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 CANONIGO
NAME EXTENSION (SR., JR.)
FIRST NAME ALDAVE -
MIDDLE NAME SABROSO
3. DATE OF BIRTH
16. CITIZENSHIP
(mm/dd/yyyy) 08/23/1997 Filipino Dual Citizenship
by by
birth naturalization
4. PLACE OF BIRTH CEBU CITY If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male Female
6 CIVIL STATUS Single Married 17. RESIDENTIAL ADDRESS SAN ANTONIO
Widowed Separated House/Block/Lot No. Street
Other/s:
BULACAO
Subdivision/Village Barangay
7. HEIGHT (m) 5'2 CEBU CITY CEBU
City/Municipality Province
8. WEIGHT (kg) 85kg ZIP CODE 6000
9. BLOOD TYPE A+
18. PERMANENT ADDRESS SAN ANTONIO
House/Block/Lot No. Street
10. GSIS ID NO. N/A BULACAO
Subdivision/Village Barangay
11. PAG-IBIG ID NO. 121241731456 CEBU CITY CEBU
City/Municipality Province
12. PHILHEALTH NO. N/A ZIP CODE 6000
13. SSS NO. N/A 19. TELEPHONE NO. N/A
14. TIN NO. 763-163-897-000 20. MOBILE NO. 09686076582
15. AGENCY EMPLOYEE NO. N/A 21. E-MAIL ADDRESS (if any) canonigoaldave23@[Link]
II. FAMILY BACKGROUND
DATE OF BIRTH (mm/dd/yyyy)
22. SPOUSE'S SURNAME 23. NAME of CHILDREN (Write full name and list all)
NAME EXTENSION (SR., JR.)
FIRST NAME
-
MIDDLE NAME
OCCUPATION
EMPLOYER/BUSINESS NAME
BUSINESS ADDRESS
TELEPHONE NO.
24. FATHER'S SURNAME CANONIGO
NAME EXTENSION (SR., JR.)
FIRST NAME ALBERTO -
MIDDLE NAME DELA CALZADA
25. MOTHER'S MAIDEN NAME
SURNAME CANONIGO
FIRST NAME PACITA
MIDDLE NAME SABROSO (Continue on separate sheet if necessary)
III. EDUCATIONAL BACKGROUND
NAME OF SCHOOL HIGHEST LEVEL/
26. BASIC EDUCATION/DEGREE/COURSE PERIOD OF ATTENDANCE UNITS YEAR
SCHOLARSHIP/
LEVEL (Write in EARNED GRADUATED
ACADEMIC HONORS
(Write in full) RECEIVED
full) (if not graduated)
From To
ELEMENTARY Immaculate Heart of Mary Academy Primary 2005 2011 GRADUATED 2011
SECONDARY /
VOCATIONAL Immaculate Heart of Mary Academy Secondary 2011 2015 GRADUATED 2015
TRADE
COURSE
COLLEGE University of San Jose Recoletos Tertiary 2015 2016
GRADUATE STUDIES
(Continue on separate sheet if necessary)
SIGNATURE DATE 08/1/2023
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
(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)
(Continue on separate sheet if necessary)
SIGNATURE DATE 08/1/2023
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
(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) (mm/dd/yyyy) Supervisory/ (Write in full)
Technical/etc)
From To
(Continue on separate sheet if necessary)
VIII. OTHER INFORMATION
NON-ACADEMIC DISTINCTIONS / RECOGNITION MEMBERSHIP IN ASSOCIATION/ORGANIZATION
31. SPECIAL SKILLS and HOBBIES 32. 33. (Write in full)
(Write in full)
(Continue on separate sheet if necessary)
SIGNATURE DATE 08/1/2023
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? N
YES
O
b. within the fourth degree (for Local Government Unit - Career Employees)? N
YES
O
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
a.
items:
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:
REFERENCES (Person not related by consanguinity or affinity to applicant /appointee)
41.
NAME ADDRESS TEL. NO.
ID picture taken within
95 M. VELEZ GUADALUPE, CEBU the last 6 months
Coun. JAMES CUENCO 3.5 cm. X 4.5 cm
CITY (passport size)
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 ([Link], GSIS, SSS, PRC, Driver's License, etc.)
PLEASE INDICATE ID Number and Date of
Issuance
Government Issued ID: TIN ID
ID/License/Passport No.: 763-163-897-000 Signature (Sign inside the box)
08/1/2023
Date/Place of Issuance:
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
