Professional Documents
Culture Documents
Personal Data Sheet
Personal Data Sheet
212
Revised 2017
I. PERSONAL INFORMATION
2. SURNAME CATRAL
NAME EXTENSION (JR., SR
FIRST NAME KING SOLOMON
9. BLOOD TYPE B
18. PERMANENT ADDRESS #24 CITY
House/Block/Lot No. S
10. GSIS ID NO. PUROK 1 CALA
Subdivision/Village Bar
SANTIAGO CITY
11. PAG-IBIG ID NO. 0019-6587-7708
City/Municipality Pro
12. PHILHEALTH NO. 06-025054493-9 ZIP CODE 3311
15. AGENCY EMPLOYEE NO. 21. E-MAIL ADDRESS (if any) Kcatral@yahoo.com
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME CATRAL 23. NAME of CHILDREN (Write full name and list all)
NAME EXTENSION (JR., SR) FRANCHESKA MEL ATHENA O. CATRAL
FIRST NAME SALVACION
TELEPHONE NO.
SURNAME CATRAL
TRADE
COURSE
COLLEGE UNIVERSITY OF LA SALETTE 7/18/1999 3/24/2004
GRADUATE STUDIES
CS FORM
L DATA SHEET
erience Sheet shall cause the filing of administrative/criminal case/s against the person
Dual Citizenship
by naturalization
CITY ROAD
Street
CALAO WEST
Barangay
ISABELA
Province
3311
CITY ROAD
Street
CALAO WEST
Barangay
ISABELA
Province
3311
09262740296 or 09486017935
Kcatral@yahoo.com
Deceased
SCHOLARSHIP/
YEAR
ACADEMIC
GRADUATED
HONORS
RECEIVED
1995
1999
2007
2004
6/12/2011 2/15/2012 Computer Technician & Cashier Kenzon Computer Shop P 3,500.00 Part-time
Southern Isabela College of Arts &
7/12/2010 2/16/2011 Instructor P 15.000.00 Contractual
Trades -TESDA
4/23/2010 7/9/2010 Call Center Agent NCO - RMH Teleservices Asia Pacific Inc. P 18,000.00 Contractual
3/4/2010 4/9/2010 Call Center Agent Teleperformance Telephilippines Inc. P 10,000.00 Contractual
Southern Isabela College of Arts &
4/15/2009 11/25/2009 Instructor P 20,000.00 Contractual
Trades -TESDA
Southern Isabela College of Arts &
2/1/2009 4/12/2009 Instructor P 15,000.00 Contractual
Trades -TESDA
(Continue on separate sheet if necessary)
Date of
Validity
GOV'T
SERVICE
(Y/
N)
N
N
arate sheet if necessary)
N/A
N/A
SIGNATURE DATE
/ PEOPLE / VOLUNTARY ORGANIZATION/S
CONDUCTED/ SPONSORED BY
(Write in full)
MEMBERSHIP IN ASSOCIATION/ORGANIZATION
(Write
in full)
b. within the fourth degree (for Local Government Unit - Career Employees)? YES
If YES, give details:
________________________________
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? ________________________________
________________________________
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:
Mr. Alaine Gallarde Santiago City, Isabela 90658760010 With full and handwritten
name tag and signature over
printed name
Mr. Amads Elias Santiago City, Isabela 9359263393
Computer generated
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and or photocopied picture
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 , affiant exhibiting his/her validly issued government ID as indicated above.