CS Form No. 212 Personal Data Sheet revised (1).xlsx

	A	B	D	G	I	J	K	L	M	N
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3	PERSONAL DATA SHEET
4	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.
5	READ THE ATTACHED GUIDE TO FILLING OUT THE PERSONAL DATA SHEET (PDS) BEFORE ACCOMPLISHING THE PDS FORM.
7	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)
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9	I. PERSONAL INFORMATION
10	2.	SURNAME
11		FIRST NAME						NAME EXTENSION (JR., SR)
12		MIDDLE NAME
13	3.	DATE OF BIRTH (mm/dd/yyyy)		16. CITIZENSHIP
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15	4.	PLACE OF BIRTH		If holder of dual citizenship,				Pls. indicate country:
16	5.	SEX		please indicate the details.
17	6	CIVIL STATUS		17. RESIDENTIAL ADDRESS
18	6	CIVIL STATUS			House/Block/Lot No.			Street
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21					Subdivision/Village			Barangay
22	7.	HEIGHT (m)
23	7.	HEIGHT (m)			City/Municipality			Province
24	8.	WEIGHT (kg)		ZIP CODE
25	9.	BLOOD TYPE		18. PERMANENT ADDRESS
26	9.	BLOOD TYPE			House/Block/Lot No.			Street
27	10.	GSIS ID NO.
28	10.	GSIS ID NO.			Subdivision/Village			Barangay
29	11.	PAG-IBIG ID NO.
30	11.	PAG-IBIG ID NO.			City/Municipality			Province
31	12.	PHILHEALTH NO.		ZIP CODE
32	13.	SSS NO.		19. TELEPHONE NO.
33	14. TIN NO.			20. MOBILE NO.
34	15. AGENCY EMPLOYEE NO.			21. E-MAIL ADDRESS (if any)
35	II. FAMILY BACKGROUND
36	22.	SPOUSE'S SURNAME			23. NAME of CHILDREN (Write full name and list all)				DATE OF BIRTH (mm/dd/yyyy)
37		FIRST NAME		NAME EXTENSION (JR., SR)
38		MIDDLE NAME
39		OCCUPATION
40		EMPLOYER/BUSINESS NAME
41		BUSINESS ADDRESS
42		TELEPHONE NO.
43	24.	FATHER'S SURNAME
44		FIRST NAME		NAME EXTENSION (JR., SR)
45		MIDDLE NAME
46	25.	MOTHER'S MAIDEN NAME
47		SURNAME
48		FIRST NAME
49		MIDDLE NAME			(Continue on separate sheet if necessary)
50	III. EDUCATIONAL BACKGROUND
51	26.	LEVEL	NAME OF SCHOOL (Write in full)	BASIC EDUCATION/DEGREE/COURSE (Write in full)		PERIOD OF ATTENDANCE		HIGHEST LEVEL/ UNITS EARNED (if not graduated)	YEAR GRADUATED	SCHOLARSHIP/ ACADEMIC HONORS RECEIVED
52	26.					PERIOD OF ATTENDANCE
53						From	To
54		ELEMENTARY
55		SECONDARY
56		VOCATIONAL / TRADE COURSE
57		COLLEGE
58		GRADUATE STUDIES
59	(Continue on separate sheet if necessary)
60	SIGNATURE					DATE
61	CS FORM 212 (Revised 2017), Page 1 of 4
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