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 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 TATTAO
NAME EXTENSION (JR., SR)
FIRST NAME MARY

MIDDLE NAME SININING

3. DATE OF BIRTH
(mm/dd/yyyy) 12/25/1979 16. CITIZENSHIP

FILIPINO
4. PLACE OF BIRTH ZAMBOANGA SIBUGAY If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX FEMALE

17. RESIDENTIAL ADDRESS 34 BRILL STREET

6 CIVIL STATUS MARRIED
House/Block/Lot No. Street
WEST BAJAC-BAJAC
Subdivision/Village Barangay
OLONGAPO CITY ZAMBALES
7. HEIGHT (m) 1.55m
City/Municipality Province
8. WEIGHT (kg) 57 kgs ZIP CODE

18. PERMANENT ADDRESS 34 BRILL STREET

9. BLOOD TYPE O
House/Block/Lot No. Street
WEST BAJAC-BAJAC
10. GSIS ID NO. N/A
Subdivision/Village Barangay
OLONGAPO CITY ZAMBALES
11. PAG-IBIG ID NO. 1210-4058-6118
City/Municipality Province

12. PHILHEALTH NO. 07-025487783-0 ZIP CODE 2200

13. SSS NO. 08-1410667-9 19. TELEPHONE NO.

14. TIN NO. 250-123-863000 20. MOBILE NO. 09389221755

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

II. FAMILY BACKGROUND

22. SPOUSE'S SURNAME TATTAO 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
NAME EXTENSION (JR., SR) JOHN PAUL S. TATTAO
FIRST NAME MARIO 12/11/2011
MARIANNE S. TATTAO
MIDDLE NAME CALAR 9/26/2018

OCCUPATION DOCTOR'S ASSISTANT

EMPLOYER/BUSINESS NAME MIRABUENO MEDICAL CLINIC

BUSINESS ADDRESS #18 A 20th STREET, WEST BAJAC-BAJAC, OLONGAPO CITY

TELEPHONE NO. 9292713699

24. FATHER'S SURNAME SININING

NAME EXTENSION (JR., SR)
FIRST NAME CLAUDIO

MIDDLE NAME CAJERAS

25. MOTHER'S MAIDEN NAME

SURNAME CRISTORIA

FIRST NAME EDILTRUDES

MIDDLE NAME AMANTE (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

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

BUUG PILOT CENTRAL SCHOOL FOURTH

ELEMENTARY
BUUG, ZAMBOANGA SIBUGAY
PRIMARY 6/4/1987 1993/28/3 N/A 1993
HONOR
LANAO DEL NORTE NATIONAL COMPREHENSIVE
HIGH SCHOOL AND MINDANAO STATE UNIVERSITY- FULL
SECONDARY /
VOCATIONAL BUUG COLLEGE
SECONDARY 6/6/1993 1997/25/3 N/A 1997
SCHOLAR
MANPOWER ADVANCED STUDYING IN TECHNICAL
TRAINING,INC.
BASIC COMPUTER APPLICATION 4/7/2004 3/4/2005 N/A 2004 N/A
TRADE TEACHING
MINDANAO STATE UNIVERSITY BUUG - BATCHELOR OF SECONDARY EDUCATION
COURSE
COLLEGE
COLLEGE,BUUG ZAMBOANGA SIBUGAY MAJOR IN BIOLOGY
3/1/1997 7/9/2002 N/A 2002 PROFICIENC
Y
GRADUATE STUDIES N/A N/A N/A N/A N/A N/A N/A
(Continue on separate sheet if necessary)

SIGNATURE DATE May 17, 2021

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
SPECIAL LAWS/ CES/ CSEE EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
(If Applicable) NUMBER Date of
BARANGAY ELIGIBILITY / DRIVER'S LICENSE CONFERMENT
Validity

LICENSURE EXAMINATION FOR TEACHERS 0.8 8/1/2003 ZAMBOANGA CITY 0827634 24/25/12

(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)
SCHOOLS DIVISION OF OLONGAPO CITY- CONTRACTUA
1/3/2022 PRESENT LEARNING SUPPORT AIDE 7800.00 N/A Y
TAPINAC ELEMENTARY SCHOOL L
CONTRACTUA
5/9/2022 5/9/2022 Support Staff COMMISSION ON ELECTIONS 60000.00 N/A Y
L
SCHOOLS DIVISION OF OLONGAPO CITY-
10/4/2021 12/31/2021 LEARNING SUPPORT AIDE 7800.00 N/A CONTRACTUA Y
TAPINAC ELEMENTARY SCHOOL
L
SCHOOLS DIVISION OF OLONGAPO CITY- CONTRACTUA
1/4/2021 6/30/2021 LEARNING SUPPORT AIDE 7800.00 N/A Y
TAPINAC ELEMENTARY SCHOOL L
12/18/2007 11/15/2021 OWNER 2MJP VARIETY STORE OLONGAPO CITY FLEXIBLE N/A N/A N
ST. AGUSTIN INTERNATIONAL SCHOOL, CONTRACTUA
2/5/2007 4/5/2007 TEACHER 1 11000.00 N/A N
BIÑAN, LAGUNA L
CONTRACTUA
12/4/2006 2/5/2007 SUBSTITUTE TEACHER CANOSA SCHOOL, STA. ROSA, LAGUNA 9000.00 N/A N
L
FAMILY BUSINESS WITH FILMAX CONTRACTUA
5/5/2007 11/26/2007 LOGISTIC OFFICER 2000.00 N/A N
NETWORKING COMPANY L
NEW HAPPY VALLEY SUPERSTORE CONTRACTUA
11/5/2005 5/5/2006 CASHIER 4000.00 N/A N
OLONGAPO CITY L
RENPOLI HARDWARE CONTRACTUA
6/16/2004 8/16/2005 SALES CLERK 3000.00 N/A N
MUZON,SAN JOSE DELMONTE,BULACAN L
FILMART PHARMACY CONTRACTUA
9/30/2002 3/4/2003 SALESCLERK 1500.00 N/A N
PALA-O,ILIGAN CITY L
PRINCESS JOYCE BAKESHOP AND CONTRACTUA
6/6/2002 9/19/2002 SALESCLERK 900.00 N/A N
GENERAL MERCHANDISE,PAGADIAN CITY L
COMMISSION ON ELECTION CONTRACTUA
3/25/1998 4/25/1998 ENUMERATOR 3000.00 N/A Y
BUUG,ZAMBOANGA SIBUGAY L
NATIONAL PEOPLE'S COALITION CONTRACTUA
5/11/1998 5/12/1998 POLL WATCHER 2000.00 N/A N
BUUG,ZAMBOANGA SIBUGAY L

(Continue on separate sheet if necessary)

SIGNATURE DATE 05/ 17/2022

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

HOMEROOM PARENT TEACHER'S ASSOCIATION 6/9/2017 PRESENT N/A VICE PRESIDENT,AUDITOR,PRESIDENT

GENERAL PARENT TEACHERS' ASSOCIATION 6/10/2017 3/30/2018 N/A BOARD OF DIRECTOR

BUKLOD NG PAG- IBIG,ST.JOSEPH PARISH,OLONGAPO CITY 8/16/2005 10/20/2006 N/A CHOIR

SANGGUNIANG KABATAAN,COMPOSTELA,BUUG,ZAMBOANGA SIBUGAY 4/5/1997 5/31/2002 N/A TREASURER/ COUNCILOR

YOUTH MINISTRY- PARISH AND CHAPEL LEVEL,KRISTOHANONG

4/5/1997 5/31/2002 N/A PRESIDENT/ SECRETARY/FACILITATOR
KATILINGBAN,BUUG,ZAMBOANGA SIBUGAY
STUDENTS' SOCIETY FOR LIFE SCIENCES
7/10/2001 3/30/2002 N/A SECRETARY
MINDANAO STATE UNIVERSITY- BUUG COLLEGE,BUUG,ZAMBOANGA SIBUGAY

(Continue on separate sheet if necessary)

VII. LEARNING AND DEVELOPMENT (L&D) INTERVENTIONS/TRAINING PROGRAMS ATTENDED
INCLUSIVE DATES OF
ATTENDANCE Type of LD
30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS ( Managerial/ CONDUCTED/ SPONSORED BY
NUMBER OF HOURS
(Write in full) Supervisory/ (Write in full)
(mm/dd/yyyy)
Technical/etc)
From To
HBRID INSET ON ENHANCING TEACHER'S PRODUCTIVITY AND EFFECTIVENESS IN THE
1/31/2022 2/4/2022 40 HOURS MANAGERIAL TAPINAC ELEMENTARY SCHOOL
BETTER NORMAL CUM MID- YEAR PERFORMANCE REVIEW AND EVALUATION

& TECHNICAL

MANPOWER ADVANCED IN TECHNICAL TRAINING,INC.( TESDA ACCREDITED)-BASIC

11/7/2004 3/4/2005 72 HOURS TECHNICAL
COMPUTER APPLICATION STA.MARIA,BULACAN

(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)
OLONGAPO MULTI-PURPOSE
COMPUTER LITERATE LOYALTY AWARD
COOPERATIVE,OLONGAPO CITY
KABALIKAT PARA SA MAUNLAD NA
BUHAY,INC.OLONGAPO CITY

(Continue on separate sheet if necessary)

SIGNATURE DATE 05/ 17/ 2022

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? NO
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? NO
If YES, give details:
________________________________
________________________________
b. Have you been criminally charged before any court? 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 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
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? ________________________________
END OF CONTRACT
________________________________
38. a. Have you ever been a candidate in a national or local election held within the last year (except
Barangay election)? NO
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: No
39. Have you acquired the status of an immigrant or permanent resident of another country?
If YES, give details (country):
NO
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: NO
b. Are you a person with disability?
If YES, please specify ID No: No
c. Are you a solo parent?
If YES, please specify ID No: 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
4.5 cm. X 3.5 cm
SCHOOLS DIVISION OFFICE OF
MRS. ARLENE DELA REA ( EDUCATION SPECIALIST ) OLONGAPO CITY
(passport size)

NELLIE E.BROWN ELEMENTARY

Computer generated
MR.ELBERT CANTILLO ( MASTER TEACHER II) SCHOOL,WEST BAJAC- or photocopied picture
BAJAC,OLONGAPO
NELLIE CITY
E. BROWN ELEMENTARY is not acceptable
MRS. CECILIA DE GUZMAN SAN MIGUEL
SCHOOL,WEST BAJAC-
(MASTERTEACHER I) BAJAC,OLONGAPO CITY
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: PRC

ID/License/Passport No.: 0827634

Signature (Sign inside the box)

Date/Place of Issuance: 10/08/2021-PAMPANGA

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