CS Form No.

212

PERSONAL DATA SHEET

Revised 2017

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 BONA
NAME EXTENSION (JR., SR)
FIRST NAME ANNE

MIDDLE NAME TORALDE

3. DATE OF BIRTH
(mm/dd/yyyy)
4/12/1961 16. CITIZENSHIP Filipino Dual Citizenship
by birth by naturalization
4. PLACE OF BIRTH LARAPJOSE PANGANIBANCAMARINESNORTE
If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male Female

Single Married
17. RESIDENTIAL ADDRESS #55 ZONE 1
6 CIVIL STATUS
Widowed Separated House/Block/Lot No. Street
BAGUMBAYAN
Other/s:
Subdivision/Village Barangay
BULA CAMARINES SUR
7. HEIGHT (m) 1.6
City/Municipality Province
8. WEIGHT (kg) 70 ZIP CODE 4430

18. PERMANENT ADDRESS #55 ZONE 1

9. BLOOD TYPE 0
House/Block/Lot No. Street
BAGUMBAYAN
10. GSIS ID NO. B61HCATBO13
Subdivision/Village Barangay
BULA CAMARINES SUR
11. PAG-IBIG ID NO. ABT 014575-LRD
City/Municipality Province

12. PHILHEALTH NO. 10-00148130-5 ZIP CODE 4430

13. SSS NO. NONE 19. TELEPHONE NO. NONE

14. TIN NO. 114077-250 20. MOBILE NO. 09306736293

15. AGENCY EMPLOYEE NO.
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME
FIRST NAME
2016-064 21. E-MAIL ADDRESS (if any) bonaanne1961@gmail.com
BONA 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
NAME EXTENSION (JR., SR)
SOFRONIO BILLY NIKKI GAYLE T. BONA 4/28/1990

MIDDLE NAME NEDIA KIMBERLY ANN T. BONA 10/18/1995

OCCUPATION SELF-EMPLOYED/FARMER

EMPLOYER/BUSINESS NAME N/A

BUSINESS ADDRESS N/A

TELEPHONE NO. N/A

24. FATHER'S SURNAME TORALDE

NAME EXTENSION (JR., SR)
FIRST NAME VICTOR(D)

MIDDLE NAME EMBATE

25. MOTHER'S MAIDEN NAME

SURNAME BALLECER

FIRST NAME FELICIDAD

MIDDLE NAME SORETA (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

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

MARCH
ELEMENTARY LARAP ELEMENTARY SCHOOL ELEMENTARY JUNE 1968 GRADUATED 1974 N/A
1974
MARCH APRIL
SECONDARY NAGA COLLEGE SECONDARY GRADUATED 1978 3RD HONOR
1974 1978
VOCATIONAL /
TRADE COURSE
N/A N/A N/A N/A N/A N/A N/A

BACHELOR OF SCIENCE IN INDUSTRIAL MARCH

COLLEGE UNIVERSITY OF NUEVA CACERES
ENGINEERING
JUNE 1978 GRADUATED 1983 N/A
1983

MARCH
GRADUATE STUDIES UNIVERSITY OF NUEVA CACERES MASTER IN PUBLIC ADMINISTRATION JUNE 1984 18 UNITS N/A N/A
1986
(Continue on separate sheet if necessary)

SIGNATURE DATE April 27, 2017

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