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Personal Data Sheet: Filipino Dual Citizenship by Birth by Naturalization
Personal Data Sheet: Filipino Dual Citizenship by Birth by Naturalization
212
Revised 2017
I. PERSONAL INFORMATION
2. SURNAME GAUIRAN
NAME EXTENSION (JR., SR)
FIRST NAME MARIA DONNA
6 CIVIL STATUS
✘ Single Married 17. RESIDENTIAL ADDRESS 155 TEMPLANZA
Separat House/Block/Lot No. Street
Widowed
Other/s: ed SILAUAN NORTE
Subdivision/Village Barangay
ECHAGUE ISABELA
7. HEIGHT (m) 1.57
City/Municipality Province
8. WEIGHT (kg) 49 ZIP CODE 3309
15. AGENCY EMPLOYEE NO. 1998-8310 21. E-MAIL ADDRESS (if any) mdr11gauiran@gmail.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
ELEMENTARY ECHAGUE WEST CENTRAL SCHOOL PRIMARY 6/16/1994 3/31/2000 N/A 2000 N/A
SECONDARY /
VOCATIONAL SCHOOL OF SAINT JOSEPH THE WORKER HIGHSCHOOL 6/5/2000 3/26/2004 N/A 2004 N/A
SOUTHERN ISABELA COLLEGE OF ARTS & TRADES CHS/TM1/SMAW/GMAW NC II 6/3/2013 1/19/2015 N/A N/A N/A
TRADE
PNP
COURSE
COLLEGE AMA COMPUTER UNIVERSITY BS COMPUTER ENGINEERING 5/17/2004 4/13/2008 272 2008
SCHOLAR
GRADUATE STUDIES
CIVIL SERVICE EXAMINATION PROFESSIONAL 80.97 3/12/2017 TUGUEGARAO WEST CENTRAL SCHOOL 147789
TRANSFORM YOUR CERTIFICATION PROCESS WITH LEEPS (LINCOLN ELECTRIC THE LINCOLN ELECTRIC COMPANY (ASIA PACIFIC)
06/30/2020 06/30/2020 4
EDUCATION PARTNER SCHOOLS) WEBINAR PTE LTD
REGIONAL WRITESHOP FOR CURRICULUM DEVELOPMENT OF DIPLOMA PROGRAMS 10/10/2019 10/11/2019 16 TESDA REGION/ ISAT
AMERICAN WELDING SOCIETY CERTIFIED INSPECTION TECHNOLOGY AND AWS RTC DAVAO/ KORE-PHILIPPINES VOCATIONAL
9/2/2019 9/27/2019 160
WELDER CERTIFICATION TRAINING TRAINING CENTER
TRAINER'S TRAINING ON GOOGLE CERTIFIED EDUCATOR LEVEL I 9/24/2018 9/28/2018 40 NATIONAL TVET TRAINERS ACADEMY (NTTA)
CONDUCT OF COMPETENCY ASSESSMENT AND CERTIFICATION MODERATION 6/15/2017 6/15/2017 7 N/A NESTOR C. AVE, Ph.D.
35. a. Have you ever been found guilty of any administrative offense? YES ✘ NO
If YES, give details:
________________________________
________________________________
YES ✘ NO
b. Have you been criminally charged before any court?
If YES, give details:
________________________________
Date Filed:
________________________________
Status of Case/s:
YES ✘ NO
36. Have you ever been convicted of any crime or violation of any law, decree, ordinance or regulation
by any court or tribunal?
If YES, give details:
________________________________
YES NO
________________________________
✘
37. Have you ever been separated from the service in any of the following modes: resignation,
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? ________________________________
YES ✘ NO
________________________________
38. a. Have you ever been a candidate in a national or local election held within the last year (except
Barangay election)?
YES If YES, give details:
✘ NO
b. Have you resigned from the government service during the three (3)-month period before the last
election to promote/actively campaign for a national or local candidate? NO
YES If YES, give details:
✘
39. Have you acquired the status of an immigrant or permanent resident of another country?
If YES, give details (country):
40. Pursuant to: (a) Indigenous People's Act (RA 8371); (b) Magna Carta for Disabled Persons (RA YES ✘ NO
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?
If YES, please specify ID No:
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.