Beis.

d 2017
PERSONAL DATA SHEET
REAO fHE AffACHED GUDE fO FILLll{o OUf fllE PERSOIIAL DA|A SHEEr (mS) AEFORE ACCONPUSHING IHE PDS FOR .
DO I{OT ABBREVIATE. CS lO No (Do not lill Fo. cSC uso
T',ick and use sileel lndicale N/A if not

,. pERSOT/AL
a rrv .,"^ '{
2. CRUZ
a{ nE EXIEXSIOU !R, SR)

Flt

'*;,p
GARCIA

1 l6.CITIZENSHIP
E Fitipino n Duaicitjue shlp
! by Hrth n by mturallza0on

1. PLACE OF BIRTH
@ ll hold€.ol d(d dtr.hC$,

d.os. lndiceb tr. dcllls.

Pls. indicab county:

5 SEX
) Single
7\trr"'*t' Mani€d 17, RESIDENTIAL ADDRESS 1 STAR STREET
6 CIVIL STATUS
( E sepaEted

7. HEGHr (m)

E. WEIGHI ltg)
tilt771
m
qr- I ztPcooE 1007
METRO MANILA

PERMANENT ADDRESS 1 STAR STREET

9, BLOOOTYPE o+

10 GS|S L0NO

11. PAG|E|G tD flo.

00G00G000

00m-000G0000
-1 I!^^
) Cr
METRO MANILA

12. PHILHEATH NO, 00(I)000000m 1N7

7
13. SSS N0. 00-000000G0 NO
-/
14 TtN l,to. 00G000.00G000
I 20, MOEILE NO 09123,156789

JG0ELACRUZ@GilAlL.CoM
5. AGENCY EMPTOYEE NO, 00d)00 E I/lAlL
-l
E sPousE s suR LlJE
I
ti)ffrRm CHILDREN ($Ifl. ill nama md lisl all) DATE or BIRTH (mm/ddryyy)

FIRSTNAI{E

MIoDLE NA\IE
MARY

SANTOS
m.Y.\
U
JUAN G. DELA CRUZJR. 0ti[1/20t7

OCCUPATION N/A !
EMPLOYERtsUSINESS NAME N/A

EUSINESSADDRESS

TELEPHONENO.
N/A

N/A
7-
I
24, FATHER'S SURNAI'E DELA CRUZ
\
FIRST NAIIE ANGELITO
NAIE E(iENSIOt 0R., Si)
l-17 )
I,IIDOLE NAUE srsoN
.1 /
25, MOTXERS MAIOEN NAIIE

SURNAI{E GARCIA
7)7-l
FIRST NAJE

MIODLE NAIIE

I
EMMALYI{

REYES --aJ G(
)

26.
LEVEL
NA E OF SCHOOT

C/iriL in tll)
BASIC EOUCATION/DEGREE,ICOURSE
0 r'b intull) @,
EEilEIir.E HGHEST LEVEU
. UNIIS EARNEO
r"a,..o
scHq-AnsHF/

toNoRs
\a
ft +. / RECEI\iEO

ELEMEI,ITARY I{ERCURY ELEI{ENTARY SCHOOL ELEiIENTARY 1986 1932 D N/A r{ia I

7
SECONDARY

vocATtoNAL/
PLUTO HIGH SCHOOL HIGH SCHOOL

t{IA
1992 1996 N/A

N/A
-/ -aa N/
TRADE COURSE

- CruEGE
EIruCATIONAL lxSfiUIE OF THE BACHELOR OF SCIET{CE II{ SECOTIDARY
1996 2000 t{/A 2000
I{AGNA
PHIUPPIilES EDUCATION CUfl LAIIDE

GRADUATE STUOIES EDUCANONAL UNIVERSITY OF LUZON ASIERS IX PUBUC ADI{INISTRATION 2010 2012 2012 N/A

SIGIVATURE DAfE 06/01/2023

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NiA NiA N/A N/A

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E SPEC At SK LLS 32
Nori.AcADE lC olsTt{CI|ONS i RECOGTmON UEI{BERSHIPIN
31 (wibit,r{)
'[ ail
urrurh @ llF'SI,IffinE

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counuren UA

EO{IIIIG USIIIG PHOTOSHOP AND

ILLI'STRAIOR
BAS|C KXoIILEDGE lN PflP, JAVA PYTHOIT,
vlsull Blslc
PC TROUBLESHOOTING / HARDWARE
v

STGA'AIURE DAfE 06/01/2023

34 Are you relaled by mnsanguinity or affnity to the appointing or remmmending authority, or to the
chiefofbureau or office orto lhe person who has immediate supeMsion over you in the Office,
Bureau or oepartmentwhere you will be apppointed,
a. within the hird degree? E YEs ENo
b. within the fourth degree (for Local Govemment lJnit - Career Employees)? E YEs Erc
lfYES, give details:

35. a -, guilty of any administrative offense?

! YEs ENo
lf YES, give details:

b criminally ctr any murt? tr YEs ENo

lf YES, give detsils:
Date Filed:
Status of Case/s:

36. Have you ever been

by any murt or fibunal?
any of any law, decree, ordinance or regulation
E YEs E o
lf YES, give details:

37. Have you ever been

retirement, dmpped from the rol
from tn follov{ing modes: resignalion,
of term, finished contrad or phased
fl YEs El No
lf YES, gi\re details:
out (abolition) in hs public or

u. a. Have pu ever been a candidate in a local within 6e last year (except

n YEs ENo
Barangay election)?
ItYES, give dstails:

b. Have you resigned from $e govemment three period before he last E YEs ENo
eleclion to promote/aclively campaign lor a or lfYES, give dotails:

39 Have you acquired the status of an immigrant or permanent of

! YEs ENo
lf YES, give debils (counfy):

40, Pursusnt to: (a) lnd Act 8371); (b) Carta for Disabled (Rc
7277); and (c) Solo answerthe
a. Are you a member
E YEs UNo
lf YES, please speci!:
b Are you a person with disability? n YEs ENo
lf YES, please speciry lD No:
Arc you a solo parent?
! YEs ENo
lI YES, please soecifu lD No:

41 . REFERENCES (Pelson nol related by consenguinity or afiinity to apptcanl /appoinlee)

---
NAME

JOSEPH L, MOOII
ADDRESS

BAI{GKAL, I{AXATI C
^.EI
t ooo{of
iEt

ANITA G. SATURN

JOHI{ ANGELO B, PLUTO

B.F. HO ES, PARAiAOUE

HOLY SPIRIT, QUEZO}I CITY

CL
!
w^,
@^t
I dedare under oah that I have personally accomplished fiis Pe6onal Data Sheet which is a fue, d
mmplete statement pursuant to the provisions of perlinent laws, rules and regulations of the of lhe
Philippines. I authodze he agency head/authorized representalive to verirytua date the contents stated herein
I agree hat any misrepresentation made in this document and its atlachments shall cause the filing oT0
administrative/cdminal case/s against me.
/
./ 7
Govemment lSSUed lD (!.P.s6ro1. cgs, sss, PRc, Odtrl3 um., .lG )

PLEASE INDICATE lD Nunbet and Date of lssuan@

(
Govemmeflt lssued lD: PAGIBIG lD

lD/l-icsns6/PassponNo.: 0001!00000000
Sign.ture {Sign inside lhe box)

oate/Place of lssuenc€: ANILA

SUBSCRIBEO AND SWORN to before mefiis , affiant exhibitjng his,ihervalidly issued govemment I as indic.tod above

(MUST BE NOTARTZED)
Person Administedng Oath