‭EMPLOYEE INFORMATION SHEET‬

‭PERSONAL INFORMATION‬
‭Last Name‬ ‭De la Pe‬‭ña‬
‭First Name‬ ‭Jose Gabrielle‬
‭Middle Name‬ ‭Villagracia‬
‭Suffix‬ ‭N/A‬
‭ ard Name‬
C
‭Last Name, First Name, Middle Name‬
‭(Maximum of 20 characters)‬ ‭De la Pe‬‭ña,‬‭Jose Gabrielle Villagracia‬
‭ obile Number (Format:‬
M
‭09111111111)‬ ‭09208469634‬
‭Landline Number (Format: 8111111)‬ ‭N/A‬
‭Birthday (MM/DD/YYYY)‬ ‭11/18/1998‬
‭Personal Email Address‬ ‭jgdelapena246@gmail.com‬
‭Place of Birth‬ ‭Lopez, Quezon‬
‭Nationality‬ ‭Filipino‬
‭Gender‬ ‭Male‬
‭Civil Status‬ ‭Single‬
‭Spouse’s Name‬ ‭N/A‬
‭Spouse’s Employer‬ ‭N/A‬
‭Spouse’s Contact Number‬ ‭N/A‬

‭TIN‬ ‭60080322900000‬
‭SSS No.‬ ‭35-0642930-2‬
‭PAG-IBIG No.‬ ‭121286687957‬
‭PhilHealth No.‬ ‭02-027465612-4‬

‭PRESENT ADDRESS DETAILS‬

‭House Number‬ ‭1640‬
‭Street/Village/Subdivision/Brgy.‬ ‭Saturno st., Brgy. 812‬
‭Country‬ ‭Philippines‬
‭Region‬ ‭NCR‬
‭Province‬ ‭Manila‬
‭City/Municipality‬ ‭Paco, Manila‬
‭Zip Code‬ ‭1007‬

‭PERMANENT ADDRESS DETAILS‬

‭House Number‬ ‭1640‬
‭Street/Village/Subdivision/Brgy.‬ ‭Saturno st., Brgy. 812‬
‭Country‬ ‭Philippines‬
‭Region‬ ‭NCR‬
‭Province‬ ‭Manila‬
‭City/Municipality‬ ‭Paco, Manila‬
‭Zip Code‬ ‭1007‬

I‭ hereby declare that the information provided is true and correct. I also understand that any‬
‭willful dishonesty may render for refusal of this application or immediate termination of‬
‭employment‬

‭Jose Gabrielle V. De la Pe‬‭ñ‬‭a‬‭________‬

‭Full Name‬

‭___________02 February 2024____________‬

‭Date‬