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 LABRADOR
NAME EXTENSION (JR., SR) N/A
FIRST NAME JOHN DANIEL

MIDDLE NAME FERRER

3. DATE OF BIRTH
(mm/dd/yyyy)
4/12/1999 16. CITIZENSHIP

CORON DISTRICT HOSPITAL BRGY.

4. PLACE OF BIRTH If holder of dual citizenship, Pls. indicate country:
POBLACION 5, CORON, PALAWAN
please indicate the details.
5. SEX

17. RESIDENTIAL ADDRESS

6 CIVIL STATUS
House/Block/Lot No. Street
SITIO MAQUINIT BRGY. TAGUMPAY
Subdivision/Village Barangay
CORON PALAWAN
7. HEIGHT (m) 172 m
City/Municipality Province
8. WEIGHT (kg) 70 Kg ZIP CODE 5316
18. PERMANENT ADDRESS
9. BLOOD TYPE O
House/Block/Lot No. Street
SITIO MAQUINIT BRGY. TAGUMPAY
10. GSIS ID NO. N/A
Subdivision/Village Barangay

11. PAG-IBIG ID NO. N/A CORON PALAWAN

City/Municipality Province

12. PHILHEALTH NO. N/A ZIP CODE 5316

13. SSS NO. N/A 19. TELEPHONE NO. N/A

14. TIN NO. 358-602-994 20. MOBILE NO. 09121162915

15. AGENCY EMPLOYEE NO. N/A 21. E-MAIL ADDRESS (if any) jaydeelabri12@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) N/A N/A
FIRST NAME

MIDDLE NAME

OCCUPATION

EMPLOYER/BUSINESS NAME

BUSINESS ADDRESS

TELEPHONE NO.

24. FATHER'S SURNAME LABRADOR

NAME EXTENSION (JR., SR) N/A
FIRST NAME RENATO

MIDDLE NAME CRUZ

25. MOTHER'S MAIDEN NAME

SURNAME FERRER

FIRST NAME EDITHA

MIDDLE NAME UBALEZ (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

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

ELEMENTARY TAGUMPAY ELEMENTARY SCHOOL ELEMENTARY 2005 2011 GRADUATED 2011 4TH HONORS

SECONDARY
VOCATIONAL / CORON SCHOOL OF FISHERIES HIGH SCHOOL 2011 2015 GRADUATED 2015 6TH HONORS

N/A N/A N/A N/A N/A N/A N/A

TRADE
COURSE BACHELOR OF SECONDARY EDUCATION
COLLEGE PALAWAN STATE UNIVERSITY-CCRD CORON
MAJOR IN ENGLISH
2015 2019 GRADUATED 2019 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 CS FORM 212 (Revised 2017), Page 1 of 4

IV. CIVIL SERVICE ELIGIBILITY
27. CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER DATE OF LICENSE (if applicable)
SPECIAL LAWS/ CES/ CSEE EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
BARANGAY ELIGIBILITY / DRIVER'S LICENSE CONFERMENT NUMBER Date of
Validity

LICENSURE EXAMINATION FOR TEACHERS 80.20 9/29/2019 PUERTO PRINCESA CITY N/A N/A

NOTHING FOLLOWS

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

10/05/2019 PRESENT TEACHER STA. MONICA NATIONAL HIGH SCHOOL N/A N/A VOLUNTEER N

NOTHING FOLLOWS

(Continue on separate sheet if necessary)

SIGNATURE DATE CS FORM 212 (Revised 2017), Page 2 of 4

VI. VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S
INCLUSIVE DATES
29. NAME & ADDRESS OF ORGANIZATION
(Write in full) (mm/dd/yyyy) NUMBER OF HOURS POSITION / NATURE OF WORK
From To

N/A N/A N/A N/A N/A

NOTHING FOLLOWS

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

Literacy training Service (LTS) Componet of the National Service Training

June 2017 04/07/2018 421 TECHNICAL PSU-CORON
Program (NSTP)
LENS: A SEMINAR WORKSHOP ON PHOTOJOURNALISM AND FINE ART
PHOTOGRAPHY
01/21/2018 01/21/2018 8 TECHNICAL PSU-CORON

INCLUSION AND MAINSTREAMING STUDENTS WITH SPECIAL NEEDS: TEACHING

APPROACHES, STRATEGIES, AND METHODS
1/19/2018 1/20/2018 16 TECHNICAL PSU-CORON

NOTHING FOLLOWS

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

3
NON-ACADEMIC DISTINCTIONS / RECOGNITION MEMBERSHIP IN ASSOCIATION/ORGANIZATION
31. SPECIAL SKILLS and HOBBIES 32. 3
(Write in full) (Write in full)
.

VOLLEYBALL N/A N/A

SINGING N/A N/A

NOTHING FOLLOWS

(Continue on separate sheet if necessary)

SIGNATURE DATE CS FORM 212 (Revised 2017), Page 3 of 4

 34. Are you related by consanguinity or affinity to the appointing or recommending authority, or to the
chief of bureau or office or to the person who has immediate supervision over you in the Office,
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, ordinance or regulation 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, retirement,
dropped from the rolls, dismissal, termination, end of term, finished contract or phased out (abolition) in If YES, give details:
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
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 national or local candidate? 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 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?

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
GERALDINE GAMALA BRGY. SAN. MONICA CORON, PAL. 09501414359 3.5 cm. X 4.5 cm
(passport size)

MARIANNE M. TORIO CORON SCHOOL OF FISHERIES 09503084908 With full and handwritten
name tag and signature over
printed name
LENIE S. GAID BRGY. TAGUMPAY, CORON, PAL. 09503091889
Computer generated
42. or photocopied picture
I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and complete is not acceptable
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 administrative/criminal case/s against PHOTO
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: TIN #

ID/License/Passport No.: 358-602-994

Signature (Sign inside the box)

JANUARY 29, 2020

Date/Place of Issuance: 11/27/2019
Date Accomplished Right Thumbmark

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

Person Administering Oath

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