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 DATU-DACULA
NAME EXTENSION (JR., SR) N/A
FIRST NAME SOHAYNAH
MIDDLE NAME DATU-HARON
3. DATE OF BIRTH
(mm/dd/yyyy) 23/11/1995 16. CITIZENSHIP FILIPINO

4. PLACE OF BIRTH CAGAYAN DE ORO CITY, PHILIPPINES If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX FEMALE Philippines

6 CIVIL STATUS SINGLE

17. RESIDENTIAL ADDRESS N/A TOWNHOUSE
House/Block/Lot No. Street
NORMALA VILLAGE MONCADO KADINGILAN
Subdivision/Village Barangay
7. HEIGHT (m) 1.7m MARAWI CITY LANAO DEL SUR
City/Municipality Province
8. WEIGHT (kg) 53kgs ZIP CODE 9700

9. BLOOD TYPE "O"+

18. PERMANENT ADDRESS N/A TOWNHOUSE
House/Block/Lot No. Street

10. GSIS ID NO. NONE NORMALA VILLAGE MONCADO KADINGILAN

Subdivision/Village Barangay

11. PAG-IBIG ID NO. NONE MARAWI CITY LANAO DEL SUR

City/Municipality Province

12. PHILHEALTH NO. NONE ZIP CODE 9700

13. SSS NO. 34-9930046-0 19. TELEPHONE NO. N/A

14. TIN NO. 766-953-150 20. MOBILE NO. 0919-751-5682

15. AGENCY EMPLOYEE NO. NONE 21. E-MAIL ADDRESS (if any) sohaynahdatudacula@gmail.com

II. FAMILY BACKGROUND

22. SPOUSE'S SURNAME DATE OF BIRTH (mm/dd/yyyy)

NAME EXTENSION (JR., SR)

FIRST NAME N/A

MIDDLE NAME

OCCUPATION NONE

EMPLOYER/BUSINESS NAME NONE

BUSINESS ADDRESS NONE

TELEPHONE NO. NONE

24. FATHER'S SURNAME DATU-DACULA

SR.
FIRST NAME TALIB

MIDDLE NAME SOLAMAN

25. MOTHER'S MAIDEN NAME

SURNAME DATU-HARON

FIRST NAME SORAYDA

MIDDLE NAME HAMDAG (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

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

AMAI PAK-PAK CENTRAL ELEMENTARY WITH

ELEMENTARY ITERMEDIATE 2009
SCHOOL HONOR
MARAWI CAPITOL COLLEGE
SECONDARY
VOCATIONAL / HIGHSCHOOL 2013
FOUNDATION, INC

TESDA COMPUTER HARDWARE NC II 01/03/2014 01/06/2014 2014

TRADE
ADIONG MEMORIAL POLYTECHNIC STATE BACHELOR OF ELEMENTARY
COURSE
COLLEGE 2017
COLLEGE EDUCATION

GRADUATE STUDIES NONE NONE NONE

(Continue on separate sheet if necessary)

SIGNATURE DATE 23/08/2021

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

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

02/12/2019 28/02/2020 ENUMERATOR IDEALS, INC 8k N

03/12/2020 30/03/2021 PROJECT OFFICER IDEALS, INC 24k N

(Continue on separate sheet if necessary)

SIGNATURE DATE 8/23/21

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

MAGUNGAYA MINDANAO INCORPORATED 01/07/2019 30/12/2019 6mons WOMEN FRIENDLY SPACE FACILITATOR

(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/ SPONSORED BY
NUMBER OF HOURS
(Write in full) (mm/dd/yyyy) Supervisory/ (Write in full)
Technical/etc)
From To

GENDER AND DEVELOPMENT AND COVID-19 MANAGEMENT TRAINING 01/27/2021 01/28/2021 16hrs IDEALS, INC

PSYCHOLOGICAL FIRST AID TRAINING 05/23/2020 8hrs ACTION AGAINST HUNGER

LIVELIHOOD SKILLS TRAINING 03/02/2020 03/05/2020 32hrs MAGUNGAYA MINDANAO INCORPORATED

BUSINESS PLANNING WORKSHOP 02/18/2020 02/19/2020 16hrs MAGUNGAYA MINDANAO INCORPORATED

TRAINING OF COMMUNITY ENUMERATORS FOR THE BRING VOICE TO MDM 18/11/2019 19/11/2019 16hrs IDEALS, INC

PAGNAO KO KALUMBAYAN PEACE CONNECT

MERANAO SWEET DELICACIES SKILLS TRAINING 01/10/2019 03/10/2019 24hrs PROJECT

WOMEN FRIENDLY SPACE MANAGEMENT TRAINING 24/06/2019 28/06/2019 40hrs MAGUNGAYA MINDANAO INCORPORATED

BREAD MAKING (LEADING TO BREAD AND PASTRY PRODUCTION NC II) 27/12/2017 10/01/2018 80hrs CULINARY INSTITUTE OF CAGAYAN DE ORO

TECHNICAL EDUCATION AND SKILLS

PREPARE AND COOK HOT MEALS LEADING TO COOKERY NC II 09/08/2017 11/08/2017 24hrs DEVELOPMENT AUTHORITY
TECHNICAL EDUCATION AND SKILLS
COMPUTER HARDWARE SERVICING NC II 01/03/2014 01/06/2014 4mons DEVELOPMENT AUTHORITY

(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)
DANCING, COOKING, BAKING, DRIVING and
N/A DATU-HARON YOUNGSTER
READING
COMPUTER LITERATE KALUMBAYAN SA RANAO

HARDWORKING ~NOTHING FOLLOWS~

FLEXIBLE

CAN DEAL WITH DIFFERENT PERSONALITIES

(Continue on separate sheet if necessary)

SIGNATURE DATE 8/23/21

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:
________________________________
NO

35. a. Have you ever been found guilty of any administrative offense?
If YES, give details:
________________________________
NO
________________________________
b. Have you been criminally charged before any court?
If YES, give details:
________________________________
Date Filed: NO
________________________________
Status of Case/s: NO

36. Have you ever been convicted of any crime or violation of any law, decree, ordinance or regulation
by any court or tribunal?
If YES, give details:
________________________________
NO
________________________________
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? ________________________________
NO
________________________________
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: NO

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)

ID picture taken within

NAME ADDRESS CEL. NO
the last 6 months
3.5 cm. X 4.5 cm
ALI MONTAHA DH BABAO MULONDO, LDS 0938-667-4122 (passport size)

With full and handwritten

NORHANNAH H. MOHAMMADALI, Rsw MARAWI CITY 0945-254-1024 name tag and signature over
printed name

Computer generated
ESNAIRA I. LUCMAN, Ph.D MARAWI CITY 0909-285-8713 or photocopied picture
is not acceptable
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)
August 23, 2021
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