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

I. PERSONAL INFORMATION
2. SURNAME CASTAÑEDA
NAME EXTENSION (JR., SR
FIRST NAME REMIL

MIDDLE NAME PORTUNES

3. DATE OF BIRTH
(mm/dd/yyyy) 11/9/1988 16. CITIZENSHIP ✘ Filipino Dual Citizenship
by birth by
4. PLACE OF BIRTH SAGAY CITY If holder of dual citizenship, Pls. indicate cou
please indicate the details.
5. SEX ✘ Male Female

✘ Single Married 17. RESIDENTIAL ADDRESS

6 CIVIL STATUS
Widowed Separated House/Block/Lot No. S
OLD
Other/s:
Subdivision/Village Ba
SAGAY CITY NEGROS
7. HEIGHT (m) 1.68
City/Municipality Pr
8. WEIGHT (kg) 87 ZIP CODE 6122

18. PERMANENT ADDRESS

9. BLOOD TYPE O
House/Block/Lot No. S
OLD
10. GSIS ID NO. N/A
Subdivision/Village Ba
SAGAY CITY NEGROS
11. PAG-IBIG ID NO. 121012522271
City/Municipality Pr

12. PHILHEALTH NO. 110504363805 ZIP CODE 6122

13. SSS NO. 0725602204 19. TELEPHONE NO. N/A

14. TIN NO. 292456509 20. MOBILE NO. 09950142010

15. AGENCY EMPLOYEE NO. N/A 21. E-MAIL ADDRESS (if any) remil.castaneda09@gmail.com

II. FAMILY BACKGROUND

22. SPOUSE'S SURNAME N/A 23. NAME of CHILDREN (Write full name and list all)
NAME EXTENSION (JR., SR) N/A
FIRST NAME N/A

MIDDLE NAME N/A

OCCUPATION N/A

EMPLOYER/BUSINESS NAME N/A

BUSINESS ADDRESS N/A

TELEPHONE NO. N/A

24. FATHER'S SURNAME CASTAÑEDA

NAME EXTENSION (JR., SR)
FIRST NAME REX
 MIDDLE NAME DE LA CRUZ

25. MOTHER'S MAIDEN NAME

SURNAME PORTUNES

FIRST NAME EMILY

MIDDLE NAME ARELLANO (Continue on separate sheet if necessar

III. EDUCATIONAL BACKGROUND

NAME OF SCHOOL HIGHEST LEVEL/
26. BASIC EDUCATION/DEGREE/COURSE PERIOD OF ATTENDANCE UNITS
LEVEL (Write in EARNED
(Write in full)
full) (if not graduated)
From To

ELEMENTARY OLD SAGAY ELEMENTARY SCHOOL PRIMARY EDUCATION 1995 2001

SECONDARY /
VOCATIONAL SAGAY NATIONAL HIGH SCHOOL HIGH SCHOOL 2001 2005

NORTHERN NEGROS STATE COLLEGE OF

SCIENCE AND TECHNOLOGY
SEAFARING-CATERING-STEWARDING 2005 2006

TRADE
COURSE NORTHERN NEGROS STATE COLLEGE OF
COLLEGE
SCIENCE AND TECHNOLOGY
BACHELOR OF SECONDARY EDUCATION 2006 2010

GRADUATE STUDIES

(Continue on separate sheet if necessary)

SIGNATURE DATE
CS FOR
L DATA SHEET
erience Sheet shall cause the filing of administrative/criminal case/s against the person

EFORE ACCOMPLISHING THE PDS FORM.

(Do not fill up. For CSC use only)

NAME EXTENSION (JR., SR)

Dual Citizenship

by naturalization

Pls. indicate country:

Street
OLD SAGAY
Barangay
NEGROS OCCIDENTAL
Province
6122

Street
OLD SAGAY
Barangay
NEGROS OCCIDENTAL
Province

6122

N/A

09950142010

remil.castaneda09@gmail.com

DATE OF BIRTH (mm/dd/yyyy)

N/A
 (Continue on separate sheet if necessary)

SCHOLARSHIP/
YEAR
ACADEMIC
GRADUATED
HONORS
RECEIVED

2001

2005

2006

2010

parate sheet if necessary)

CS FORM 212 (Revised 2017), Page 1 of 4

IV. CIVIL SERVICE ELIGIBILITY
27. CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER DATE OF
RATING
SPECIAL LAWS/ CES/ CSEE EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
(If Applicable)
BARANGAY ELIGIBILITY / DRIVER'S LICENSE CONFERMENT

LICENSURE EXAMINATION FOR TEACHERS 76.40 3/11/2012 ILOILO

(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 SALARY/ JOB/ PAY
POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY GRADE (if
(mm/dd/yyyy) MONTHLY
(Write in full/Do not (Write in SALARY
applicable)& STEP
(Format "00-0")/
abbreviate) full/Do not abbreviate) INCREMENT
From To

12/09/10 17/12/01 TEAM LEADER TRAINEE CONVERGYS BACOLOD 19,000.00

12/06/11 12/08/01 TECHNICAL SUPPORT REPRESENTATIVE TELETECH BACOLOD 12,000.00

10/2010 05/2012 CUSTOMER SERVICE REPRESENTATIVE TRANSCOM BACOLOD 12,500.00

04/2010 07/2010 CUSTOMER SERVICE REPRESENTATIVE TELEPERFORMANCE BACOLOD 9,000.00

 (Continue on separate sheet if necessary)

SIGNATURE DATE
CS FORM 212
 LICENSE (if applicable)

NUMBER Date of
Validity

1370130 11/9/2022

ue on separate sheet if necessary)

n of duties should be indicated in the attached Work Experience sheet. GOV'T

SERVICE

STATUS OF
APPOINTMENT

(Y/
N)
PERMANENT N

PROBATIONARY N

PERMANENT N

PROBATIONARY N
ue on separate sheet if necessary)

CS FORM 212 (Revised 2017), 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) (mm/dd/yyyy) NUMBER OF HOURS POSITION /
From To

N/A N/A N/A N/A

(Continue on separate sheet if necessary)

VII. LEARNING AND DEVELOPMENT (L&D) INTERVENTIONS/TRAINING PROGRAMS ATTENDED
(Start from the most recent L&D/training program and include only the relevant L&D/training taken for the last five (5) years for Division Chief/Executive/Managerial positions)
INCLUSIVE DATES OF
ATTENDANCE Type of LD
30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS ( Managerial/ CONDUCTED/
NUMBER OF HOURS
(Write in full) Supervisory/
(mm/dd/yyyy)
Technical/etc)
From To
TECHNICAL
COMPUTER SYSTEMS SERVICING 10/17/2018 12/15/2018 280 TECHNICAL
DEVELOPME
 (Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

MEMBERS
NON-ACADEMIC DISTINCTIONS / RECOGNITION
31. SPECIAL SKILLS and HOBBIES 32. 33.
(Write in full)

DATA ANALYSIS LEADERSHIP AWARDEE

SETTING UP COMPUTER NETWORKS

COOKING

COMPUTER GAMING

(Continue on separate sheet if necessary)

SIGNATURE DATE
/ PEOPLE / VOLUNTARY ORGANIZATION/S

POSITION / NATURE OF WORK

N/A

eparate sheet if necessary)

ROGRAMS ATTENDED
five (5) years for Division Chief/Executive/Managerial positions)

CONDUCTED/ SPONSORED BY
(Write in full)

TECHNICAL EDUCATION AND SKILLS

DEVELOPMENT AUTHORITY
eparate sheet if necessary)

MEMBERSHIP IN ASSOCIATION/ORGANIZATION
(Write
in full)

N/A

eparate sheet if necessary)

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 apppointed,
a. within the third degree? YES ✘ NO
b. within the fourth degree (for Local Government Unit - Career Employees)? YES ✘ NO
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
YES ✘ NO
by any court or tribunal?
If YES, give details:
________________________________
________________________________
37. Have you ever been separated from the service in any of the following modes: resignation, YES ✘ NO
retirement, dropped from the rolls, dismissal, termination, end of term, finished contract or phased If YES, give details:
out (abolition) in 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:
b. Have you resigned from the government service during the three (3)-month period before the last YES ✘ NO
election to promote/actively campaign for a national or local candidate? 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); 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:
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 ADDRESS TEL. NO.

ID picture taken within
the last 6 months
GINA B. ADION SAGAY CITY 9289898332 3.5 cm. X 4.5 cm
(passport size)

JOHN LENNOLD S. NARAZETH BACOLOD CITY 9129975208 With full and handwritten
name tag and signature over
printed name
RONIE B. GUTIERREZ BACOLOD CITY 9173000810
Computer generated
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and or photocopied picture
is not acceptable
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 PHOTO
administrative/criminal case/s against me.
Government Issued ID (i.e.Passport, GSIS, SSS, PRC, Driver's License, etc.)
PLEASE INDICATE ID Number and Date of
Issuance
Government Issued ID: Voter's ID

ID/License/Passport No.: 4523-0245A-K0988PRC10000

Signature (Sign inside the box)

Date/Place of Issuance: SAGAY CITY

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 2017), Page 4 o

If YES, give details (country):
, affiant exhibiting his/her validly issued government ID as indicated above.

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