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 DELA CRUZ
NAME EXTENSION (JR., SR)
FIRST NAME JESSICA N/A

MIDDLE NAME JOSE

3. DATE OF BIRTH
16. CITIZENSHIP
(mm/dd/yyyy) AUGUST 28, 1994 ✘ Filipino Dual Citizenship
by
✘ by naturalization
birth
4. PLACE OF BIRTH DAGUPAN CITY, PANGASINAN If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male ✘ Female
✘ Single Married 17. RESIDENTIAL ADDRESS PUROK 1 RIZAL AVENUE
6 CIVIL STATUS
Widowed House/Block/Lot No. Street
Separated
Other/s: ROSARIO
Subdivision/Village Barangay

7. HEIGHT (m) 1.55M SANTIAGO CITY ISABELA

City/Municipality Province
8. WEIGHT (kg) 54KG ZIP CODE 3311
18. PERMANENT ADDRESS PUROK 1 RIZAL AVENUE
9. BLOOD TYPE O
House/Block/Lot No. Street
ROSARIO
10. GSIS ID NO. 02005572948
Subdivision/Village Barangay
SANTIAGO CITY ISABELA
11. PAG-IBIG ID NO. 1211-4180-8263
City/Municipality Province

12. PHILHEALTH NO. 0105-2093-4885 ZIP CODE 3311

13. SSS NO. 01-2469243-3 19. TELEPHONE NO. (078) 305-5325

14. TIN NO. 488-939-318 20. MOBILE NO. +639066370923

15. AGENCY EMPLOYEE NO. 20200200924 21. E-MAIL ADDRESS (if any) jessicajosedelacruz28@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)
FIRST NAME N/A N/A N/A N/A

MIDDLE NAME N/A

OCCUPATION N/A

EMPLOYER/BUSINESS NAME N/A

BUSINESS ADDRESS N/A

TELEPHONE NO. N/A

24. FATHER'S SURNAME DELA CRUZ

NAME EXTENSION (JR., SR)
FIRST NAME JAIME N/A
MIDDLE NAME SOY
25. MOTHER'S MAIDEN NAME

SURNAME JOSE
FIRST NAME RHODORA
MIDDLE NAME OCBIAN (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 SANTIAGO SOUTH CENTRAL SCHOOL PRIMARY EDUCATION 06/04/2001 03/26/2007 GRADUATED 2007 N/A

VOCATIONAL
SECONDARY /
UNIVERSITY OF LA SALETTE HIGH
SCHOOL
HIGH SCHOOL 06/11/2007 03/29/2011 GRADUATED 2011 N/A

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

TRADE
BACHELOR OF SCIENCE IN BUSINESS
COURSE
COLLEGE UNIVERSITY OF LA SALETTE ADMINISTRATION MAJOR IN FINANCIAL 06/01/2011 04/08/2016 GRADUATED 2016 N/A
MANAGEMENT

SECONDARY EDUCATION
COLLEGE ISABELA COLLEGES, INC. (PROFESSIONAL EDUCATION UNITS)
06/22/2019 10/19/2019 15 UNITS 2019 N/A

GRADUATE STUDIES AMA ONLINE UNIVERSITY MASTER'S IN PUBLIC ADMINISTRATION 08/18/2020 N/A 12 UNITS N/A N/A

(Continue on separate sheet if necessary)

SIGNATURE DATE 10/09/2023

CS FORM 212 (Revised 2017), Page 1 of 4
IV. CIVIL SERVICE ELIGIBILITY
27. CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER SPECIAL DATE OF LICENSE (if applicable)
RATING
LAWS/ CES/ CSEE BARANGAY EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
(If Applicable) NUMBER Date of
ELIGIBILITY / DRIVER'S LICENSE CONFERMENT
Validity

LICENSURE EXAMINATION FOR TEACHERS

86.60 09/26/2021 CAUAYAN CITY, ISABELA 1883854 08/28/2025
(RA1080)
CAREER SERVICE PROFESSIONAL
80.30 11/20/2016 CAUAYAN CITY, ISABELA N/A N/A
EXAMINATION

(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.
28. SALARY/ JOB/ PAY GOV'T SERVICE
INCLUSIVE DATES (mm/dd/yyyy) POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY GRADE (if
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)

PHILIPPINE NATIONAL POLICE -

NON UNIFORMED PERSONNEL / NATIONAL POLICE TRAINING
01/01/2020 PRESENT P27,284 SG 11-2 PERMANENT YES
TRAINING SPECIALIST 1 INSTITUTE - REGIONAL TRAINING
CENTER 2

DEPARTMENT OF INTERIOR AND

LOCAL GOVERNMENT/ PHILIPPINE
03/01/2019 12/31/2019 TRAINING SPECIALIST 1 P20,754 SG 11-1 PERMANENT YES
PUBLIC SAFETY COLLEGE /
REGIONAL TRAINING CENTER 2

(Continue on separate sheet if necessary)

SIGNATURE DATE 10/09/2023

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

PHILIPPINE NATIONAL BANK - SANTIAGO CITY 11/03/2015 1/3/2016 400.0 ON-THE-JOB TRAINING
(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

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

From To

INTERNATIONAL CRIMINAL
POLICE ETHICS COURSE 08/28/2023 09/01/2023 80 SUPERVISORY INVESTIGATIVE TRAINING ASSISTANCE
PROGRAM
WORKSHOP ON SOFT SKILLS TRAINING TOWARDS 21ST
08/09/2023 08/10/2023 16 TECHNICAL REGIONAL TRAINING CENTER 1
CENTURY READINESS
INTERNATIONAL CRIMINAL
COMMUNITY ORIENTED POLICING COURSE 07/17/2023 07/21/2023 80 SUPERVISORY INVESTIGATIVE TRAINING ASSISTANCE
PROGRAM
INTERNATIONAL CRIMINAL
INSTRUCTOR DEVELOPMENT COURSE 12/05/2022 12/16/2022 80 SUPERVISORY INVESTIGATIVE TRAINING ASSISTANCE
PROGRAM

HUMAN RIGHTS BASED-POLICING 10/03/2022 10/04/2022 16 SUPERVISORY NATIONAL POLICE TRAINING INSTITUTE

TECHNICAL EDUCATION AND SKILLS

MANAGING YOUR PERSONAL FINANCES 09/05/2022 09/12/2022 48 TECHNICAL
DEVELOPMENT AUTHORITY ONLINE

TECHNICAL EDUCATION AND SKILLS

DEVELOPING TRAINING CURRICULUM 08/22/2022 09/02/2022 80 SUPERVISORY
DEVELOPMENT AUTHORITY ONLINE

TECHNICAL EDUCATION AND SKILLS

SUPERVISING WORK-BASED LEARNING 06/28/2022 07/06/2022 56 SUPERVISORY
DEVELOPMENT AUTHORITY ONLINE

FOURTH LEG OF VIRTUAL POLICE LEADERSHIP AND GOOD PHILIPPINE NATIONAL PPOLICE PATROL
04/28/2022 04/28/2022 3 SUPERVISORY
GOVERNANCE LECTURE SERIES FOR 2022 PLAN 2030 - PGEN DIONARDO B CARLOS

DEPARTMENT OF INFORMATION AND

DIGITAL GOVERNANCE AND MANAGEMENT TRAINING 04/26/2022 04/28/2022 12 SUPERVISORY
COMMUNICATIONS TECHNOLOGY
DEPARTMENT OF INFORMATION AND
VISUAL STORYTELLING 101 FOR TEACHERS 04/22/2022 04/22/2022 3 TECHNICAL
COMMUNICATIONS TECHNOLOGY
EDUTECH PHILIPPINES - INSPIRING THE NEXT
02/16/2022 02/17/2022 16 TECHNICAL TERRAPINN - SHARON ROESSEN
GENERATION ACROSS THE PHILIPPINES
PREPARING THE FILIPINO YOUTH FOR A FINANCIALLY BANGKO SENTRAL NG PILIPINAS - MARIA
11/26/2021 11/26/2021 3 TECHNICAL
HEALTHY FUTURE FARAH D. ANGKA

BANGKO SENTRAL NG PILIPINAS - MARIA

STOCK MARKET INVESTING 101 11/24/2021 11/24/2021 3 TECHNICAL
FARAH D. ANGKA

CUSTOMER CENTRICITY IN THE FINANCIAL SERVICES BANGKO SENTRAL NG PILIPINAS - MARIA

11/23/2021 11/23/2021 3 TECHNICAL
INDUSTRY FARAH D. ANGKA

EDUTECH ASIA - INSPIRING THE NEXT GENERATION

11/09/2021 11/11/2022 24 TECHNICAL TERRAPINN - SHARON ROESSEN
ACROSS ASIA

JOHNS HOPKINS UNIVERSITY THROUGH

COVID 19 CONTACT TRACING 09/18/2020 09/24/2020 6 TECHNICAL
COURSERA

PUBLIC SECTOR LEADERS AND HR FORUM: THEME: CIVIL SERVICE COMMISSION - CIVIL
09/10/2020 09/10/2020 8 MANAGERIAL
PUBLIC SERVICE CONTINUITY AND RECOVERY SERVICE INSTITUTE

BUSINESS COACH, INC - CSC LEARNING

EFFECTIVE BUSINESS WRITING 08/22/2020 08/22/2020 3 TECHNICAL
AND DEVELOPMENT I1054ACCREDITED

INTERNAL AUDIT SEMINAR 2020 02/02/2020 02/02/2020 8 TECHNICAL REGIONAL TRAINING CENTER 2

REVISED RULES ON ADMINISTRATIVE CASES IN THE CIVIL CIVIL SERVICE COMMISSION - ATTY.
09/11/20119 11/09/2019 8 TECHNICAL
SERVICE MARCELO C. CABILDO

(Continue on separate sheet if necessary)

SIGNATURE DATE 10/09/2023

CS FORM 212 (Revised 2017), Page 3 of 4
VIII. OTHER INFORMATION

NON-ACADEMIC DISTINCTIONS / RECOGNITION MEMBERSHIP IN ASSOCIATION/ORGANIZATION

31. SPECIAL SKILLS and HOBBIES 32. 33.
(Write in full) (Write in full)

MEDALYA NG KASANAYAN - AWARDED BY PMGEN RITCHIE MEDARDO A

HOSTING/ EMCEEING N/A
POSADAS ON AUGUST 4, 2023 (GO # NPTI-GO-AW-2023-521)

CERTIFICATE OF RECOGNITION - BEST GROUP IN COMMUNITY ORIENTED

DANCING/CHOREOGRAPHY POLICING COURSE BY INTERNATIONAL CRIMINAL INVESTIGATIVE TRAINING
ASSISTANCE PROGRAM ON JULY 21, 2023

MEDALYA NG PAPURI - AWARDED BY PMGEN RITCHIE MEDARDO A POSADAS ON

SINGING
JULY 18, 2023 (GO # NPTI-GO-AW-2023-319)

MEDALYA NG PAPURI - AWARDED BY PMGEN RITCHIE MEDARDO A POSADAS ON

PHOTO AND VIDEO EDITING
JULY 18, 2023 (GO # NPTI-GO-AW-2023-423)

MEDALYA NG PAPURI - AWARDED BY PMGEN RITCHIE MEDARDO A POSADAS ON

MAY 24, 2023 (GO # NPTI-GO-AW-2023-48)

MEDALYA NG PAPURI - AWARDED BY PMGEN RITCHIE MEDARDO A POSADAS ON

APRIL 4, 2023 (GO # NPTI-GO-AW-2023-65)

CERTIFICATE OF RECOGNITION - BEST PRESENTER IN INSTRUCTOR

DEVELOPMENT COURSE BY INTERNATIONAL CRIMINAL INVESTIGATIVE
TRAINING ASSISTANCE PROGRAM ON DECEMBER 16, 2022

MEDALYA NG KASANAYAN - AWARDED BY PMGEN DOMINGO R LUCAS ON

SEPTEMBER 5, 2022 (GO # NPTI-GO-AW-2022-183)

MEDALYA NG KASANAYAN - AWARDED BY PMGEN ALEX B SINTIN ON MAY 16,

2022 (SO # NPTI-GO-AW-2022-84 NPTI)

COMMENDATION - TOP ONE IN CCMD PARAMETERS FOR BEST UNIT AWARD AS

OF APRIL 2022 (REGIONAL TRAINING CENTER 2 - JUNE 02, 2022)

MEDALYA NG PAPURI - AWARDED BY PMGEN ALEX B SINTIN ON APRIL 25, 2022

(SO # NPTI-GO-AW-2022-64 NPTI)

CERTIFICATE OF RECOGNITION - KEYNOTE SPEAKER ENTITLED "WOMEN AND

THE ENVIRONMENT: TOXIC FREE FUTURE" ON JANUARY 11, 2022 AT REGIONAL
TRAINING CENTER 2

MEDALYA NG PAPURI - AWARDED BY PMGEN RAMON L RAFAEL ON SEPTEMBER

8, 2020 (SO #2020-258 NPTI)

COMMENDATION FOR GOOD PERFORMANCE IN REGIONAL TRAINING CENTER 2

(NOVEMBER 20, 2019)

CERTIFICATE OF APPRECIATION - JUDGE IN DANCE COMPETITION OF ISABELA

STATE UNIVERSITY - JONES CAMPUS (OCTOBER 28, 2019)

CERTIFICATE OF COMMENDATION FOR BEING A COURSE COORDINATOR OF

PSBRC CLASS 2019-01 FOXTROT COMPANY (OCTOBER 02, 2019)

CERTIFICATE OF RECOGNITION - SPEAKER IN THE ORIENTATION OF THE PRIME

HRM AND BENEFITS & COMPENSATION AND WELFARE ADMINISTRATION (PPSC -
RTC 2 07/12/2019)

COMMENDATION - ISO CERTIFICATION (REGIONAL TRAINING CENTER 2 (JULY 19,

2019)

OUTSTANDING SERVICE AWARD (PHILIPPINE PUBLIC SAFETY COLLEGE

07/05/2019)

(Continue on separate sheet if necessary)

SIGNATURE DATE 10/09/2023

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 by YES ✘ NO
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 ✘ YES NO
the public or private sector? If YES, give details:
________________________________
RESIGNATION - PRIVATE SECTOR
________________________________
38. a. Have you ever been a candidate in a national or local election held within the last year (except
Barangay election)? YES ✘ NO
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); If YES, please specify:
a. and (c) Solo
Are you Parents
a member of Welfare Act of 2000
any indigenous (RA 8972), please answer the following items:
group? YES ✘ NO

If YES, please specify ID No:

YES ✘ NO
b. Are you a person with disability?
If YES, please specify ID No:
YES ✘ NO
c. Are you a solo parent?

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

ID picture taken within
NAME ADDRESS TEL. NO. the last 6 months
3.5 cm. X 4.5 cm
(passport size)
RICHARD M A AQUITANIA ALBAY, BICOL 09177770867
With full and handwritten
name tag and signature over
RICSON R GUIAB ALICIA, ISABELA 09950419082 printed name

Computer generated
AIDA A PARAGUISON RAMON, ISABELA 09569319215 or photocopied picture
is not acceptable
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and complete
statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the Philippines. I authorize PHOTO
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 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: PNP

ID/License/Passport No.: 20L0400220 Signature (Sign inside the box)

10/09/2023 Right Thumbmark
Date/Place of Issuance: DECEMBER 04, 2020
Date Accomplished

SUBSCRIBED AND SWORN to before me this , affiant exhibiting his/her validly issued government ID as indicated above.
PLTCOL ARTHUR D BAYBAYAN
OIC, RRSU2
Person Administering Oath
CS FORM 212 (Revised 2017), Page 4 of 4