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 CELESTE
NAME EXTENSION (JR., SR)
FIRST NAME EMAN RALPH

MIDDLE NAME CHAVEZ

3. DATE OF BIRTH
(mm/dd/yyyy) 11/8/1994 16. CITIZENSHIP ✘

4. PLACE OF BIRTH SAN FERNANDO,CAMARINES SUR If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX ✘

✘ 17. RESIDENTIAL ADDRESS PUROK 1

6 CIVIL STATUS
House/Block/Lot No. Street
BANAGO
Subdivision/Village Barangay
NAGCARLAN LAGUNA
7. HEIGHT (m) 1.68
City/Municipality Province
8. WEIGHT (kg) 95 ZIP CODE 4002

18. PERMANENT ADDRESS ZONE 1A

9. BLOOD TYPE A
House/Block/Lot No. Street
DEL PILAR
10. GSIS ID NO. 2005261241
Subdivision/Village Barangay
SAN FERNANDO CAMARINES SUR
11. PAG-IBIG ID NO. 1211-0192-7297
City/Municipality Province

12. PHILHEALTH NO. 100251572520 ZIP CODE 4415

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

14. TIN NO. 489-861-837 20. MOBILE NO. 09959571457

15. AGENCY EMPLOYEE NO.
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME
FIRST NAME
C17131 21. E-MAIL ADDRESS (if any) ralph.celeste011@gmail.com
CELESTE 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
NAME EXTENSION (JR., SR) RALPH TIMOTHY OQUIALDA CELESTE
JANINE ELAH N/A 12/30/2020

MIDDLE NAME OQUIALDA

OCCUPATION HOUSEWIFE

EMPLOYER/BUSINESS NAME N/A

BUSINESS ADDRESS N/A

TELEPHONE NO. N/A

24. FATHER'S SURNAME CELESTE

NAME EXTENSION (JR., SR)
FIRST NAME RAFAEL

MIDDLE NAME DELA CRUZ

25. MOTHER'S MAIDEN NAME

SURNAME CHAVEZ

FIRST NAME JESUSA

MIDDLE NAME AMADOR (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
HONORS
(Write in full)
full) (if not graduated) RECEIVED
From To

ELEMENTARY SAN FERNANDO ELEMENTARY SCHOOL PRIMARY EDUCATION 2000 2006 N/A 2006 N/A

SECONDARY /
VOCATIONAL SAN FERNANDO NATIONAL HIGH SCHOOL HIGH SCHOOL 2006 2010 N/A 2010 N/A

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

TRADE
COURSE BACHELOR OF SCIENCE IN
COLLEGE NAGA COLLEGE FOUNDATION 2010 2015 N/A 2015 N/A
CRIMINOLOGY

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

(Continue on separate sheet if necessary)

SIGNATURE DATE 16 August 2023

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
RA 1080- CRIMINOLOGY LICENSURE 10/17/2015-
76.9 10/19/2015
LEGAZPI CITY 122126 11/8/2025
EXAMINATION

(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)

07/01/2017 PRESENT FIRE OFFICER I BUREAU OF FIRE PROTECTION 29,668.00 10-1 PERMANENT Y

(Continue on separate sheet if necessary)

SIGNATURE DATE 16 August 2023

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
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

FIRE BASIC RECRUIT COURSE 04/22/2019 09/06/2019 640.0 TECHNICAL NATIONAL FIRE TRAINING INSTITUTE

(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)

COMPUTER LITERATE, MICROSOFT OFFICE APPLICATION MEDALYA NG PAGTULONG SA NASALANTA (3) N/A

DRIVING VEHICLE MEDALYA NG KASANAYAAN (2)

CERTIFICATE OF COMMENDATION (3)

(Continue on separate sheet if necessary)

SIGNATURE DATE 16 August 2023

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:

________________________________

35. a. Have you ever been found guilty of any administrative offense? ✘

If YES, give details:

________________________________
________________________________
b. Have you been criminally charged before any court? ✘

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 ✘
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, ✘
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 ✘
Barangay election)?
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:
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) 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:
b. Are you a person with disability? ✘

If YES, please specify ID No:

c. Are you a solo parent? ✘

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
the last 6 months
CINSP FIEGALAN, DOMINGO F LUISIANA, LAGUNA (049) 307-6929 4.5 cm. X 3.5 cm
(passport size)

SFO3 FRONDA, CRISTINA O CALAMBA CITY, LAGUNA 09171338392

Computer generated
or photocopied picture
RET. INSP GUTIERREZ, WENER A SAN PABLO CITY LAGUNA (049)-503-6630 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: PRC ID

ID/License/Passport No.: 122126

Signature (Sign inside the box)
16 August 2023
Date/Place of Issuance: 03/11/2016 PRC LEGASPI
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