CS Form No.
212
Revised 2025
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
NAME EXTENSION (JR., SR)
2. FIRST NAME
MIDDLE NAME
3. DATE OF BIRTH
(dd/mm/yyyy) 16. CITIZENSHIP
Filipino Dual Citizenship
by birth by
4. PLACE OF BIRTH If holder of dual citizenship, Pls. indicate country: naturalization
please indicate the details.
5. SEX AT BIRTH
Male Female
17. RESIDENTIAL ADDRESS
6 CIVIL STATUS Single Married House/Block/Lot No. Street
Widowed Separate
Other/s: d Subdivision/Village Barangay
7. HEIGHT (m)
City/Municipality Province
8. WEIGHT (kg) ZIP CODE
18. PERMANENT ADDRESS
9. BLOOD TYPE
House/Block/Lot No. Street
10. UMID ID NO.
Subdivision/Village Barangay
11. PAG-IBIG ID NO.
City/Municipality Province
12. PHILHEALTH NO. ZIP CODE
13. PhilSys Number (PSN): 19. TELEPHONE NO.
14. TIN NO. 20. MOBILE NO.
15. AGENCY EMPLOYEE NO. 21. E-MAIL ADDRESS (if any)
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (dd/mm/yyyy)
NAME EXTENSION (JR., SR)
FIRST NAME
MIDDLE NAME
OCCUPATION
EMPLOYER/BUSINESS NAME
BUSINESS ADDRESS
TELEPHONE NO.
24. FATHER'S SURNAME
NAME EXTENSION (JR., SR)
FIRST NAME
MIDDLE NAME
25. MOTHER'S MAIDEN NAME
SURNAME
FIRST NAME
MIDDLE NAME (Continue on separate sheet if necessary)
III. EDUCATIONAL BACKGROUND
HIGHEST LEVEL/
26. NAME OF SCHOOL PERIOD OF ATTENDANCE YEAR SCHOLARSHIP/
LEVEL (Write in BASIC EDUCATION/DEGREE/COURSE
(Write in full)
UNITS
GRADUATED ACADEMIC HONORS
full) EARNED RECEIVED
(if not graduated)
From To
ELEMENTARY
SECONDARY
VOCATIONAL /
TRADE
COURSE
COLLEGE
GRADUATE STUDIES
(Continue on separate sheet if necessary)
SIGNATURE DATE
CS FORM 212 (Revised 2025), Page 1 of 4
IV. CIVIL SERVICE ELIGIBILITY
27. LICENSE (if applicable)
CES/CSEE/CAREER SERVICE/RA 1080 (BOARD/ RATING DATE OF PLACE OF EXAMINATION /
BAR)/UNDER SPECIAL LAWS/CATEGORY II/ IV ELIGIBILITY (If Applicable) EXAMINATION / CONFERMENT
and ELIGIBILITIES FOR UNIFORMED PERSONNEL CONFERMENT NUMBER Valid Until
(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 GOV'T SERVICE
(dd/mm/yyy) POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY STATUS OF
(Write in full/Do not (Write in APPOINTMENT
abbreviate) full/Do not abbreviate)
From To (Y/ N)
(Continue on separate sheet if necessary)
SIGNATURE DATE
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
(Continue on separate sheet if necessary)
VII. LEARNING AND DEVELOPMENT (L&D) INTERVENTIONS/TRAINING PROGRAMS ATTENDED
INCLUSIVE DATES OF
30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS ATTENDANCE Type of L&D
NUMBER OF ( Managerial/ CONDUCTED/ SPONSORED BY
(Write in full) (dd/mm/yyyy) HOURS Supervisory/ (Write in full)
Technical/etc)
From To
(Continue on separate sheet if necessary)
VIII. OTHER INFORMATION
MEMBERSHIP IN ASSOCIATION/ORGANIZATION
31. SPECIAL SKILLS and HOBBIES 32. NON-ACADEMIC DISTINCTIONS / RECOGNITION (Write in full) 33. (Write in
full)
(Continue on separate sheet if necessary)
SIGNATURE DATE
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:
________________________________
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 out (abolition) YES NO
in the public or private sector? If YES, give details:
________________________________
________________________________
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
election to promote/actively campaign for a national or local candidate? NO
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,
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?
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 OFFICE / RESIDENTIAL ADDRESS CONTACT NO. AND/OR
EMAIL
Passport-sized unfiltered
digital picture taken within
the last 6 months
4.5 cm. X 3.5 cm
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:
ID/License/Passport No.:
Signature (Sign inside the box)
Date/Place of Issuance:
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 2025), Page 4 of 4
