CSC Form 212 (Personal Data Sheet)rmhs.xlsx

	A	B	D	G	I	J	K	L	M	N
1
2	PERSONAL DATA SHEET
3	WARNING: Any misinterpretation made in the Personal Data Sheet and the Work Experience Sheet shall cause the filing of administrative/criminal case/s against the person concerned.
4	READ THE ATTACHED GUIDE TO FILLING OUT THE PERSONAL DATA SHEET (PDS) BEFORE ACCOMPLISHING THE PDS FORM.
6	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)
7
8	I. PERSONAL INFORMATION
9	2.	SURNAME
10		FIRST NAME						NAME EXTENSION (JR., SR)
11		MIDDLE NAME
12	3.	DATE OF BIRTH (mm/dd/yyyy)		16. CITIZENSHIP
13
14	4.	PLACE OF BIRTH		If holder of dual citizenship,				Pls. indicate country:
15	5.	SEX		please indicate the details.
16	6	CIVIL STATUS		17. RESIDENTIAL ADDRESS
17	6	CIVIL STATUS			House/Block/Lot No.			Street
18
19
20					Subdivision/Village			Barangay
21	7.	HEIGHT (m)
22	7.	HEIGHT (m)			City/Municipality			Province
23	8.	WEIGHT (kg)		ZIP CODE
24	9.	BLOOD TYPE		18. PERMANENT ADDRESS
25	9.	BLOOD TYPE			House/Block/Lot No.			Street
26	10.	GSIS ID NO.
27	10.	GSIS ID NO.			Subdivision/Village			Barangay
28	11.	PAG-IBIG ID NO.
29	11.	PAG-IBIG ID NO.			City/Municipality			Province
30	12.	PHILHEALTH NO.		ZIP CODE
31	13.	SSS NO.		19. TELEPHONE NO.
32	14. TIN NO.			20. MOBILE NO.
33	15. AGENCY EMPLOYEE NO.			21. E-MAIL ADDRESS (if any)
34	II. FAMILY BACKGROUND
35	22.	SPOUSE'S SURNAME			23. NAME of CHILDREN (Write full name and list all)				DATE OF BIRTH (mm/dd/yyyy)
36		FIRST NAME		NAME EXTENSION (JR., SR)
37		MIDDLE NAME
38		OCCUPATION
39		EMPLOYER/BUSINESS NAME
40		BUSINESS ADDRESS
41		TELEPHONE NO.
42	24.	FATHER'S SURNAME
43		FIRST NAME		NAME EXTENSION (JR., SR)
44		MIDDLE NAME
45	25.	MOTHER'S MAIDEN NAME
46		SURNAME
47		FIRST NAME
48		MIDDLE NAME			(Continue on separate sheet if necessary)
49	III. EDUCATIONAL BACKGROUND
50	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
51	26.					PERIOD OF ATTENDANCE
52						From	To
53		ELEMENTARY
54		SECONDARY
55		VOCATIONAL / TRADE COURSE
56		COLLEGE
57		GRADUATE STUDIES
58	(Continue on separate sheet if necessary)
59	SIGNATURE					DATE
60	CS FORM 212 (Revised 2017), Page 1 of 4
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101