILLS IN THE PROJECT PROCUREMENT & CONTRACT 12/12/2024 13/12/2024 TECHNICAL DEPARTMENT OF AGRARIAN REFORM REGIONAL OFFICE
MANANGEMENT 16 XIII
GOVERNMENT PROCUREMENT POLICY BOARD -
ESSENTIAL SKILLS IN PROJECT PROCUREMENT & CONTRACT MANAGEMENT BATCH 3 26/11/2024 29/11/2024 TECHNICAL TECHNICAL SUPPORT OFFICE
32
ISO 9001:2015 QUALITY MANANGEMENT TRAINING BASED ON ISO 19011:2018 20/05/2024 21/05/2024 TECHNICAL DEPARTMENT OF AGRARIAN REFORM REGIONAL OFFICE
GUIDELINES FOR AUDITING MANANGEMENT SYSTEM 16 XIII
DEPARTMENT OF AGRARIAN REFORM REGIONAL OFFICE
ORIENTATION WORKSHOP ISO 9001:2015 QUALITY MANAGEMENT SYSTEMS (ISO-QMS) 15/04/2024 17/04/2024 TECHNICAL XIII
24
REGIONWIDE TRAINING & WORKSHOP OF R.A. 9184 (GOVERNMENT PROCUREMENT 07/02/2024 '09/02/2024 TECHNICAL DEPARTMENT OF AGRARIAN REFORM REGIONAL OFFICE
REFORM ACT) 24 XIII
WORKSHOP FOR THE UPDATING OF THE CARAGA REGIONAL DISASTER RISK 21/07/2022 21/07/2022 TECHNICAL REGIONAL DISASTER RISK REDUCTION MANAGEMENT
REDUCTION & MANANGEMENT PLAN (RDRRMP) 2020-2028 8 COUNCIL - OFFICE OF CIVIL DEFENSE
DEPARTMENT OF AGRARIAN REFORM REGIONAL OFFICE
TECHNICAL TRAINING/WORKSHOP ON BUSINESS CORRESPONDENCE 18/08/2022 19/08/2022 TECHNICAL XIII
16
CASCADING OF THE UPDATES ON RA 9184: GOVERNMENT PROCUREMENT REFROM 09/02/2022 10/02/2022 TECHNICAL DEPARTMENT OF AGRARIAN REFORM REGIONAL OFFICE
ACT 16 XIII
DEPARTMENT OF AGRARIAN REFORM REGIONAL OFFICE
CASCADING SESSION FOR THE REVISED INDIVIDUAL DEVELOPMENT PLAN (IDP) 17/11/2021 17/11/2021 TECHNICAL XIII
8
DEPARTMENT OF AGRARIAN REFORM REGIONAL OFFICE
CASCADING ON THE DAR CORE COMPETENCIES 26/10/2021 26/10/2021 TECHNICAL XIII
8
PHILIPPINE GOVERNMENT ELECTRONIC PROCUREMENT SYSTEM (PHILGEPS) ONLINE 16/11/2020 17/11/2020 TECHNICAL E-BLACKBOARDS LEARNING & SOLUTIONS, INC.
TRAINING FOR BUYERS 16
WORKSHOP/WRITESHOP ON REGIONAL ISO-QMS MANUAL CUM REVISITING OF THE 16/12/2019 18/12/2019 TECHNICAL DEPARTMENT OF AGRARIAN REFORM REGIONAL OFFICE
PROCESSES & RISK MANAGEMENT PLAN 24 XIII
DEPARTMENT OF AGRARIAN REFORM REGIONAL OFFICE
DOCUMENT CONTROLLER TRAINING 17/12/2019 17/12/2019 TECHNICAL XIII
8
DEPARTMENT OF AGRARIAN REFORM REGIONAL OFFICE
OMNIBUS RULES ON APPOINTMENT & OTHER HUMAN RESOURCE ACTIONS (ORAOHRA) 23/04/2019 23/04/2019 TECHNICAL XIII
8
DEPARTMENT OF AGRARIAN REFORM REGIONAL OFFICE
WRITESHOP ON ORGANIZATIONAL CONTEXT & RISK MANAGEMENT PLAN 16/01/2019 18/01/2019 TECHNICAL XIII
24
CONTROL OF DOCUMENTED INFORMATION SEMINAR 06/12/2018 06/12/2018 TECHNICAL GUARDIAN INDEPENDENT CERTIFICATE (GIC)
8
ISO 9001:2015 CAPABILITY DEVELOPMENT TRAINING FOR DAR-QMS DOCUMENT 20/11/2018 23/11/2018 TECHNICAL DEPARTMENT OF AGRARIAN REFORM CENTRAL OFFICE
CONTROLLERS 32
5S BASIC GOOD HOUSEKEEPING PRACTICES 23/05/2018 23/05/2018 TECHNICAL DEPARTMENT OF LABOR & EMPLOYMENT
8
DEPARTMENT OF AGRARIAN REFORM REGIONAL OFFICE
BASIC GRAMMAR & BUSINESS WRITING SEMINAR WORKSHOP 26/04/2018 27/04/2018 TECHNICAL XIII
16
DEPARTMENT OF AGRARIAN REFORM REGIONAL OFFICE
SEMINAR WORKSHOP ON PROCUREMENT PROCESS ENHANCEMENT 19/03/2018 20/03/2018 TECHNICAL XIII
16
HANDS-ON TRAINING USING THE LEO SYSTEM OF RECORDS RETRIEVAL (LAY OF 06/02/2018 07/02/2018 TECHNICAL DEPARTMENT OF AGRARIAN REFORM REGIONAL OFFICE
ESSENTIALS ORDINANCES & OTHER DOCUMENTS) 16 XIII
DEPARTMENT OF AGRARIAN REFORM REGIONAL OFFICE
FIRST AID TRAINING 24/10/2017 26/10/2017 TECHNICAL XIII
24
DEPARTMENT OF AGRARIAN REFORM REGIONAL OFFICE
CASCADING ON ISO QMS 9001:2015 AWARENESS 13/09//2017 13/09//2017 TECHNICAL XIII
8
GENDER & DEVELOPMENT PUBLIC ACCOUNTABILITY & VALUES ENHANCEMENT 07/09/2017 08/09/2017 TECHNICAL COUNCIL FOR THE RESTORATION OF FILIPINO VALUES
SEMINAR (GAD PAVES) 16 (CRFV)
SEMINAR WORKSHOP ON GOVERNMENT PROCUREMENT REFORM ACT (GPRA-9184) & 04/07/2017 07/07/2017 TECHNICAL DEPARTMENT OF AGRARIAN REFORM REGIONAL OFFICE
ITS 2016 REVISED IMPLEMENTING RULES & REGULATIONS (IRR) 28 XIII
TRAINING WORKSHOP ON THE USE OF AGENCY PROCUREMENT COMPLIANCE DEPARTMENT OF AGRARIAN REFORM CENTRAL OFFICE
PERFORMANCE INDICATOR (APCPI) SYSTEM 25/04/2017 29/04/2017 TECHNICAL WITH GPPB
40
ORIENTATION ON THE GUIDELINES IN THE FILLING OUT OF REVISED SALN & ADVOCACY DEPARTMENT OF AGRARIAN REFORM REGIONAL OFFICE
SEMINAR ON THE EMPLOYEES COMPENSATION PROGRAM 28/10/2016 28/10/2016 TECHNICAL XIII
8
INFORMATIONAL SESSION ON THE UPDATES ON THE REVISED IMPLEMENTING RULES & GOVERNMENT PROCUREMENT POLICY BOARD -
REGULATIONS OF REPUBLIC ACT NO. 9184 24/10/2016 25/10/2016 TECHNICAL TECHNICAL SUPPORT OFFICE
16
TRAINING WORKSHOP ON THE PROCEDURES IN THE DOCUMENTATION & PROCESSING DEPARTMENT OF AGRARIAN REFORM REGIONAL OFFICE
OF OLT CLAIMS & THOSE FOR FINAL SURVEY ADJUSTMENT 04/10/2016 06/10/2016 TECHNICAL XIII
24
(Continue on separate sheet if necessary)
VIII. OTHER INFORMATION
MEMBERSHIP IN ASSOCIATION/ORGANIZATION
31. SPECIAL SKILLS and HOBBIES 32. NON-ACADEMIC DISTINCTIONS / RECOGNITION 33. (Write in
(Write in full)
full)
DATA ENCODER DEPARTMENT OF AGRARIAN REFORM - EMPLOYEES
N/A ASSOCIATION (DAREA)
INTERNET SURFING DEPARTMENT OF AGRARIAN REFORM LADIES
ASSOCIATION (DARLA)
RECORDS KEEPER, CLERICAL WORKS
ROTARY CLUB OF MIDTOWN BUTUAN (RCMB)
STATISTICIAN
xxx
PLAYING VOLLEYBALL/DANCING/SNGING
(Continue on separate sheet if necessary)
SIGNATURE DATE January 13, 2026
CS FORM 212 (Revised 2025), 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:
a. Have you ever been found guilty of any administrative offense?
35. NO
YES
If YES, give details:
b. Have you been criminally charged before any court? NO
YES
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,
NO
dropped from the rolls, dismissal, termination, end of term, finished contract or phased out (abolition) YESgive details:
If YES,
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)? NO
YESgive details:
If YES,
b. Have you resigned from the government service during the three (3)-month period before the last NO
election to promote/actively campaign for a national or local candidate? YES
If YES, give details:
39. Have you acquired the status of an immigrant or permanent resident of another country?
NO
YES
If YES, give details (country):
40. Pursuant to: (a) Indigenous People's Act (RA 8371); (b) Magna Carta for Disabled Persons (RA 7277,
as amended); and (c) Expanded Solo Parents Welfare Act (RA 11861), please answer the following
items:
a. Are you a member of any indigenous group?
NO
If YES,YES
please specify:
b. Are you a person with disability? NO
If YES,YES
please specify ID No:
c. Are you a solo parent?
NO
If YES,YES
please specify ID No:
41. REFERENCES (Person not related by consanguinity or affinity to applicant /appointee)
CONTACT NO. AND/OR
NAME OFFICE / RESIDENTIAL ADDRESS EMAIL
JOHN BENJAMIN P. ROSALES BRGY. HALL LIMAHA, BUTUAN CITY (085-***-****
Passport-sized unfiltered
digital picture taken within
EMMA D. CHAN DEPED/J. ROSALES AVE., BUTUAN CITY (085-***-**** the last 6 months
4.5 cm. X 3.5 cm
BRGY HALL BIT-OS/BRGY. BIT-OS,
HARTLEY JOHN PONTIMAR BUTUAN CITY 910-***-****
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct, 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 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: DRIVERS LICENSE
ID/License/Passport No.: K01-05-000352
Signature (Sign inside the box)
January 13, 2026
Date/Place of Issuance: 6/1/2022/BUTUAN CITY
Date Accomplished Right Thumbmark
SUBSCRIBED AND SWORN to before me this, affiant exhibiting his/her validly issued government ID as indicated above.
JOIE L. CEBALLOS
Director III/ARD for STO & ARBDSP
Person Administering Oath
CS FORM 212 (Revised 2025), Page 4 of 4
Contact this candidate