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Personal Data Sheet: Filipino Dual Citizenship by Birth by Naturalization
Personal Data Sheet: Filipino Dual Citizenship by Birth by Naturalization
212
Revised 2017
I. PERSONAL INFORMATION
Y SURNAME VICENCIO
NAME EXTENSION (JR., SR)
FIRST NAME JIERSON
15. AGENCY EMPLOYEE NO. JNHS F12-0069 21. E-MAIL ADDRESS (if any) jiersonvicencio@deped.gov.ph
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME VICENCIO 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
NAME EXTENSION (JR., SR)
FIRST NAME ANGIE
OCCUPATION Housewife
SURNAME VICENCIO
Electrical Installation Maintenance NCII TESDA NC II 6/15/2015 12/5/2015 562 hrs 2015
ILOILO SCIENCE AND TECHNOLOGY -
COLLEGE TRADE BSIE (Electricity) 1982' 1986' 1985-86
COURSE UNIVERSITY
ILOILO SCIENCE AND TECHNOLOGY -
GRADUATE STUDIES
UNIVERSITY
MSEI ( Educ'l Management) 21 units
(Continue on separate sheet if necessary)
Professional Board Examination for Teachers 75.43 %' 10/26/1986 Iloilo City 563546 5/7/1987
REGISTERED MASTER ELECTRICIAN EXAMINATION
(PRC)
70.00%' 5/21/1988 Iloilo City 12627 9/14/1988
1/1/2018 12/31/2018 Master Teacher I DepEd ( Jaro Nat'l High School) 39,007.00' Permanent Yes
4/2/2017 12/31/2017 Master Teacher I DepEd ( Jaro Nat'l High School) 36,532.00' Permanent Yes
4/2/2017 12/31/2015 Master Teacher I DepEd ( Jaro Nat'l High School) 36,532.00' Permanent Yes
1/1/2017 4/1/2017 Master Teacher I DepEd ( Jaro Nat'l High School) 36,111.00' Permanent Yes
1/1/2016 12/31/2016 Master Teacher I DepEd ( Jaro Nat'l High School) 33,831.00' Permanent Yes
4/2/2014 12/31/2015 Master Teacher I DepEd ( Jaro Nat'l High School) 31,696.00' Permanent Yes
6/1/2012 4/1/2014 Master Teacher I DepEd ( Jaro Nat'l High School) 31,351.00' Permanent Yes
6/1/2011 5/31/2012 Master Teacher I DepEd ( Jaro Nat'l High School) 28,305.00' Permanent Yes
4/1/2011 5/31/2001 Master Teacher I DepEd ( Jaro Nat'l High School) 25,259.00' Permanent Yes
6/24/2010 3/31/2011 Teacher I DepEd ( Jaro Nat'l High School) 17,237.00' Permanent Yes
7/1/2009 6/23/2010 Teacher I DepEd ( Jaro Nat'l High School) 16,011.00' Permanent Yes
6/18/2009 6/30/2009 Teacher I DepEd ( Jaro Nat'l High School) 13,948.00' Permanent Yes
7/1/2007 6/30/2008 Teacher I DepEd ( Jaro Nat'l High School) 13,608.00' Permanent Yes
6/18/2006 6/30/2007 Teacher I DepEd ( Jaro Nat'l High School) 12371.00 Permanent Yes
6/18/2003 6/17/2006 Teacher I DepEd ( Jaro Nat'l High School) 11,246.00' Permanent Yes
7/1/2001 6/17/2003 Teacher I DepEd ( Jaro Nat'l High School) 10,971.00' Permanent Yes
6/18/2000 6/30/2001 Teacher I DepEd ( Jaro Nat'l High School) 10,794.00' Permanent Yes
1/1/2000 6/17/2000 Teacher I DepEd ( Jaro Nat'l High School) 10,194.00' Permanent Yes
11/1/1997 12/31/1999 Teacher I DepEd ( Jaro Nat'l High School) 16162.00' Permanent Yes
6/18/1997 6/17/1997 Teacher I DepEd ( Jaro Nat'l High School) 9,041.00' Permanent Yes
1/1/1996 12/31/1996 Teacher I DepEd ( Jaro Nat'l High School) 7,558.00' Permanent Yes
1/1/1995 __ Teacher I DepEd ( Jaro Nat'l High School) 7,433.00' Permanent Yes
1/1/1994 12/31/1994 Teacher I DepEd ( Jaro Nat'l High School) 6,044.00' Permanent Yes
Reg.
6/17/1991 12/31/1993 Reg. Substitute DepEd ( Jaro Nat'l High School) 4,985.00' Yes
Substitute
Reg.
10/28/1990 3/30/1991 Reg. Substitute DepEd ( Jaro Nat'l High School) 3902.00' Yes
Substitute
Reg.
8/1/1990 10/27/1990 Reg. Substitute DepEd ( Jaro Nat'l High School) 3102.00 Yes
Substitute
School Based In-Service Training 10/21/2019' 10/25/2019 40hrs Technical DepEd (Jaro National High School)
Gender and Development Program on RA11036 Mental
10/18/2019' 10/19/2019 16hrs Technical DepEd (Jaro National High School)
Health
Division In-Service Training (INSET) 5/27/2019 5/29/2019 24hrs Technical DepEd (Division of Iloilo City)
School Based In-Service Training 5/30/2019 5/31/2019 16hrs Technical DepEd (Jaro National High School)
Division In-Service Training (INSET) 2018 10/22/2018 10/24/2018 24hrs Technical DepEd (Division of Iloilo City)
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, YES ✘ NO
retirement, dropped from the rolls, dismissal, termination, end of term, finished contract or If YES, give details:
phased 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
YES ✘ NO
(except Barangay election)?
If YES, give details:
b. Have you resigned from the government service during the three (3)-month period before YES ✘ NO
the last 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:
Ms. ZENAIDA SILVEDERIO ALTA TRIA JARO, ILOILO CITY 508-21-56 With full and handwritten
name tag and signature over
printed name
Hon. MARRIETA ORLEANS CUARTERO JARO, ILOILO CITY 09482731700
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 PHOTO
filing of administrative/criminal case/s against me.
SUBSCRIBED AND SWORN to before me this February 05,2020, affiant exhibiting his/her validly issued government ID as indicated above.