CS Form No.

212
Revised 2017

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 againts the
person concerned.

READ THE ATTACHED GUIDE TO FILLING OUT THE PERSONAL DATA SHEET (PDS) BEFORE ACCOMPLISHING THE PDS FORM
1. CS ID
Print legibly. Tick appropriate boxes ( ) and use separate sheet if nescessary. Indicate N/A if not applicable. DO NOT ABBREVATE. No.

I. PERSONAL INFORMATION
2. SURNAME
Asahid
FIRST NAME NAME EXTENSION (SR, JR)
Kris Diana
MIDDLE NAME
Enoy
3. DATE OF BIRTH December 31,1999 16. CITIZENSHIP
(mm/dd/yyyy) Filipino dual citizenship

4. PLACE OF BIRTH by birth by naturalization

Timuay Danda If holder of dual citizenship,
5. SEX please indicate thedetails. pls. Indicate country:
MALE FEMALE
6. CIVIL STATUS 17. RESIDENTIAL ADDRESS Prk. 1 Prk. 1
SINGLE MARRIED House/Block/Lot No. Street

Timuay Danda
WIDOWED
NSubdivision/Village Barangay
SEPARATED Kabasalan Zamboanga Sibugay
ZIP CODE
OTHER/S:
City/Municipality Province
7005
7. Height 178 cm
8. WEIGHT
60 kg
9. BLOOD TYPE 18. PERMANENT ADDRESS 14435 Prk. 1
O+
House/Block/Lot No. Street
10. GSIS ID NO. Bulacan
Subdivision/Village Barangay
11. PAG IBIG ID NO. ZIP CODE
Kabasalan Zamboanga Sibugay
7005
City/Municipality Province
12. PHILHEALTH NO.
13. SSS NO. 19. TELEPHONE NO.
14. TIN NO. 20. MOBILE NO.
09353971671
15. AGENCY EMPLOYEE 21. EMAIL ADDRESS (if any)
NO.
krisdiana@gmail.com
II. FAMILY BACKGROUND
22. SPOUSE’S SURNAME
23.NAME OF CHILDREN DATE OF BIRTH
NAME EXTENSION (JR, SR)
FIRST NAME

MIDDLE NAME
OCCUPATION
EMPLOYER/BUSINESS
NAME
BUSINESS ADDRESS
TELEPHONE NO.
24. FATHER’S SURNAME
Asahid
NAME EXTENSION (JR, SR)
FIRST NAME Romeo
MIDDLE NAME Nubog
25.MOTHER’S MAIDEN
NAME
SURNAME
Enoy
Milarosa
FIRST NAME
Sevilla
MIDDLE NAME
III. EDUCATIONAL BACKGROUND
26. BASICEDUCATION/ PERIOD OF HIGHEST YEAR SCHOLARSHIP/
GRADUATED ACADEMIC/
LEVEL NAME OF SCHOOL DEGREE/COURSE ATTENDANCE LEVEL/ HONORS
(Write in full) (Write in full) From To UNITS EARNED RECIEVED
(If not graduated)
ELEMENTARY Timuay Danda Elementary School 2012
SECONDARY
Kabasalan National High School 2016
VOCATIONAL/TRADE
COURSE
COLLEGE Dr. Aurelio Mendoza Memorial Colleges BSED
GRADUATE STUDIES
(Continue on separate sheet if necessary)
SIGNITURE DATE
CS FORM 212 (Revised 2017). Page 1 of 4

IV. CIVIL SERVICE ELIGIBILITY

27. CAREER SERVICE/ RA 1080 LICENSE

(BOARD/BAR)
RATING DATE OF EXAMINATION PLACE OF EXAMINATION
SPECIAL LAW/ CES/ CSEE (If Applicable) / CONFERMENT / CONFERMENT DATE OF
BARANGAY ELIGIBILITY/DRIVER’S NUMBER
VALIDITY
LICENCES

(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
28. INCLUSIVE DATES MONTHLY SALARY/JOP GOV’T
/PAY GRADE STATUS SERVICE
POSITION TITTLE DEPARTMENT /AGENCY OFFICE COMPANY SALARY OFAPPOINTMENT
(WRITE IN FULL DO NOT ABBREVIATE) (WRITE IN FULL DO NOT ABBREVIATE) (if applicable) (Y/N)

(Continue on separate sheet if necessary)

SIGNITURE DATE

CS FORM 212 (Revised 2017), Page 2 of 4

VI.VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION

INCLUSIVE DATES
NAME AND ADDRESS OF ORGANIZATION (MM/DD/YYYY) NUMBER
(WRITE IN FULL) OF POSITION/ NATURE OF WORK
FROM TO HOURS

(SSG) President

(Continue on separate sheet if necessary)

VII. LEARNING AND DEVELOPED (LAD) INTERVENTIONS/TRAINING PROGRAMS ATTENDED

INCLUSIVE DATES OF
NUMBER Type of LD
30. TITTLE OF LEARNING AND DEVELOPMENT ATTENDANCE
OF (Management, CONDUCTED SPONSORED BY
INTERVENTIONS/ TRAINING PROGRAMS (mm/dd/yyyy)
HOURS Supervisory, (Write in full)
(Write in Full) Technical,
From To etc)

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

31. SPECIAL SKILLS AND HOBBIES 32. NON-ACADEMIC DISTINCTIONS/RECOGNITION 33. MEMBERSHIP ON ASSOCIATION/ORGANIZATION
(WRITE IN FULL)

COOKING

(Continue on separate sheet if necessary)

SIGNITURE 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 appointed,
a. within the third degree? YES NO
b. within the fourth degree (for Local Government Unit – Career Employee)? YES NO
If YES, give details:

35. a. Have you ever been found guilty of any administrative offenses? 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
YESNO
any court or tribunal?
If YES, give details:

37. Have you ever been separated from the service in any of the following modes: resignation, retirement,
YES NO
dropped from the rolls, dismissal, termination, end of term, finished contract or phased out (abolition) in
If YES, give details:
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 YES NO
Barangay election)? If YES, give details:

YES NO
b. Have you resign from the government service during the three (3)-month period before the last If YES, give details:
election to promote/actively campaign for a national or local candidate?

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 Person (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:Subanen

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.:

40. REFERENCES (Person not related by consanguinity or affinity to applicant/ appointee)

NAME ADDRESS TEL NO.

42. I declare under oath that I have personally accomplish this Personal Data Sheet which is a true, correct and complete statement
pursuant to the provision of pertinent laws, rules and regulation of the Republic of the Philippines. I authorize the agency head/authorized Photo
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.

Government issued ID (i.e. Passport, SSS, PRC, Driver’s license etc.)

PLEASE INDICATE ID Number and Date of Issuance

Government Issued ID:

ID/License/Passport No.:
SIGNITURE (SIGN INSIDE THE BOX)
Date/Place of Issuance:
DATE ACCOMPLISHED Right Thumb mark

SUBSCRIBED AND SWORN to before me this , affiant exhibiting his/her validity issued government ID as indicated above.

Person Administering oath

CS FORM 212 (Revised 2017), Page 4 of 4
Attachment to CS Form No. 212

WORK EXPERIENCE SHEET

Instruction: 1. Include only the work experiences relevant to the position being applied to.
2. The duration should include start and finish dates, if known, month in abbreviated form,
if known, and year in full. For the current position, use the word Present, e.g., 1998-
Present. Work experience should be listed from most recent first.
Sample: If applying to Supervising Administrative Officer

 Duration: February 11, 2011 – Present

 Position: Human Resource Management Officer III
 Name of Office/Unit: Finance and Administrative Service
 Immediate Supervisor: Maria Estrada
 Name of Agency/Organization and Location: Department of Human Resources, Metro Manila

 List of Accomplishments and contributions (If any)

° Developed recruitment plan

° Designed training program for retirees under EO 366

 Summary of Actual Duties

° Responsible for the management of the recruitment and selection process and the
coordination of training activities of the department; provides assistance in the management of
the division’s programs and activities and performs other related functions.

 Duration: January 2, 2002 – February 10, 2011

 Position: Administrative Officer III
 Name of Office/Unit: Finance and Administrative Division
 Immediate Supervisor: Celia Romano
 Name of Agency/Organization and Location: Department of Finance

 List of Accomplishments and contributions (If any)


 Summary of Actual Duties

° Responsible in performing administrative and technical tasks e.g., pre-screening of

applicants, preparation of monthly report on accession and separation, report of appointments
issued, preparation of minutes of meetings of various HR committees and monitoring of
trainings conducted; response to queries and performs other related functions.

KRIS DIANA, ASAHID ENOY

(Signature over Printed Name
of Employee/Applicant)

Date: