ARMED FORCES OF THE PHILIPPINES

RESERVIST INFORMATION DATA SHEET

FOR FILLING CN
REFERENCE ONLY

I. PERSONAL DATA: PERSONNEL

CLASSIFICATION

RANK FIRSTNAME MIDDLE NAME LAST NAME EXT

AFPSN BOS CLASSIFICATION MOB CEN SOURCE OF COMMISSION

COMMISSION CATEGORY

II. CAREER DETAILS

A. CIVILIAN OCCUPATION/DESIGNATION
INCLUSIVE
Occupation Designation Company Name Company Address Tel Nr
DATES

B. ELIGIBILITY AND LICENSE

Eligibility License Eligibility Type Authority

C. EDUCATIONAL ATTAINMENT
Course Date Date Honor Completed
Course School Name and Location
Type Started Completed Received (Yes/No)

***USE ADDITIONAL SHEET/S IF NECESSARY***

D. OTHER TRAININGS/SEMINARS/WORKSHOP ATTENDED

Date Date Honor Completed
Course/Seminar School Name and Location
Started Completed Received (Yes/No)

***USE ADDITIONAL SHEET/S IF NECESSARY***

E. MILITARY TRAININGS/COURSES TAKEN

Date Date Total Status (On going,
Course/Class Standing Grade
Started Completed Student Completed or Dropped)

***USE ADDITIONAL SHEET/S IF NECESSARY***

F. POSITION/DESIGNATION
DATE DATE AUTHORITY DETAILS
UNIT DESIGNATION DUTY TYPE
ASSUMED TERMINATED

***USE ADDITIONAL SHEET/S IF NECESSARY***

 III. MILITARY SERVICE RECORD
A. COMMISSIONSHIP/ENLISTMENT

TYPE RANK EFFECTIVITY AUTHORITY

***USE ADDITIONAL SHEET/S IF NECESSARY***

B. PROMOTIONS/DEMOTIONS
FROM TO
TYPE EFFECTIVITY AUTHORITY
RANK: RANK:

***USE ADDITIONAL SHEET/S IF NECESSARY***

C. ACTIVE DUTY TRAINING(ADT)

ADT TYPE PURPOSE INCLUSIVE DATES AUTHORITY

***USE ADDITIONAL SHEET/S IF NECESSARY***

D. AWARDS

TYPES OF AWARD ACHIEVEMENT AUTHORITY

***USE ADDITIONAL SHEET/S IF NECESSARY***

E. CERTIFICATES/PLAQUES/MERITS

TYPE DATE AWARDED DESIGNATION

***USE ADDITIONAL SHEET/S IF NECESSARY***

IV. PERSONAL INFORMATION

PRESENT ADDRESS:

PERMANENT ADDRESS:

NICKNAME BIRTHDAY BIRTHPLACE (CITY, PROVINCE) TEL NR PRIMARY CP NR: ______________

(MM/DD/YEAR) ALTERNATE: __________________

SEX CIVIL STATUS HEIGHT (CM) WEIGHT (KG) BUILD EMAIL

PRIMARY: ___________________
ALTERNATE: _________________
 RELIGION ETHNIC HOBBIES SHOES SIZE WAISTLINE CAP SIZE
GROUPS (IN) (IN) (CM)

SSS NR TIN NR GSIS NR PHILHEALTH NR

BLOOD COMPLEXION EYES HAIR DISTINGUISHING SKILLS

TYPE (COLOR) (COLOR) MARK

V. FAMILY INFORMATION
A. FAMILY MEMBERS
BIRTH CITIZEN-
NAME RELATION BIRTHPLACE ADDRESS
DATE SHIP

B. NEXT OF KIN
BIRTH- CITIZEN-
NAME RELATION BIRTHPLACE ADDRESS
DATE SHIP

I HEREBY CERTIFY that all entries in these documents are true and correct according to my personal knowledge and
that failure to report any discrepancies or false entries contained herein be considered as a deliberate omission or falsification and
shall be ground for filing criminal, Courts-Martial as well as other administrative charges against me.

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_______________________________________
SIGNATURE OVER PRINTED NAME

LTJG EMMANUEL B BILAGOT JR PN

SIGNATURE OVER PRINTED NAME OF
ADMINISTERING OFFICER