Professional Documents
Culture Documents
212
Revised 2017
I. PERSONAL INFORMATION
2. SURNAME MUÑOZ
NAME EXTENSION (JR., SR)
FIRST NAME JARMVIE N/A
6 CIVIL STATUS
✘ Single Married 17. RESIDENTIAL ADDRESS 388 APITONG
Widowed Separated House/Block/Lot No. Street
ALION
Other/s:
Subdivision/Village Barangay
MARIVELES BATAAN
7. HEIGHT (m) 1.67m
City/Municipality Province
8. WEIGHT (kg) 60kg ZIP CODE 2105
15. AGENCY EMPLOYEE NO. N/A 21. E-MAIL ADDRESS (if any) jarmvie@outlook.com
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME N/A 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
NAME EXTENSION (JR., SR)
FIRST NAME N/A N/A N/A N/A
OCCUPATION N/A
SURNAME CELORICO
ELEMENTARY OLD ALION ELEMENTARY SCHOOL N/A 7/6/2004 9/4/2010 GRADUATED 2010 N/A
TRADE SKOLAR NG
POLYTECHNIC UNIVERISITY OF THE PHILIPPINES - BACHELOR OF SCIENCE IN INFORMATION
COURSE
COLLEGE
BATAAN BRANCH TECHNOLOGY
06/13/2015 04/16/2019 GRADUATED 2019 BAYAN / ACT-CIS
SCHOLAR
N/A
2/6/2021 2/3/2023 TELEMARKETING 167 ARCHO RESOURCES INC. 11000.00 N/A REGULAR N
05/21/2019 05/31/2019 INFORMATION TECHNOLOGY DESKTOP BAGS PHILS. INC. 4200.00 N/A CASUAL N
1ST CENTRAL LUZON YOUTH CONGRESS OON INFORMATION TECHNOLOGY 4/3/2017 4/3/2017 8.0 TECHNICAL EGLOBIO
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? RESIGNATION
________________________________
________________________________
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:
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:
JEFFRE NAVIDA BALON ANITO, MARIVELES, BATAAN (0945) 2505 469 ID picture taken within
the last 6 months
4.5 cm. X 3.5 cm
SARAH MAE HUELAR ALION, MARIVELES, BATAAN (0906) 2070 124 (passport size)
MARLO JAN NAVARRO IPAG, MARIVELES, BATAAN (0977) 1681 609 Computer generated
or photocopied picture
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and 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.
SUBSCRIBED AND SWORN to before me this MARCH 19, 2024 , affiant exhibiting his/her validly issued government ID as indicated above.