Republic of the Philippines

Department of the Interior and Local Government

NATIONAL POLICE COMMISSION
NATIONAL HEADQUARTERS PHILIPPINE NATIONAL POLICE
Camp Crame, Quezon City

PNP PERSONAL DATA SHEET BADGE NO:

TIN NO:
PNP ID:

Warning !

The correctness of all statements or entries made herein is subject to verification and any deliberate omission or
distortion of information may give sufficient cause of investigation.

I. GENERAL INFORMATION
1. NAME (Last Name, First Name, Middle Name, Qualifier)

2. RANK 3. DESIGNATION 4. DATE DESIGNATED

5. UNIT 6. TEL #
SUBUNIT :
STATION :
ADDRESS :
7. DATE OF BIRTH 8. PLACE OF BIRTH

9. HOME ADDRESS (House No. / Street / Mun. / City / Province) 10. PHONE #

11. SEX 12. CIVIL STATUS 13. RELIGION

14. COLOR OF EYES 15. HEIGHT (ft.) 16. WEIGHT (kgs)

17. BLOOD TYPE 18. BUILD 19. COMPLEXION

20. COLOR OF HAIR 21. IDENTIFYING MARKS

22. LANGUAGES/DIALECT (Read/Write/Speak) 23. ETHNIC GROUP

24. HOUSING DATA

25. DEPENDENTS
NAME RELATIONSHIP BIRTH DATE ADDRESS

II. APPOINTMENT DATA

26. EFF. DATE OF PRESENT APPNTMT 27. STATUS OF PRESET APPNTMT 28. IF TEMPORARY STATE REASON

29. CHARACTER OF PRESENT APPNTMT 30. ORIGINAL RANK 31. FIRST UNIT ASSIGNMENT

32. DATE OF ENLISTMENT 33. ORIGINAL APPNTMNT STATUS 34. SOURCE OF COMMISSION

III. EDUCATIONAL BACKGROUND

LEVEL COURSE SCHOOL INCLUSIVE DATE

COLLEGE

HIGH SCHOOL

ELEMENTARY

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Signature
 IV. TRAINING
COURSE TITLE CLASS FINAL LOCATION AUTHORITY INCLUSIVE DATE
NO. GRADE

V. ELIGIBILITIES
DATE TITLE TESTING CENTER RATING

VI. PNP OCCUPATIONAL SPECIALTY (POS) / QUALIFICATION/SKILLS

POS/SKILL YRS. EXPERIENCE PLACE OF PRACTICE RELEVANT COURSE TRAINING

VII. ASSIGNMENT RECORD

ASSIGNMENT, DESIGNATION AUTHORITY SOURCE EFFECTIVITY DATE
 VIII. PROMOTION RECORD
RANK AUTHORITY EFFECTIVITY DATE REMARKS

IX. MEDALS / AWARDS / COMMENDATION

NATURE OF AWARD SSC # BAL # AUTHORITY AWARDED BY REMARKS

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Signature

X. FIREARMS RECORD
MR/LIC NO KIND MAKE CALIBER SERIAL NO AMMO ISSUING UNIT

XI. PHYSICAL AND MEDICAL RECORD

DATE OF LAST PHYSICAL/MENTAL EXAMINATION: WHERE TAKEN:

DATE OF LAST DENTAL EXAMINATION: WHERE TAKEN:
DATE OF LAST NP EXAMINATION: WHERE TAKEN:
XII. OFFENSE DATA
OFFENSE AS CHARGED OFFENSE OFFENSE STATUS DATE
COMMITTED

XIII. PERFORMANCE EVALUATION RATING

RATING PERIOD NUMERICAL RATING ADJECTIVAL RATING

XIV. DATA ON PREVIOUS RETIREMENT/DISMISSAL/RESIGNATION/SUSPENSION/OTHER

Have your ever been retired, dismissed, forced to resigned or suspended from any employment for reason other than lack of funds?
( ) YES ( ) NO If Yes, give particulars. ______________________________________________________________________
_____________________________________________________________________________________________________

Have you ever been a candidate in a national or local election (Including Barangay Election) ? ( ) YES ( ) NO If Yes, give particulars

POSITION PLACE DATE

 XV. REFERENCES (Persons not related by consanguinity or affinity)
NAME ADDRESS

PLEASE COPY IN OWN HAND WRITING

“Our London Business is good but Vienna and Berlin are quiet, Mr. D Lord has gone to Switzerland and I hope for
goodness. He will be there for a week at 1946 Zenatt St., and then goes to Turnie and Rome and will join Co. Perry.”
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CERTIFICATION
THIS IS TO CERTIFY that the answers given above are true and correct to the best of my knowledge and belief.

__________________________
SIGNATURE OVER PRINTED NAME

LEFT THUMBMARK RIGHT THUMBMARK

SUBSCRIBED AND SWORN TO before me this ___ day of _______________ 20___ at _______________________

________________________________
(Printed Name and Signature)
Administering Officer

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Signature