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. Tick appropriate boxes ( ) and use separate sheet if necessary. Indicate N/A if not applicable. DO NOT ABBREVIATE. 1. CS ID No. (Do not fill up. For CSC use only)

I. PERSONAL INFORMATION
2. SURNAME PAYAWAL
NAME EXTENSION (JR., SR)
FIRST NAME SHEILA JOY

MIDDLE NAME MOLINA

3. DATE OF BIRTH _x000D_
(mm/dd/yyyy) 1/25/1997 16. CITIZENSHIP

4. PLACE OF BIRTH CAUAYAN CITY, ISABELA If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX FEMALE

17. RESIDENTIAL ADDRESS #139 ROOSEVELT AVENUE

6 CIVIL STATUS SINGLE
House/Block/Lot No. Street
PARAISO
Subdivision/Village Barangay
QUEZON CITY
7. HEIGHT (m) 1.52 m
City/Municipality Province
8. WEIGHT (kg) 48 kg ZIP CODE

18. PERMANENT ADDRESS #96 BANNA UY

9. BLOOD TYPE AB
House/Block/Lot No. Street
DISTRICT 1
10. GSIS ID NO.
Subdivision/Village Barangay
CAUAYAN CITY ISABELA
11. PAG-IBIG ID NO. 1211-9368-6222
City/Municipality Province

12. PHILHEALTH NO. 06-251611674-4 ZIP CODE 3305

13. SSS NO. 0128000322 19. TELEPHONE NO.

14. TIN NO. 360-078-172-000 20. MOBILE NO. 09655539991

15. AGENCY EMPLOYEE NO. 00027127 21. E-MAIL ADDRESS (if any) sheila.joy.payawal@bir.gov.ph / sheilajoypayawal@gmail.com

II. FAMILY BACKGROUND

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

MIDDLE NAME

OCCUPATION

EMPLOYER/BUSINESS NAME

BUSINESS ADDRESS

TELEPHONE NO.

24. FATHER'S SURNAME PAYAWAL

NAME EXTENSION (JR., SR)
FIRST NAME VICENTE

MIDDLE NAME CRISOSTOMO

25. MOTHER'S MAIDEN NAME

SURNAME MOLINA

FIRST NAME ESMENIA

MIDDLE NAME CABARLOC (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

HIGHEST LEVEL/
NAME OF SCHOOL SCHOLARSHIP/
26. PERIOD OF ATTENDANCE UNITS YEAR
BASIC EDUCATION/DEGREE/COURSE ACADEMIC
LEVEL (Write in EARNED GRADUATED
HONORS
(Write in full) _x000D_
full) RECEIVED
(if not graduated)
 HIGHEST LEVEL/
NAME OF SCHOOL SCHOLARSHIP/
UNITS YEAR
BASIC EDUCATION/DEGREE/COURSE ACADEMIC
LEVEL (Write in EARNED GRADUATED
HONORS
(Write in full) _x000D_
full) RECEIVED
From To (if not graduated)

ELEMENTARY CAUAYAN SOUTH CENTRAL SCHOOL 2009

OUR LADY OF THE PILLAR COLLEGE-CAUAYAN

SECONDARY
VOCATIONAL / HIGHSCHOOL DEPARTMENT 2013 1ST HONOR

TRADE OUR LADY OF THE PILLAR COLLEGE-CAUAYAN & BACHELOR OF SCIENCE IN ACCOUNTING BRO/CHED/S
COURSE
COLLEGE OUR LADY OF THE PILLAR COLLEGE- SAN MANUEL TECHNOLOGY & BACHELOR OF SCIENCE IN 2017 & 2018 CHOOL
INC. ACCOUNTANCY SCHOLAR
GRADUATE STUDIES

(Continue on separate sheet if necessary)

SIGNATURE DATE
CS FORM 212 (Revised 2017), Page 1 of 4
IV. CIVIL SERVICE ELIGIBILITY
27. CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER DATE OF LICENSE (if applicable)
RATING_x000D_ Date
SPECIAL LAWS/ CES/ CSEE EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
(If Applicable) NUMBER of_x000D_
BARANGAY ELIGIBILITY / DRIVER'S LICENSE CONFERMENT
Validity

CAREER SERVICE- PROFESSIONAL PASSER 80.3 11/20/2016 CAUAYAN CITY, ISABELA

(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.
GOV'T
28. INCLUSIVE DATES SALARY/ JOB/ PAY SERVICE
POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY GRADE (if
(mm/dd/yyyy) MONTHLY STATUS OF
(Write in full/Do not (Write in SALARY
applicable)& STEP
APPOINTMENT
(Format "00-0")/
abbreviate) full/Do not abbreviate) INCREMENT
From To
(Y/ N)

12/2/2020 8/16/2020 ACCOUNTING ASSISTANT OPERATIONAL ACCOUNTING 9500.00 SEASONAL N

COLLECTION SECTION/ RDO 038- NORTH
9/1/2020 PRESENT REVENUE OFFICER I (COLL) 22316.00 PERMANENT Y
QUEZON CITY
 (Continue on separate sheet if necessary)

SIGNATURE DATE
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 / NATURE OF WORK
From To

(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_x000D_
30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS ( Managerial/ CONDUCTED/ SPONSORED BY
NUMBER OF HOURS
(Write in full) (mm/dd/yyyy) Supervisory/_x000D_ (Write in full)
Technical/etc)
From To

ON-THE-JOB TRAINING 4/4/2016 5/27/2016 300.0 N/A MALAYAN INSURANCE COMPANY INC.

OFFICE DECORUM 3/22/2016 3/22/2016 8.0 N/A

OUR LADY OF THE PILLAR COLLEGE

CAREER ORIENTATION 3/7/2016 3/7/2016 8.0 N/A

OUR LADY OF THE PILLAR COLLEGE

PERSONNEL ORIENTATION COURSE 10/19/2020 10/21/2020 18.0 N/A

REGIONAL DIRECTOR ALBINO M. GA

INFORMATION SYSTEMS AWARENESS BRIEFING 10/28/2020 10/28/2020 8.0 N/A

REGIONAL DIRECTOR ALBINO M. GA

DATA PRIVACY BRIEFING 11/4/2020 11/4/2020 8.0 N/A

REGIONAL DIRECTOR ALBINO M. GA

GENDER SENSITIVITY TRAINING (GST) 11/5/2020 11/5/2020 8.0 N/A

REGIONAL DIRECTOR ALBINO M. GA

VIOLENCE AGAINST WOMEN AND THEIR CHILDREN (VAWC) 11/27/2020 11/27/2020 8.0 N/A
REGIONAL DIRECTOR ALBINO M. GA

BASIC TAX ADMINISTRATION COURSE 3/22/2021 3/26/2021 40.0 N/A REGIONAL DIRECTOR ALBINO M. GALANZA

CSC SEMINAR ON STRATEGIC PERFORMANCE MANAGEMENT SYSTEM (SPMS)

4/30/2021 4/30/2021 2.0 N/A REGIONAL DIRECTOR ALBINO M. GALANZA
COACHING ANG MENTORING

ISO AWARENESS FOR 9001:2015 6/2/2021 6/2/2021 4.0 N/A REGIONAL DIRECTOR ALBINO M. GALANZA
CSC SEMINAR ON RECRUITMENT, SELECTION
AND PLACEMENT (RSP), LEARNING AND
7/21/2021 7/21/2021 4.0 N/A
DEVELOPMENT (L&D), AND REWARDS & REGIONAL DIRECTOR ALBINO M. GALANZ
RECOGNITION (R&R)

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

MEMBERSHIP IN ASSOCIATION/ORGANIZATION
NON-ACADEMIC DISTINCTIONS / RECOGNITION
31. SPECIAL SKILLS and HOBBIES 32. 33. (Write in
(Write in full)
full)

DRAWING GRAPHICS ART WARD

 DANCING MERITORIOUS AWARD

MOST DILIGENT STUDENT

(Continue on separate sheet if necessary)

SIGNATURE DATE
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?
b. within the fourth degree (for Local Government Unit - Career Employees)?
If YES, give details:
________________________________

35. a. Have you ever been found guilty of any administrative offense?
If YES, give details:
________________________________
________________________________
b. Have you been criminally charged before any court?_x000D_
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
_x00
by any court or tribunal?
0D_If YES, give details:
_x00
________________________________
0D_
________________________________
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 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
Barangay election)?
If YES, give details:
b. Have you resigned from the government service during the three (3)-month period before 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?
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?
If YES, please specify:
b. Are you a person with disability?
If YES, please specify ID No:
c. Are you a solo parent?
If YES, please specify ID No:

41. REFERENCES (Person not related by consanguinity or affinity to applicant /appointee)

NAME ADDRESS TEL. NO.

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 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:
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 2017), Page 4 of 4