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 SILDO
NAME EXTENSION (JR., SR)
FIRST NAME ELMA
MIDDLE NAME DELABAJAN
3. DATE OF BIRTH
(mm/dd/yyyy) 12/29/1968 16. CITIZENSHIP ✘ Filipino Dual Citizenship
✘ by birth by naturalization
4. PLACE OF BIRTH STA. MARGARITA, SAMAR If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male ✘ Female
17. RESIDENTIAL ADDRESS
6 CIVIL STATUS Single ✘ Married
House/Block/Lot No. Street
Widowed Separated
PUROK 2 CAUTOD
Other/s:
Subdivision/Village Barangay
STA. MARGARITA SAMAR
7. HEIGHT (m) 1.62
City/Municipality Province
8. WEIGHT (kg) 48 ZIP CODE 6709

18. PERMANENT ADDRESS

9. BLOOD TYPE O+
House/Block/Lot No. Street
PUROK 2 CAUTOD
10. GSIS ID NO. B68ZVEDSO11
Subdivision/Village Barangay
STA. MARGARITA SAMAR
11. PAG-IBIG ID NO. 1700-0098-0056
City/Municipality Province

12. PHILHEALTH NO. 13-00008060773 ZIP CODE 6709

13. SSS NO. 06-1259414-0 19. TELEPHONE NO. NONE

14. TIN NO. 158-024-379 20. MOBILE NO. 09751206548

15. AGENCY EMPLOYEE NO. 06300174 21. E-MAIL ADDRESS (if any) elma.sildo001@deped.gov.ph
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME SILDO 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)

JR.
FIRST NAME BENEDICTO JUNEL CHRISTIAN D. SILDO O4/17/1996

MIDDLE NAME TICONG JERICK ZEN D. SILDO 2/6/2003

OCCUPATION TEACHING

EMPLOYER/BUSINESS NAME DEPED, SAN. POLICARPO NATIONAL HIGH SCHOOL

BUSINESS ADDRESS PAJO STREET, SAN POLICARPO, CALBAYOG CITY

TELEPHONE NO. None

24. FATHER'S SURNAME DELABAJAN

NAME EXTENSION (JR., SR)
FIRST NAME FLAVIANO

MIDDLE NAME MONTEJO

25. MOTHER'S MAIDEN NAME ROCA

SURNAME DELABAJAN

FIRST NAME APOLONIA

MIDDLE NAME ALBELDA (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 STA. MARGARITA I CENTRAL ELEMENTARY SCHOOL ELEMENTARY EDUCATION 1976 1980 N/A 1980 NONE

VOCATIONAL / CLARENCIO CALAGOS MEMORIAL SCHOOL OF

SECONDARY
FISHERIES
HIGH SCHOOL 1981 1984 N/A 1984 NONE

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

TRADE
COLLEGE
COURSE
CHRIST THE KING COLLEGE BACHELOR OF SECONDARY EDUCATION 1984 1988 N/A 1988 NONE

GRADUATE STUDIES CHRIST THE KING COLLEGE MASTER OF ARTS MAJOR IN FILIPINO 1994 1996 45 UNITS N/A N/A

(Continue on separate sheet if necessary)

SIGNATURE DATE 1/17/2022
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)
RATING
SPECIAL LAWS/ CES/ CSEE EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
(If Applicable) NUMBER Date of
BARANGAY ELIGIBILITY / DRIVER'S LICENSE CONFERMENT
Validity

LICENSURE EXAMINATION FOR TEACHERS 73.92 5/30/1993 Catbalogan, Samar 0438548 9/11/1998

(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)
DEPED / DIVISION OF SAMAR / STA. REGULAR /
12/15/2014 PRESENT MASTER TEACHER II 33,859.00 19 Y
MARGARITA NATIONAL HIGH SCHOOL PERMANENT
DEPED / DIVISION OF SAMAR / STA. REGULAR /
3/28/2012 12/14/2014 MASTER TEACHER I 31,351.00 18 Y
MARGARITA NATIONAL HIGH SCHOOL PERMANENT
DEPED / DIVISION OF SAMAR / STA. REGULAR /
3/15/2008 3/27/2012 SECONDARY SCHOOL TEACHER III
MARGARITA NATIONAL HIGH SCHOOL
13,229.00 12 PERMANENT
Y

DEPED / DIVISION OF SAMAR / STA. REGULAR /

7/9/1994 3/14/2008 SECONDARY SCHOOL TEACHER I MARGARITA NATIONAL HIGH SCHOOL
3,900.00 10 Y
PERMANENT
DEPED / DIVISION OF SAMAR / STA. REGULAR
6/8/1994 7/8/2014 SECONDARY SCHOOL TEACHER MARGARITA NATIONAL HIGH SCHOOL
3,902.00 Y
SUBSTITUTE
6/1/1992 3/30/1994 CLASSROOM TEACHER LA MILAGROSA ACADEMY 2600.00 PERMANENT N

6/1/1988 3/30/1991 CLASSROOM TEACHER SAINT FRANCIS EDUCATIONAL INSTITUTE 1500.00 PROVISIONAL N

(Continue on separate sheet if necessary)

SIGNATURE DATE 01/17/2022

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

(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/ CONDUCTED/ SPONSORED BY
NUMBER OF HOURS
(Write in full) Supervisory/ (Write in full)
(mm/dd/yyyy)
Technical/etc)
From To

LDM2 INSET 11/25/2021 11/26/2021 24 Technical DEPED, STA. MARGARITA NATIONAL HIGH SCHOOL

INSET - SBM 10/21/2021 10/23/2021 32 Technical DEPED/ STA. MARGARITA NATIONAL HIGH SCHOOL

SCHOOL BASED ROLL-OUT ON DROP OUT REDUCTION PROGRAM 7/30/2019 7/31/2019 24 Technical DEPED/ STA. MARGARITA NATIONAL HIGH SCHOOL

SCHOOL BASED ROLL-OUT ON PPST /RPMS 1/31/2019 2/2/2019 32 Technical DEPED/ STA. MARGARITA NATIONAL HIGH SCHOOL

DIVISION ROLL-OUT ON PPST/RPMS 11/14/2018 11/16/2018 32 MANAGERIAL DEPED/ STA. MARGARITA NATIONAL HIGH SCHOOL

DISTRICT IN-SERVICE TRAINING FOR TEACHERS AND PRESENTATION OF MID-YEAR

10/23/2018 8 SUPERVISORY DEPED, STA. MARGARITA I DISTRICT
ACCOMPLISHMENT REPORT

INSET 10/24/2017 10/26/2017 32 Technical DEPED, STA. MARGARITA NATIONAL HIGH SCHOOL

TRAINING-WORKSHOP ON THE IMPLEMENTATION OF PROJECT HI-TEACH 9/19/2017 9/21/2017 32 MANAGERIAL DEPED/ DIVISION OF SAMAR

DISTRICT ROLL-OUT ON CHILD PROTECTION POLICY 7/1/2017 7/3/2017 32 Technical DEPED, STA. MARGARITA I DISTRICT

INSET 10/26/2017 10/28/2017 32 Technical DEPED, STA. MARGARITA NATIONAL HIGH SCHOOL

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

MEMBERSHIP IN ASSOCIATION/ORGANIZATION
NON-ACADEMIC DISTINCTIONS / RECOGNITION
31. SPECIAL SKILLS and HOBBIES 32. 33. (Write in
(Write in full)
full)

Reading N/A PARENTS TEACHERS ASSOCIATION (PTA)

SMNHS TEACHERS' CIRCLE

(Continue on separate sheet if necessary)

SIGNATURE DATE 01/17/2022

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? YES ✘ NO
b. within the fourth degree (for Local Government Unit - Career Employees)? YES ✘ NO
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:

41. REFERENCES (Person not related by consanguinity or affinity to applicant /appointee)

NAME ADDRESS TEL. NO.

ID picture taken within
the last 6 months
GLORIA B. TAMIDLES STA. MARGARITA, SAMAR 9366973872 3.5 cm. X 4.5 cm
(passport size)

JOE JEANAMEE N. ROMA STA. MARGARITA, SAMAR 9175427721 With full and handwritten
name tag and signature over
printed name

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.

Government Issued ID (i.e.Passport, GSIS, SSS, PRC, Driver's License, etc.)

PLEASE INDICATE ID Number and Date of
Issuance
Government Issued ID: PRC

ID/License/Passport No.: 0438548

Signature (Sign inside the box)
01/17/2022
Date/Place of Issuance: 09/27/1993
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