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«,Tre you reed by cneangunly or thy tthe apponing or econmendng aur, or be
thief ofbuteauor ofl the parson wh has inmate supervision oer oun te Ofc,
Bueauior Departmen whee you wllbe appohied,
a. win the hie degre? ove 10
win the ert date or Los! Goverment Urit- Crear Employee)? owe es
INVES, ge det:
Fave you wr Dee urd gly any ana oreo? ae Ts
YES, gv datas
1. Have you Bee tinny charged tefoe any cout? aves aK
YES, gv dota
Dale File
Stats of Cant
Te ave you ever oon envied ef any ete ot VEaion ot oy law, doa, odnanceor eAIINBY| cy ea 7a
a YES, gv dole:
{Five you eve bon separdd on the sno maya te alowng radon resanaTEn, aes aN
relrement depp fom thera, sisal amination, endothe conc phased out] YES, ge dats
{aboton inte pubte or prvate scar?
{= Have you ever boen acandlae nanan or bel oloslon hed win a atyearawcopt | cy ves ae
ace sete YES, ve deta
' Hove youregned om fe government serve dung he thee 3)-nonth pede telat | ves aN
‘deco fo promollately apg for aratlonal local candle? INYES, gv deta:
[eave you soquved he aaa olan Higa 8 poral ean fanaa aT ae 7a
IFYES, gv dela county
"= Pursuant (9 niga People A [RA B31 (Magna Gata for Dated Persons (RA
‘72TT: and) Slo Parents Welle Act of 200 (RA 6972) lease ance flowing em:
Je Are yous menber of ay indigenous group? a ae
rvs, ease pest:
sre you's person with seb? ows ano
Ir YE, peas spctyO No
Je Are yous soo paren? aves aK
I+ YES, lease spect 0 No:
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‘DR ZOILO, SABUYA ‘BRGY, GUTOSAN,CALUBIAN LEYTE | 09213673826
HON. EUGENIO A.CHING, JR
BRGY, ESPNOSA,CALUBIAN, LEYTE
HON. JAMES. EFE.
BRGY. ESPNOSA,CALUBIAN LEYTE
T dedatewnder oath Wa have personaly sooonpiched tis Pevsna’ Data Set which wwe, cored and
‘omplee stalement pusant fo the provisions of perinent aws, es and regains ofthe Republic of the
Phipps. | aubore te agency headfautorzntrecreserative 1 veryvaliatn he contents sisted hein |
‘910 thal ay mispresaialon mace In th document and ie allachments shal caso the fling of
_arinravelsininl case's against me