CS Form No.

212

PERSONAL DATA SHEET

Revised 2017

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 ACCOM PLISHING 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

I. PERSONAL INFORMATION
2. SURNAME BATALAO
NAME EXTENSION (JR., SR) N/A
FIRST NAME DEXTER

MIDDLE NAME GAYAWET

3. DATE OF BIRTH
(mm/dd/yyyy)
9/22/1985 16. CITIZENSHIP
Filipino Dual Citizenship
by birth by naturalization
4. PLACE OF BIRTH TUGUEGARAO CITY, CAGAYAN If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male Female

Single Married 17. RESIDENTIAL ADDRESS N/A ANCHETA ST.

6 CIVIL STATUS
Widowed Separated House/Block/Lot No. Street
PUROK 2 BULANAO NORTE
Other/s:
Subdivision/Village Barangay

7. HEIGHT (m) 1.73 m. TABUK KALINGA

City/Municipality Province
8. WEIGHT (kg) 73 kg. ZIP CODE 3800

18. PERMANENT ADDRESS N/A N/A

9. BLOOD TYPE "O"
House/Block/Lot No. Street
MANGGAWA DANGTALAN
10. GSIS ID NO. 02004253111
Subdivision/Village Barangay
PASIL KALINGA
11. PAG-IBIG ID NO. 121017951385
City/Municipality Province

12. PHILHEALTH NO. 04-000047980-4 ZIP CODE 3800

13. SSS NO. 01-1847988-2 19. TELEPHONE NO. N/A

14. TIN NO. 427-478-918-000 20. MOBILE NO. 9053591958

15. AGENCY EMPLOYEE NO. N/A 21. E-MAIL ADDRESS (if any) batalao.dexter@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/yy
NAME EXTENSION (JR., SR)
FIRST NAME XCYRILLE G. BATALAO 10/7/2003

MIDDLE NAME NASH HENRI G. BATALAO 5/4/2005

OCCUPATION MAXX DYLAN M. BATALAO 8/22/2013

EMPLOYER/BUSINESS NAME SKARLETT NEVAEH C. BATALAO 9/26/1985

BUSINESS ADDRESS

TELEPHONE NO.

24. FATHER'S SURNAME BATALAO

FIRST NAME EUGENE SR.

MIDDLE NAME MASSAGAN

25. MOTHER'S MAIDEN NAME

SURNAME GAYAWET

FIRST NAME CORAZON

MIDDLE NAME BATALAO (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

26. NAME OF SCHOOL BASIC EDUCATION/DEGREE/COURSE PERIOD OF ATTENDANCE HIGHEST LEVEL/

YEAR
LEVEL UNITS EARNED
(Write in full) (Write in full) GRADUATED
(if not graduated)
From To
ELEMENTARY BULANAO CENTRAL SCHOOL ELEMENTARY 1992 1998 N/A 1998

SECONDARY KALINGA ACADEMY HIGH SCHOOL 2003 2004 NA 2004

VOCATIONAL /
N/A N/A N/A N/A N/A N/A
TRADE COURSE
BACHELOR OF ARTS MAJOR IN POLITICAL
COLLEGE UNIVERSITY OF BAGUIO 2008 2010 N/A 2010
SCIENCE (AB POL. SCI.)

UNIVERSITY OF THE CORDILLERAS BACHELOR OF LAWS (LL.B.) 2011 2012 28 UNITS N/A
GRADUATE STUDIES
KALINGA STATE UNIVERSITY BACHELOR OF LAWS (LL.B.) 2012 2013 36 UNITS N/A

(Continue on separate sheet if necessary)

SIGNATURE DATE
CS FORM 212 (Revised 2017), Page 1
AL DATA SHEET
rk Experience Sheet shall cause the filing of administrative/criminal case/s against the person

PDS) BEFORE ACCOM PLISHING THE PDS FORM .

(Do not fill up. For CSC use only)

NAME EXTENSION (JR., SR) N/A

by naturalization
Pls. indicate country:

ANCHETA ST.
Street
BULANAO NORTE
Barangay
KALINGA
Province
3800

N/A
Street
DANGTALAN
Barangay

Province

3800

N/A

9053591958

batalao.dexter@gmail.com

DATE OF BIRTH (mm/dd/yyyy)

10/7/2003

5/4/2005

8/22/2013

9/26/1985

(Continue on separate sheet if necessary)

SCHOLARSHIP/
ACADEMIC
HONORS
RECEIVED
 N/A

N/A

N/A

DEANS LISTER

N/A

N/A

e on separate sheet if necessary)

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

CAREER SERVICE PROFESSIONAL 80.52% 7/27/2008 BAGUIO CITY, BENGUET NA NA

(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.
INCLUSIVE DATES SALARY/ JOB/ PAY
28. GRADE (if
(mm/dd/yyyy) POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY MONTHLY STATUS OF GOV'T SERVICE
applicable)& STEP
(Write in full/Do not abbreviate) (Write in full/Do not abbreviate) SALARY
(Format "00-0")/
APPOINTMENT (Y/ N)
From To INCREMENT

MUNICIPAL LOCAL GOVERNTMENT UNIT OF PASIL

1/4/2021 6/30/2021 LIAISON OFFICER PHP 10,000.00 N/A JOB ORDER YES
(MLGU PASIL, KALINGA)

MUNICIPAL LOCAL GOVERNTMENT UNIT OF PASIL

7/6/2020 12/31/2020 LIAISON OFFICER PHP 334.00 DAILY WAGE JOB ORDER YES
(MLGU PASIL, KALINGA)

MUNICIPAL LOCAL GOVERNTMENT UNIT OF PASIL

7/1/2016 6/4/2018 SANGGUINIANG BAYAN MEMBER PHP 36,436.00 SG-24 ELECTIVE YES
(MLGU PASIL, KALINGA)

DEPARTMENT OF PUBLIC WORKS & HIGHWAYS -

9/24/2012 6/1/2015 COMPUTER MAINTENANCE TECHNOLOGIST II PHP 24,887.00 SG-15 PERMANENT YES
KALINGA DISTRICT ENGINEERING OFFICE
DEPARTMENT OF PUBLIC WORKS & HIGHWAYS -
11/22/2010 6/1/2012 LEGAL AIDE CORDILLERA ADMINISTRATIVE REGION, REGIONAL PHP 320.13 DAILY WAGE JOB ORDER YES
OFFICE
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS -
4/16/2008 6/30/2008 MESSENGER PHP 272.00 DAILY WAGE JOB ORDER YES
KALINGA DISTRICT ENGINEERING OFFICE
 (Continue on separate sheet if necessary)

SIGNATURE DATE
CS FORM 212 (Revised 2017), Page 2 of 4
VI. VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S
NAME & ADDRESS OF ORGANIZATION INCLUSIVE DATES
29.
(Write in full) (mm/dd/yyyy) NUMBER OF HOURS POSITION / NATURE OF WORK
From To

PASIL STUDENT ORGANIZATION (TABUK CITY CHAPTER) 6/16/2008 6/1/2009 N/A CHAPTER PRESIDENT

(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 Type of LD

30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS ATTENDANCE ( Managerial/ CONDUCTED/ SPONSORE
NUMBER OF HOURS
(Write in full) (mm/dd/yyyy) Supervisory/ (Write in full)
Technical/etc)
From To

COVID-19 First Aid Modifications Webinar 9/12/2020 9/22/2020 8.0 Technical Philippine Red Cross

RC-143 Municipal Coordinator's Training 8/7/2020 8/7/2020 8.0 Technical Philippine Red Cross - Kalinga Chap

Philippine Councilor's League - PCL

Training-Seminar on Research Methods in Public Administration 1/19/2018 1/21/2018 24.0 Technical
Academy & Cagayan State Universit
Department of Interior and Local Gov
Orientation on the Ladderized Governance Training Program 9/15/2017 9/15/2017 8.0 Technical
& Philippine Councilor's League
Regional Convention of the Philippine Councilor's League - Cordillera Region "Genuine Department of Interior and Local Gov
8/31/2017 9/2/2017 24.0 Technical
Legislation: Key to Sustainable Development" Cordillera & Philippine Councilor's L
Provincial Orientation for City/Municipal Expanded Ugnayan ng Barangay at Simbahan - Department of Interior and Local Gov
3/22/2017 3/22/2017 8.0 Technical
Technical Working Group Province of Kalinga
Regional Convention of the Philippine Councilor's League - Cordillera Region "Federalism : Department of Interior and Local Gov
2/23/2017 2/25/2017 24.0 Technical
Key to Sustainable Development" Cordillera & Philippine Councilor's L

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

NON-ACADEMIC DISTINCTIONS / RECOGNITION MEMBERSHIP IN ASSOCIATION
31. SPECIAL SKILLS and HOBBIES 32. 33.
(Write in full) (Write in full)

PROFICIENT IN MICROSOFT OFFICE APPLICATION PASIL STUDENT ORGANIZATION

Certificate of Appreciation for Invaluable Support from Kalinga Police Provincial Office CHAPTER
(WORD, EXCEL, POWERPOINT)
KALINGA-APAYAO STUDENT ASSOC
COMPUTER MAINTENANCE & TROUBLE SHOOTING Certificate of Appreciation for Invaluable Contribution from Bible Christian Fellowship
CITY CHAPTER

BASIC AUTOMOTIVE TROUBLESHOOTING Certificate of Appreciation as Guest Speaker from Galdang Elementary School POLITIS - UNIVERSITY OF B
 KALINGA LAW STUDENT ASSOCIAT
READING Certificate of Appreciation as Coordinator from Philippine Red Cross - Kalinga Chapter
BENGUET CHAPTER

PHILIPPINE COUNCILORS LEAGUE - K

(Continue on separate sheet if necessary)

SIGNATURE DATE
MENT / PEOPLE / VOLUNTARY ORGANIZATION/S

POSITION / NATURE OF WORK

CHAPTER PRESIDENT

(Continue on separate sheet if necessary)

NG PROGRAMS ATTENDED
g taken for the last five (5) years for Division Chief/Executive/Managerial positions)

CONDUCTED/ SPONSORED BY
(Write in full)

Philippine Red Cross

Philippine Red Cross - Kalinga Chapter

Philippine Councilor's League - PCL Legislative

Academy & Cagayan State University
Department of Interior and Local Government-Kalinga
& Philippine Councilor's League
Department of Interior and Local Government -
Cordillera & Philippine Councilor's League
Department of Interior and Local Government -
Province of Kalinga
Department of Interior and Local Government -
Cordillera & Philippine Councilor's League

(Continue on separate sheet if necessary)

MEMBERSHIP IN ASSOCIATION/ORGANIZATION
(Write in full)

PASIL STUDENT ORGANIZATION - TABUK CITY

CHAPTER
KALINGA-APAYAO STUDENT ASSOCIATION - BAGUIO
CITY CHAPTER

POLITIS - UNIVERSITY OF BAGUIO

 KALINGA LAW STUDENT ASSOCIATION - BAGUIO -
BENGUET CHAPTER

PHILIPPINE COUNCILORS LEAGUE - KALINGA CHAPTER

(Continue on separate sheet if necessary)

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: APRIL 08, 2018
Status of Case/s: DECIDED (Undergone Plea Bargaining Agreement)
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: ________________________________
________________________________
VIOLATION OF R.A. 9165 & R.A. 10591

37. Have you ever been separated from the service in any of the following modes: resignation, retirement, YES NO
dropped from the rolls, dismissal, termination, end of term, finished contract or phased out (abolition) If YES, give details:
in the public or private sector? Resigned from DPWH-Kalinga District Office on 06/01/2015.

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 items:
a. Are you a member of any indigenous group? YES NO
If YES, please specify: KALINGA
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:

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

NAME ADDRESS TEL. NO.

ID picture taken within
the last 6 months
FOREST TABBANG DANGTALAN, PASIL, KALINGA 9175146979 3.5 cm. X 4.5 cm
(passport size)
PUROK 5, BULANAO CENTRO, TABUK CITY,
RUBY A. UYAM KALINGA
9175199874 With full and handwritten
name tag and signature over
PUROK 3, BULANAO NORTE, TABUK CITY, printed name
CECILLE B. LUCIO KALINGA
9569928489
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
complete statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the is not acceptable

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 (i.e.Passport, GSIS, SSS, PRC, Driver's License, etc.)

PLEASE INDICATE ID Number and Date of Issuance
Government Issued ID: DRIVERS LICENSE

ID/License/Passport No.: P03-03-005845

Signature (Sign inside the box)
October 24, 2022
Date/Place of Issuance: 07/07/2020 - TABUK CITY, KALINGA
Date/Place of Issuance: 07/07/2020 - TABUK CITY, KALINGA
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

If YES, give details (country):
, affiant exhibiting his/her validly issued government ID as indicated above.

CS FORM 212 (Revised 2017), Page 4 of 4