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/crimina
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

I. PERSONAL INFORMATION
2. SURNAME TRAGANTE
FIRST NAME JOSEPHINE NAME EXTENSION (JR., SR)
MIDDLE NAME CUIZON
3. DATE OF BIRTH 06/23/1981 16. CITIZENSHIP
(mm/dd/yyyy) ✘ Filipino Dual Citizenship
✘ by birth
4. PLACE OF BIRTH CENTRO NAPU, TUDELA, MIS. OCC. If holder of dual citizenship, Pls. indicate country:
5. SEX please indicate the details.
Male ✘ Female

Single ✘ Married 17. RESIDENTIAL ADDRESS PUROK 5

6 CIVIL STATUS Widowed Separated
House/Block/Lot No. Street
CABOL-ANON
Other/s: Subdivision/Village Barangay
7. HEIGHT (m) 5'0 TUDELA, MISAMIS OCCIDE
City/Municipality Province
8. WEIGHT (kg) 60 kls. ZIP CODE 7202
9. BLOOD TYPE "AB"
18. PERMANENT ADDRESS PUROK 5
House/Block/Lot No. Street
CABOL-ANONAN
10. GSIS ID NO.
Subdivision/Village Barangay
TUDELA, MISAMIS OCCIDENTAL
11. PAG-IBIG ID NO. 12-1085333873
City/Municipality Province
12. PHILHEALTH NO. 15-201061076-6 ZIP CODE 7202
13. SSS NO. 34-0479527-7 19. TELEPHONE NO. N/A
14. TIN NO. 342-192-000 20. MOBILE NO. 09126397080
15. AGENCY EMPLOYEE NO. 156 21. E-MAIL ADDRESS (if any) tragantejosephine3@gmail.c
II. FAMILY BACKGROUND
23. NAME of CHILDREN (Write full
22. SPOUSE'S SURNAME TRAGANTE
name and list all)
FIRST NAME DEOLITO NAME EXTENSION (JR., SR) DEON JOSHUA C. TRAGANTE
MIDDLE NAME TABO DEON JASPHER C. TRAGANTE
OCCUPATION SECURITY GUARD
EMPLOYER/BUSINESS NAME
BUSINESS ADDRESS MANILA
TELEPHONE NO. N/A
24. FATHER'S SURNAME CUIZON
NAME EXTENSION (JR., SR)
FIRST NAME JOSE N/A

MIDDLE NAME BONGOBNG

25. MOTHER'S MAIDEN NAME TOLEDO
SURNAME CUIZON
FIRST NAME LEONORA
MIDDLE NAME GALLETO (Continue on separate sheet if necessary)
III. EDUCATIONAL BACKGROUND HIGHEST
LEVEL/
BASIC PERIOD OF
26. NAME OF SCHOOL
EDUCATION/DEGREE/COURSE ATTENDANCE UNITS
LEVEL
EARNED
(Write in full)
(Write in full)
(if not
graduated)
 HIGHEST
LEVEL/
BASIC PERIOD OF
26. NAME OF SCHOOL
EDUCATION/DEGREE/COURSE ATTENDANCE UNITS
LEVEL
EARNED
(Write in full)
(Write in full)
From To (if not
GRADUATE
graduated)
ELEMENTARY TUDELA CENTRAL SCHOOL PRIMARY EDUCATION 06/1/1990 03/05/1995
D
VOCATIONAL / GRADUATE
SECONDARY SAN ISIDRO ACADEMY HIGH SCOOL DIPLOMA 06/1/1996 03/08/1999
D
MISAMIS UNIVERSITY OZAMIZ CITY CARE -GIVER 10/1/2004 3/27/2004 GRADUATED

TRADE COURSE
COLLEGE MISAMIS UNIVERSITY OZAMIZ CITY 2NDYR. IN BSN 06/1/2001 03/20/2003 Under Grad

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

(Continue on separate sheet if necessary)

SIGNATURE DATE NOV.____202

CS FORM 212 (Revised 2

ONAL DATA SHEET
eet and the Work Experience Sheet shall cause the filing of administrative/criminal case/s against

DATA SHEET (PDS) BEFORE ACCOMPLISHING THE PDS FORM.

(Do not fill up. For CSC use only)

NAME EXTENSION (JR., SR) N/A

Dual Citizenship
✘ by birth by naturalization
Pls. indicate country:

Street
CABOL-ANONAN
Barangay
MISAMIS OCCIDENTAL
Province
7202

Street
CABOL-ANONAN
Barangay
MISAMIS OCCIDENTAL
Province
7202
N/A
09126397080
tragantejosephine3@gmail.com

(Continue on separate sheet if necessary)

SCHOLARSHIP/ ACADEMIC HONORS

RECEIVED
 SCHOLARSHIP/ ACADEMIC HONORS
RECEIVED

WITH HONOR
WITH AWARD

WITH CERTIFICATE

N/A
(Continue on separate sheet if necessary)

NOV.____2021

CS FORM 212 (Revised 2017), Page 1 of 4

IV. CIVIL SERVICE ELIGIBILITY

CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER SPECIAL LICENSE (if applicable)
27. RATING DATE OF EXAMINATION / PLACE OF EXAMINATION /
LAWS/ CES/ CSEE BARANGAY
(If Applicable) CONFERMENT CONFERMENT Date of
ELIGIBILITY / DRIVER'S LICENSE NUMBER
Validity
N/A N/A N/A N/A N/A N/A

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

MSGNI (Multi Source Global Networks

2/102009 2/2/2010 FIELD INTERVIEWER
Inc.)
P 8,000 "00-0" CONTRACTUAL 1YR.

SADAN TRAD. &CONT. ALSADAN

2/2/2010 2/4/2012 CARE GIVER
TRAC
P12,000 "00-0" CONTRACTUAL 2YRS.

AL MOHAMMAD MAINTENACE & GEN.

2/13/2013 4/3/2015 CARE GIVER
SERVICES
P15,000 "00-0" CONTRACTUAL 2YRS.

2/5/2016 07/22/2020 JOB ORDER LGU -TUDELA P 5,280 "00-0" CONTRACTUAL 5YRS.

(Continue on separate sheet if necessary)

SIGNATURE DATE Nov.___2021
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

TUDELA PARISH YOUTH CHOIR 1/6/1995 6/25/2000 MEMBER

JUNIOR CAOTHLIC WOMENS LEAGUE 2/2/2010 2/2/2012 MEMBER

(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

PRE DEPARTURE SEMINAR FOR OFW 8HRS. OWWA MANILA

2/2/2010 3/2/2010
PRE DEPARTURE SEMINAR FOR OFW 2/1/2013 3/2/2013 8HRS. OWWA MANILA

JOB ORDER EMPLOYEES ORIENTATION "VALUES AND ETHICS IN THE WORK PLACE" 1/26/2017 1/26/2017 8HRS. HRMO

CAPACITY BUILDING SEMINAR FOR PESO MANAGERS & STAFF 11/21/2019 11/22/2019 16HRS. OWWA CAGAYAN DE ORO CITY

(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
(Write in full)
in full)

COMPUTER LITERACY N/A N/A

(Continue on separate sheet if necessary)

SIGNATURE DATE NOV.____2021

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 ✘ N
b. within the fourth degree (for Local Government Unit - Career Employees)? O
YES ✘ N
If YES, give details: O
________________________________
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 YES ✘ NO
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?
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:
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
EMMANUEL GALLETO TOLEDO CAGAYAN DE ORO CITY 9159726247 the last 6 months
3.5 cm. X 4.5 cm
HON. ESTELA OBUT ESTAÑO SEBAC TUDELA, MIS. OCC. 9471568100 (passport size)

With full and handwritten

HON. SAMUEL EDUSMA III UPPER CENTRO TUDELA, MIS. OCC. name tag and signature over
printed name
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and Computer generated
complete statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the or photocopied picture
is not acceptable
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: 156 JOSEPHINE C. TRAGANTE
ID/License/Passport No.: VIN:4216-0036A-F2381JCT20000 Signature (Sign inside the box)
NOV.___201
Date/Place of Issuance: 2016 AT TUDELA, MIS. OCC.
Date Accomplished Right Thumbmark

SUBSCRIBED AND SWORN to before me this 22nd day of July 2020, affiant exhibiting his/her validly issued government ID as indicated above.

HON. SAMUEL L. PAROJINOG

Person Administering Oath

CS FORM 212 (Revised 2017), Page 4 of 4