Republic of the Philippines DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT BUREAU OF FIRE PROTECTION

SUMMARY OF INFORMATION (SOI)

Impo t!nt Inst uction" The #!t! $ene !te# b% this inst ument ! e &e % impo t!nt !n# 'ill be t e!te# confi#enti!l( The pu pose is fo the !utom!tion of pe sonnel eco #s n!tion'i#e( This is in p ep! !tion fo the e$ion!li)!tion in the p!%ment of s!l! % !n# othe benefits of !ll *FP pe sonnel( This must be FILLED-UP VERY LEGIBLY(

REGION I( PER+ONAL"

4-A

N!me ,L!st- Fi st- Mi##le N!me. M!i#en N!me ,Fo Fem!le Onl%. P esent R!n0 Appointment +t!tus D!te Commissione# Office ,fo office s onl%. D!te of L!st P omotion ,DOLP. D!te P omote# to P esent R!n0 in Pe m!nent +t!tus D!te of Reti ement Item Numbe *!#$e Numbe Account Numbe P esent Pl!ce of Assi$nment Desi$n!tion ,chec0 !pp op i!te bo/. A#minist !ti&e Cont!ct Numbe Resi#enti!l A## ess

+e /

Ope !tion

1ip Co#e Pe m!nent A## ess 1ip Co#e D!te of *i th Pl!ce of *i th Ci&il +t!tus +pouse n!me Hei$ht ,feet. 2ei$ht ,0$. TIN Numbe G+I+ Numbe P!$3ibi$ Numbe Philhe!lth Numbe D i&e 4s License Numbe ,if !n%. *loo# T%pe II( DEPENDENT+"

Le$!l Depen#ents

D!te of *i th

Rel!tionship

III( ED5CATIONAL"

Le&el

N!me- A## ess of +chool

De$ ee- Cou se

Inclusi&e #!tes of Atten#!nce

Ac!#emic Hono s Recei&e#

P im! %

+econ#! % Te ti! % Voc!tion!l G !#u!te +tu#ies Othe s

IV( ELIGI*ILITIE+"

Title of Eli$ibilit%

R!tin$

D!te 6 Pl!ce of E/!m

License Numbe 6 D!te of Issu!nce

V( MANDATOR7 IN3+ERVICE TRAINING"

Cou se

Con#ucte# *%

Inclusi&e D!tes

N of Hou s

Hono s Rec4#

VI( +EMINAR+ ATTENDED"

Title of +emin!

Con#ucte# *%

D!te Con#ucte#

Pl!ce of +emin!

VII( +IGNIFICANT DE+IGNATION+- PO+ITION+ PREVIO5+L7 HELD"

Inclusi&e #!tes

Position- Desi$n!tion ,ple!se ' ite in full.

Offices- 5nits- +t!tion- Re$ion

VIII( A2ARD+ 6 COMMENDATION+"

T%pe of A'! #- Commen#!tion

A'! #e# *%

D!te A'! #e#

I8( MEM*ER+HIP IN A++OCIATION"

N!me of Associ!tion

Ch!pte

Inclusi&e D!tes of Membe ship

8( +9ILL+ 6 HO**IE+"

+0ills

Hobbies

I #ecl! e un#e o!th th!t this +umm! % of Info m!tion ,+OI. h!s been !ccomplishe# b% me: !n# is t ue: co ect !n# complete st!tement pu su!nt to the p o&isions of pe tinent l!'s: ules !n# e$ul!tions of the Republic of the Philippines(

I !lso !utho i)e the !$enc% he!#- !utho i)e# ep esent!ti&e to &e if%- &!li#!te the contents st!te# he ein( I t ust th!t this info m!tion sh!ll em!in confi#enti!l(

;;;;;;;;;;;;;;;;;;;;;;;;;;;;;; Decl! !nt

;;;;;;;;;;;;;;;;;;;;;;;;;;;;;; D!te

Atteste# *%"

;;;;;;;;;;;;;;;;;;;;;;;;;;;;;; 5nit Comm!n#e

Inse t 'hole bo#% '!llet si)e pictu e P!sspo t si)e ID pictu e ,'-o he!#$e! . In full GOA unifo m