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 (Do not fill up. For CSC use only)
No.
I. PERSONAL INFORMATION
2. SURNAME Almojuela
NAME EXTENSION(JR, SR)
FIRST NAME Cydie N/A
MIDDLE NAME Capila
3. DATE OF BIRTH
16. CITIZENSHIP [ X ] Filipino [ ] Dual Citizenship
(mm/dd/yyy) 11/01/1994
[ ] by birth [ ] by naturalization

4. PLACE OF BIRTH PILAR, SORSOGON if holder of dual citizenship Pls. indicate country:

5. SEX [ X ] Male [ ] Female Pls. indicate the details N/A

0473 CIRCUMFERENTIAL ROAD

6. CIVIL STATUS [ ] Single [ X ] Married 17. RESIDENTIAL ADDRESS House/Block/Lot No. Street
[ ] Widowed [ ] N/A Balud II
[ ] Other/s: N/A Separated Subdivision/Village Barangay
CITY OF BORONGAN (Capital) EASTERN SAMAR
7. HEIGHT (m) 1.63 City/Municipality Province

8. WEIGHT (kg) 75 Zip Code 6800

0473 CIRCUMFERENTIAL ROAD
9. BLOOD TYPE O+ 18. PERMANENT ADDRESS
House/Block/Lot No. Street
N/A Balud II
10. GSIS ID NO. N/A
Subdivision/Village Barangay
CITY OF BORONGAN (Capital) EASTERN SAMAR
11. PAGIBIG ID NO. 1212-5000-9150
City/Municipality Province
12. PHILHEALTH NO. 130255408233 ZIP CODE 6800

13. SSS NO. 06-4305133-5 19. TELEPHONE NO. N/A

14. TIN NO. 750 471 596 20. MOBILE NO. 09956520428

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

II. FAMILY BACKGROUND

23. NAME of CHILDREN (Write full name and list DATE OF BIRTH
22. SPOUSE'S SURNAME. ALMOJUELA
all) (mm/dd/yyyy)
NAME EXTENSION (JR.,SR)
FIRST NAME JEAN CLAUDINE JILIANNA EVE PALADA ALMOJUELA 05/08/2021
N/A

MIDDLE NAME PALADA

OCCUPATION N/A

EMPLOYERS/BUSINESS NAME N/A

BUSINESS ADDRESS N/A

TELEPHONE NO. N/A

24. FATHER 'S SURNAME. ALMOJUELA

NAME EXTENSION (JR.,SR)
FIRST NAME REYNANTE
N/A

MIDDLE NAME LUNA

24. MOTHER'S MAIDEN NAME. MARIA SONIA QUIAL CAPILA

SURNAME ALMOJUELA

FIRST NAME MARIA SONIA

MIDDLE NAME CAPILA (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

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

From To

SPECIAL
ELEMENTARY EUGENIO S. DAZA PILOT ELEMENTARY SCHOOL ELEMENTARY EDUCATION 2001 2007 GRADUATED 2007 ACADEMIC
AWARD
SPECIAL
EASTERN SAMAR NATIONAL COMPREHENSIVE HIGH
SECONDARY HIGH SCHOOL 2007 2011 GRADUATED 2011 ACADEMIC
SCHOOL AWARD

VOCATIONAL / TRADE COURSE N/A N/A N/A N/A N/A N/A N/A

COLLEGE EASTERN SAMAR STATE UNIVERSITY BS IN CIVIL ENGINEERING 2011 2018 GRADUATED 2018 N/A

MASTERS IN ENGINEERING - MAJOR IN Currently Currently

GRADUATE STUDIES EASTERN SAMAR STATE UNIVERSITY 2021 30 UNITS N/A
CIVIL ENGINEERING Enrolled Enrolled

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

Bar/Board Eligibility (RA1080) 83.6 05/05/2019 CITY OF MANILA 0168818 11/01/2022

(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.
SALARY /
JOB
/ PAY
INCLUSIVE DATES GRADE GOV'T
28. POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY MONTHLY
(if STATUS OF APPOINTNMENT SERVICE
(mm/dd/yyyy) (Write in full / Do not abbreviate) (Write in full/Do not abbreviate) SALARY
(Y/N)
applicable
) & STEP
(Format
"00-0") /
From To
INCREMENT
DEPARTMENT OF THE INTERIOR AND LOCAL
01/10/2022 Present Engineering II P 35,106.00 16-1 Contract of Service YES
GOVERNMENT - EASTERN SAMAR
DEPARTMENT OF THE INTERIOR AND LOCAL
06/01/2021 12/31/2021 Engineering III P 46,791.00 19-1 Contract of Service YES
GOVERNMENT - EASTERN SAMAR
03/11/2021 05/31/2021 PROJECT ENGINEER TUBIGAN BUILDER P 20,000.00 Contractual NO

08/07/2019 07/07/2020 PROJECT ENGINEER Homemark, Inc. P 19,000.00 Permanent NO

(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
NAME AND ADDRESS OF ORGANIZATION INCLUSIVE DATES NUMBER OF
29. (Write in full) POSITION / NATURE OF WORK
(mm/dd/yyyy) HOURS
From To

N/A N/A N/A N/A N/A

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

Cascading the Local Road Governance Reforms in the Component Cities

10/20/2022 10/20/2022 8 Technical DILG-OPDS
and Municipalities (Revisiting Local Road Governance Reforms)
PREPARATION OF DETAILED ENGINEERING DESIGN (DED) FOR WATER-
09/19/2022 09/21/2022 24 Technical DILG-OPDS
RELATED INFRASTRUCTURES
TRAINING-WORKSHOP ON DETAILED ENGINEERING DESIGN (DED)
09/05/2022 09/07/2022 24 Technical DILG-OPDS
PREPARATION FOR LOCAL ROAD PROJECTS
ORIENTATION ON SAFETY AND HEALTH IN THE IMPLEMENTATION OF
08/30/2022 09/02/2022 24 Technical DILG-OPDS
INSFRASTRUCTURE PROJECTS
TRAINING ON ROAD SAFETY ENGINEERING 08/08/2022 08/09/2022 16 Technical DILG REGION VIII
SEMIINAR ON THE DETAILED ENGINEERING DESIGN (DED) PREPARATION
07/21/2022 07/22/2022 14 Technical DILG-OPDS
STANDARDS FOR VERTICAL STRUCTURE PROJECTS
ENHANCED ROAD AND BRIDGE INFORMATION SYSTEM (RBIS)
11/03/2021 11/03/2021 8 Technical DILG-OPDS
ACCUSTOMIZATION
STRENGTHENING OF WATER SERVICE PROVIDERS 10/07/2021 10/08/2021 12 Technical DILG-OPDS
TRAINING ON CONTRACT MANAGEMENT AND CONSTRUCTION
SUPERVISION (CMCS) FOR MUNICIPAL LOCAL GOVERNMENT UNITS 08/25/2021 08/27/2021 24 Technical DILG-OPDS
(MLGUs)
Training on Structural Design, Analysis, & Detailing of Midrise Structures
08/16/2021 08/20/2021 40 Technical DILG REGION VIII
using MIDAS GEN & REVIT Workflow for the LFPs under MEALGU
PROJECT DEVELOPMENT TRAINING AND PROJECT PROPOSAL
07/26/2021 07/30/2021 40 Technical DILG REGION VIII
PREPARATION FOR TECHNICAL STAFF
COACHING SUPPORT TO CONDUCT WORK FORCE REVIEW OF
PROVINCIAL OFFICESRELATED TO RAOD PLANNING AND PROPER 07/12/2021 07/14/2021 24 Technical DILG REGION VIII
IMPLEMENTATION
TRAINING ON DETAILED ENGINEERING DESIGN (DED) PREPARATION FOR
06/30/2021 07/02/2021 24 Technical DILG-OPDS
LOCAL ROAD PROJECTS
2021 PICE Virtual Midyear National Convention and Technical
Conference with theme "The Future Now of Digital and Data-Driven 06/25/2021 06/26/2021 16 Technical PICE, Inc.
Civil Engineering Practice"
SEMINAR ON STRUCTURAL ANALYSIS AND DESIGN OF REINFORCED
11/23/2017 11/24/2017 16 Technical PICE - ESSU STUDENT CHAPTER
CONCRETE BUILDING
SEMINAR AND WORKSHOP ON BIDDING AND PROCUREMENT
03/28/2017 03/28/2017 4 Technical PICE - ESSU STUDENT CHAPTER
PROCEDURE
SEMINAR AND WORKSHOP ON CONSTRUCTION AND SAFETY
03/28/2017 03/28/2017 2 Technical PICE - ESSU STUDENT CHAPTER
MANAGEMENT
SEMINAR AND WORKSHOP ON TENDER DOCUMENT PREPARATION 03/28/2017 03/28/2017 2 Technical PICE - ESSU STUDENT CHAPTER
42ND PICE NATIONAL CONVENTION IN SM LANANG DAVAO CITY WITH A
THEME "CIVIL ENGINEERING INNOVATIONS TOWARDS A BETTER 11/17/2016 11/19/2016 24 Technical PICE, Inc.
PHILIPPINES"
(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

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

BASIC SKETHCUP N/A N/A

(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 [ ] YES [X] NO
Department where you will be apppointed,
a. within the third degree?
. [ ] YES [X] NO
If Yes, give details:
b. within the fourth degree (for Local Government Unit - Career Employees)?
[ ] YES [X] NO
35. a. Have you ever been found guilty of any administrative offense?
If Yes, give details:

. [ ] YES [X] NO
Date Filed :
b. Have you been criminally charged before any court?
. [ ] YES [X] NO
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 [ ] YES [X] NO
or tribunal? If Yes, give details:

37. Have you ever been separated from the service in any of the following modes: resignation, retirement, dropped [X] YES [ ] NO
from the rolls, dismissal, termination, end of term, finished contract or phased out (abolition) in the public or
private sector?
If Yes, give details:

RESIGNATION.
38. a. Have you ever been a candidate in a national or local election held within the last year (except Barangay [ ] YES [X] NO
election)? If Yes, give details:

. [ ] YES [X] 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?
[ ] YES [X] NO
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) [ ] YES [X] NO
Solo Parents Welfare Act of 2000 (RA 8972), please answer the following items: If Yes, please specify:
a. Are you a member of any indigenous group?
. [ ] YES [X] NO
If Yes, please specify ID No:
b. Are you a person with disability
. [ ] YES [X] NO
If Yes, please specify ID No:
c. Are you a solo parent?

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

ID picture taken within
NAME ADDRESS TEL. NO. the last 6 months
3.5 cm. X 4.5 cm
DR. LEOVIGILDO E. CARDENAS BRGY. SONGCO BORONGAN CITY 09199911706 (passport size)
ENGR. JENITH L. BANALDIA BRGY. STA FE, BORONGAN CITY 09219770369
With full handwritten
JEAN CLAUDINE P. ALMOJUELA Brgy. Balud II, Borongan City 09058430219 name tag and signature
over
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and complete statement printed name
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 Computer generated
document and its attachments shall cause the filing of administrative/criminal case/s against me. or photocopied picture
is not acceptable
PHOTO

Government Issued ID (i.e.Passport, GSIS, SSS, PRC, Driver's

License, etc.) PLEASE INDICATE ID Number
Government Issued ID: PRC LICENSE
Signature (Sign inside the
ID/License/Passport No. 0168818
box)
Date/Place of Issuance: 05/20/2021/TACLOBAN CITY
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