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 DEALA
NAME EXTENSION (JR., SR) N/A
FIRST NAME SANNY BOONE

MIDDLE NAME LANDERIO

3. DATE OF BIRTH
MAY 13,1984 16. CITIZENSHIP
(mm/dd/yyyy)

4. PLACE OF BIRTH LAMBUNAO,ILOILO If holder of dual citizenship, Pls. indicate country:

please indicate the details.
5. SEX MALE

17. RESIDENTIAL ADDRESS

6 CIVIL STATUS MARRIED
House/Block/Lot No. Street
ALUGMAWA
Subdivision/Village Barangay
LAMBUNAO ILOILO
7. HEIGHT (m) 163CM
City/Municipality Province
8. WEIGHT (kg) 62KG ZIP CODE 5042
18. PERMANENT ADDRESS
9. BLOOD TYPE O
House/Block/Lot No. Street
ALUGMAWA
10. GSIS ID NO. N/A
Subdivision/Village Barangay

11. PAG-IBIG ID NO. N/A LAMBUNAO ILOILO

City/Municipality Province
12. PHILHEALTH NO. 11-05037045-0 ZIP CODE 5042
13. SSS NO. 07-2347045-4 19. TELEPHONE NO. N/A

14. TIN NO. 429-571-552 20. MOBILE NO. 09125302889

15. AGENCY EMPLOYEE NO. 20030300354 21. E-MAIL ADDRESS (if any) dealasbl13@GMAIL.COM
II. FAMILY BACKGROUND
DATE OF BIRTH
22. SPOUSE'S SURNAME DEALA 23. NAME of CHILDREN (Write full name and list all)
(mm/dd/yyyy)
NAME EXTENSION (JR., SR)
FIRST NAME DAISY JOY N/A
ALLEYA YSABELLE L. DEALA 08/23/2016

MIDDLE NAME LATUAB

OCCUPATION ADMINISTRATIVE III

EMPLOYER/BUSINESS NAME DEPED 6

BUSINESS ADDRESS DELAGADO STREET,CALINOG,ILOILO

TELEPHONE NO. 3302302
24.FATHER'S SURNAME DEALA
SR
FIRST NAME SAMSON
MIDDLE NAME SIGNACION
25. MOTHER'S MAIDEN NAME

SURNAME LANDERIO

FIRST NAME MERLYN

MIDDLE NAME LARUAN (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

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

ELEMENTARY ALUGMAWA ELEMENTARY SCHOOL ELEMENTARY 1992 1997 GRADUATED 1997 N/A

SECONDARY WEST VISAYAS STATE UNIVERSITY HIGH SCHOOL 1998 2001 GRADUATED 2001 N/A
VOCATIONAL /
TRADE COURSE
N/A N/A N/A N/A N/A N/A N/A

COLLEGE WEST VISAYAS STATE UNIVERSITY BS IN CRIMINOLOGY 2002 2008 GRADUATED 2008 N/A

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

(Continue on separate sheet if necessary)

SIGNATURE DATE JANUARY 03,2019

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

IV. CIVIL SERVICE ELIGIBILITY
27. CAREER SERVICE/ RA 1080 (BOARD/ BAR) DATE OF LICENSE (if applicable)
RATING
UNDER SPECIAL LAWS/ CES/ CSEE EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
(If Applicable) NUMBER Date of
BARANGAY ELIGIBILITY / DRIVER'S LICENSE CONFERMENT
Validity
OCTOBER 05/13/20
BOARD OF CRIMINOLOGY 75.8 ILOILO CITU 0065013
22,23,24,2011 21

(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/
28. INCLUSIVE DATES PAY GRADE (if
GOV'T
(mm/dd/yyyy) POSITION TITLE MONTHLY applicable)& STATUS OF
2016 SERVICE
(Write in full/Do not abbreviate) SALARY STEP (Format APPOINTMENT
(Y/ N)
"00-0")/
From To INCREMENT

02/19/2014 Present POLICE OFFICER ONE PHILIPPINE NATIONAL POLICE 29,990,00 10 Permanent Y

2/7/2012 02/19/2014 POLICE OFFICER ONE PHILIPPINE NATIONAL POLICE 29,990,00 10 Temporary Y

(Continue on separate sheet if necessary)

SIGNATURE DATE JANUARY 03,2019

CS FORM 212 (Revised 2017), Page 2 of 4
VI. VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S
NAME & ADDRESS OF ORGANIZATION INCLUSIVE DATES
29. NUMBER OF
(Write in full) (mm/dd/yyyy) POSITION / NATURE OF WORK
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)

INCLUSIVE DATES OF Type of LD

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

CRIME SCENE RESPONDER SEMINAR 08/16/2017 08/24/2017 40HRS REGIONAL SPECIAL TRAINING UNIT 6

SPECIAL WEAPONS AND TACTICS 12/20/2016 04/28/2017 360HRS REGIONAL SPECIAL TRAINING UNIT 6

ADVANCE E-LEARNING ON PNP PATROL PLAN 2030 07/16/2015 07/16/2015 N/A ILOILO PROVINCIAL POLICE OFFICE

CIVIL DISTURBANCE MANAGEMENT TRAINING 07/22/2014 0724/2014 N/A POLICE REGIONAL OFFICE 6

E-LEARNING ON THE PATROL PLAN 2030 & CODE-P 11/5/2014 11/5/2014 N/A ILOILO PROVINCIAL POLICE OFFICE

SPECIAL COUNTER INSURGENCY OPERATION UNIT TRAINING 09/17/2013 01/15/2014 360HRS REGIONAL SPECIAL TRAINING UNIT 6

PUBLIC SAFETY FIELD TRAINING PROGRAM/PUBLIC SAFETY BASIC

12/7/2012 08/20/2013 1920HRS PHILIPPINE PUBLIC SAFETY COLLEGE
RECRUIT COURSE

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

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

DRIVING FIFHTEEN (15) MEDALYA NG PAPURI N/A

EIGHTEEN (18) LETTER OF COMMENDATION

SEVEN (7) MEDALYA NG KASANAYAN

ONE (1) MEDALYA NG PAGLILINGKOD SA VISAYAS

ONE (1) MEDALYA NG PAGLABAN SA MANLILIGALIG

ONE (1) MEDALYA NG KAGALINGAN

(Continue on separate sheet if necessary)

SIGNATURE DATE JANUARY 03,2019

CS FORM 212 (Revised 2017), Page 3 of 4
 34. Are you related by consanguinity or affinity to the appointing or
chief of bureau or office or to the person who has immediate supervision
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, If YES, give details:
ordinance or regulation by any court or tribunal?
37.
Have you ever been separated from the service in any of the following If YES, give details:
modes: resignation, retirement, dropped from the rolls, dismissal,
termination, end of term, finished contract or phased out (abolition) in the
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 If YES, give details:
national or local candidate?
39.
Have you acquired the status of an immigrant or permanent resident of If YES, give details (country):
another 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
a 8972),
Are youplease answer
a member the following
of any indigenousitems:
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
BRGY.ALUGMAWA 3.5 cm. X 4.5 cm
JIMMY MACHITO N/A (passport size)
LAMBUNAO,ILOILO
BRGY.ALUGMAWA
JUDY CABALFIN N/A
LAMBUNA,ILOILO With full and handwritten
name tag and signature over
GUILLERMO SILVA JR BRGY.ALUGMAWA N/A printed name
LAMBUNA,ILOILO
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, Computer generated

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 PHOTO
that any misrepresentation made in this document and its attachments shall cause the
filing of 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.: 17F150235

Signature (Sign inside the box)
JANUARY 03,2019
Date/Place of Issuance: 06/15/2017, ILOILO,CITY
Date Accomplished Right Thumbmark

SUBSCRIBED AND SWORN to before me this , affiant exhibiting his/her validly issued government ID as indicated abo

Person Administering Oath

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