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

I. PERSONAL INFORMATION
2. SURNAME PONCE
NAME EXTENSION (JR., SR) N/A
FIRST NAME ERIC

MIDDLE NAME NIEGOS

3. DATE OF BIRTH
16. CITIZENSHIP
(mm/dd/yyyy) 6/9/1892 ✘ Filipino Dual Citizenship
by birth by naturalization
4. PLACE OF BIRTH TAGUIG CITY If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX ✘ Male Female

6 CIVIL STATUS Single ✘ Married 17. RESIDENTIAL ADDRESS LOPEZ JEANA

Widowed Separated House/Block/Lot No. Street
Bolck 17, Lot 7 Ridge View Park 97 Cabalawan
Other/s:
Subdivision/Village Barangay
TACLOBAN LEYTE
7. HEIGHT (m) 1.58m
City/Municipality Province
8. WEIGHT (kg) 62kg ZIP CODE 6500

18. PERMANENT ADDRESS BLK 22 LOT 29

9. BLOOD TYPE "O"
House/Block/Lot No. Street
Bolck 17, Lot 7 Ridge View Park 97 Cabalawan
10. GSIS ID NO. N/A
Subdivision/Village Barangay

11. PAG-IBIG ID NO. 1211-7735-4414 Tacloban Leyte

City/Municipality Province

12. PHILHEALTH NO. 13-2007-23677 ZIP CODE 6500

13. SSS NO. N/A 19. TELEPHONE NO. N/A

14. TIN NO. 430-413-423 20. MOBILE NO. 09531271452

15. AGENCY EMPLOYEE NO. 14D0110039 21. E-MAIL ADDRESS (if any) ponceeric381@gmail.com
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME PONCE 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yy
NAME EXTENSION (JR., SR) JUAN CARLOS III V. PONCE
FIRST NAME CYRA 12/18/2014
DIOLY JOHN V. PONCE
MIDDLE NAME VILLALINO 5/22/2014
ANGEL RHOD V. PONCE
OCCUPATION N/A 1/26/2019

EMPLOYER/BUSINESS NAME N/A

BUSINESS ADDRESS N/A

TELEPHONE NO. N/A

24. FATHER'S SURNAME PONCE (DECEASED)

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

MIDDLE NAME BASILAN

25. MOTHER'S MAIDEN NAME

SURNAME NIEGOS

FIRST NAME WENEFREDA

MIDDLE NAME SALIENTE (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

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

ELEMENTARY RIZAL CENTRAL SCHOOL PRIMARY EDUCATION 1990 1996 GRADUATED 1996

VOCATIONAL
SECONDARY / LEYTE NATIONAL HIGH SCHOOL SECONDARY 1994 1998 GRADUATED 1998

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

TRADE ASIAN DEVELOPMENT FOUNDATION COLLEGE
COLLEGE
COURSE (ADFC)
BACHELOR OF SCIENCE IN CRIMINOLOGY 2000 2004 GRADUATED 2004

GRADUATE STUDIES N/A N/A N/A N/A N/A N/A

(Continue on separate sheet if necessary)

SIGNATURE DATE
CS FORM 212 (Revised 2017), Page
AL DATA SHEET
xperience Sheet shall cause the filing of administrative/criminal case/s against the person concerned.

S) BEFORE ACCOMPLISHING THE PDS FORM.

(Do not fill up. For CSC use only)

NAME EXTENSION (JR., SR) N/A

by naturalization
Pls. indicate country:

LOPEZ JEANA
Street
97 Cabalawan
Barangay
LEYTE
Province
6500

Street
97 Cabalawan
Barangay

Province

N/A

09531271452

ponceeric381@gmail.com

DATE OF BIRTH (mm/dd/yyyy)

12/18/2014

5/22/2014

1/26/2019

(Continue on separate sheet if necessary)

SCHOLARSHIP/
ACADEMIC
HONORS
RECEIVED

N/A

N/A

N/A

N/A

N/A
ue on separate sheet if necessary)

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

CRIMINOLOGIST LICENSURE EXAMINATION 79.2 05/23,24,25/2005 TACLOBAN CITY LEYTE 0025784 05/31/2005

(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)

1/7/2019 TO PRESENT POLICE CORPORAL TACLOBAN CITY POLICE OFFICE, PS2 30867.00 12-1 PERMANENT YES

10/9/2018 03/24/2019 POLICE OFFICER 1 / PATROL PNCO TACLOBAN CITY POLICE OFFICE, PS2 29668.00 10-1 PERMANENT YES
TACLOBAN CITY PUBLIC SAFETY
5/5/2015 9/7/2018 PATROLMAN / PATROL PNCO 29668.00 10-1 PERMANENT YES
COMPANY
PRO8, REGIONAL PUBLIC SAFETY
1/11/2014 4/5/2015 POLICE OFFICER 1 / PATROL PNCO 14834.00 10-0 PERMANENT YES
BATTALION
PRO8, REGIONAL PUBLIC SAFETY
07/14/2014 10/30/2014 POLICE OFFICER / RIFLE MAN 14834.00 10-0 PERMANENT YES
BATTALION
06/24/2014 07/13/2014 POLICE OFFICER 1 / RIFLE MAN POLICE REGIONAL OFFICE 8 14834.00 10-0 TEMPORARY YES
PRO8, REGIONAL SPECIAL TRAINING UNIT
O4/14/2014 06/23/2014 POLICE OFFICER 1 / RIFLE MAN 14834.00 10-0 TEMPORARY YES
SERVICE 8
12/20/2013 04/13/2014 POLICE OFFICER/ TRAINEE POLICE REGIONAL OFFICE 8 14834.00 10-0 TEMPORARY YES
PUBLIC SAFETY COLLEGE, REGIONAL
3/12/2012 12/19/2013 POLICE OFFICER/ RIFLE MAN 14834.00 10-0 TEMPORARY YES
TRAINING SCHOOL 8
03/25/2019 06/30/2019 POLICE OFFICER. TRAINEE TCPO PS2 2966.80 10-1 PERMANENT YES

(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

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)
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

CRIME SCENE FIRST RESPONDER 10/11/2015 11/18/2015 40 HOURS TECHNICAL POLICE REGIONAL OFFICE 8

PNP SCOUT 04/14/2014 06/20/2014 360 HOURS TECHNICAL SPECIAL TRAINING UNIT SERVICE 8

PUBLIC SAFETY BASIC RECRUIT COURSE 3/12/2012 06/20/2013 1080 HOURS MANDATORY PPSC-RTS-8

(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)
PROFESSIONAL CRIMINOLOGIST
DRIVING MEDALYA NG KASANAYAN-9
ASSOCIATION OF THE PHILIPPINES
PUBLIC SAFETY SAVINGS & LOAN
MEDALYA NG PAGTULONG SA NASALANTA
ASSOCIATION CORPORATION
PUBLIC SAFETY MUTUAL BENEFIT FUND
MEDALYA NG PAPURI-19
CORPORATION
MEDALYA NG KAGALINGAN 1

(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? YES ✘

b. within the fourth degree (for Local Government Unit - Career Employees)? YES ✘

If YES, give details:

________________________________

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

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

NAME ADDRESS TEL. NO.

ID picture taken within
POLICE STATION 2, ABUCAY, TACLOBAN the last 6 months
PCPT JOSELITO B AMISTOSO CITY
9495711690 3.5 cm. X 4.5 cm
(passport size)
POLICE STATION 2, ABUCAY, TACLOBAN
PLT. NOEMI JORDAN CITY
9276488634 With full and handwritten
name tag and signature over
POLICE STATION 2, ABUCAY, TACLOBAN printed name
PLT. ALVIN CAPATOY CITY
9276573210
Computer generated
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and or photocopied picture
is not acceptable
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: PNP ID

ID/License/Passport No.: 20J1400180

Signature (Sign inside the box)

Date/Place of Issuance: CAMP CRAME, QUEZON 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