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 LLENADO

FIRST NAME OCTAVIO NAME EXTENSION (JR., SR) JR

MIDDLE NAME ENCABO

3. DATE OF BIRTH
16. CITIZENSHIP
(mm/dd/yyyy) 12/15/1984 ✘ Filipino Dual Citizenship
✘ by birth by naturalization
HIMAMAYLAN CITY,
4. PLACE OF BIRTH If holder of dual citizenship, Pls. indicate country:
NEGROS OCCIDENTAL
please indicate the details.
5. SEX ✘ Male Female

6 CIVIL STATUS Single ✘ Married

17. RESIDENTIAL ADDRESS JADE
House/Block/Lot No. Street
✘ Widowed Separated
SAN GREGORIO VILLAGE PAGLAUM
Other/s:
Subdivision/Village Barangay
7. HEIGHT (m) 1.64 BINALBAGAN NEGROS OCCIDENTAL
City/Municipality Province
8. WEIGHT (kg) 70.55kg ZIP CODE 6107

9. BLOOD TYPE "B+"

18. PERMANENT ADDRESS JADE
House/Block/Lot No. Street

10. GSIS ID NO. N/A SAN GREGORIO VILLAGE PAGLAUM

Subdivision/Village Barangay

11. PAG-IBIG ID NO. 1211-6202-9842 BINALBAGAN NEGROS OCCIDENTAL

City/Municipality Province

12. PHILHEALTH NO. 110502755676 ZIP CODE 6107

13. SSS NO. N/A 19. TELEPHONE NO. N/A

14. TIN NO. 942-109-274 20. MOBILE NO. 09688569043

15. AGENCY EMPLOYEE NO. 000-088-079-000 21. E-MAIL ADDRESS (if any) octaviollenadojr@gmail.com

II. FAMILY BACKGROUND

22. SPOUSE'S SURNAME LLENADO 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)

NAME EXTENSION (JR., SR)

FIRST NAME SHARON JOY ALECZANDREI BLAS TORILLA LLENADO 05/20/2018

MIDDLE NAME TORILLA ANANDA BLAIR TORILLA LLENADO 4/6/2020

OCCUPATION PNP NON-UNIFORMED PERSONNEL

EMPLOYER/BUSINESS NAME PHILIPPINE NATIONAL POLICE

BUSINESS ADDRESS HIMAMAYLAN CITY, NEGROS OCCIDENTAL

TELEPHONE NO. 388-3670

24. FATHER'S SURNAME LLENADO

NAME EXTENSION (JR., SR)
FIRST NAME OCTAVIO SR
MIDDLE NAME VILLACORTE

25. MOTHER'S MAIDEN NAME

SURNAME ENCABO

FIRST NAME EVELYN

MIDDLE NAME DELOS REYES (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

NAME OF SCHOOL HIGHEST LEVEL/
26. PERIOD OF ATTENDANCE YEAR SCHOLARSHIP/
BASIC EDUCATION/DEGREE/COURSE UNITS
LEVEL (Write in EARNED
GRADUATED ACADEMIC HONORS
(Write in full) RECEIVED
full) (if not graduated)
From To

ELEMENTARY TALABAN ELEMENTARY SCHOOL PRIMARY EDUCATION 1992 1998 GRADUATED 1998 N/A

SECONDARY /
VOCATIONAL HIMAMAYLAN NATIONAL HIGH SCHOOL HIGH SCHOOL 1998 2002 GRADUATED 2002 N/A

N/A
TRADE
BACHELOR OF SCIENCE IN
COURSE
COLLEGE WEST NEGROS COLLEGE 2002 2006 GRADUATED 2006 N/A
CRIMINOLOGY

GRADUATE STUDIES N/A

(Continue on separate sheet if necessary)

SIGNATURE DATE NOVEMBER 10, 2022

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

BOARD PASSER RA 6506 (CRIM) 76.45% 03/25/2012 ILOILO CITY 0130489 12/15/2024

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

13/13/2021 PRESENT POLICE LIEUTENANT PHILIPPINE NATIONAL POLICE P49,528.00 22-2 TEMPORARY Y

12/31/2016 12/12/2021 POLICE OFFICER 3 PHILIPPINE NATIONAL POLICE P32,114.00 14-2 PERMANENT Y

12/31/2012 12/30/2016 POLICE OFFICER 2 PHILIPPINE NATIONAL POLICE P16,934.00 12-1 PERMANENT Y

02/19/2010 12/30/2012 POLICE OFFICER 1 PHILIPPINE NATIONAL POLICE P9,466.00 10-0 PERMANENT Y

8/12/2009 02/18/2010 POLICE OFFICER 1 PHILIPPINE NATIONAL POLICE P9,466.00 10-0 TEMPORARY Y

8/12/2008 7/12/2009 POLICE OFFICER 1 PHILIPPINE NATIONAL POLICE P9,466.00 10-0 TEMPORARY Y

(Continue on separate sheet if necessary)

SIGNATURE DATE NOVEMBER 10, 2022

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

N/A

(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) Supervisory/ (Write in full)
(mm/dd/yyyy)
Technical/etc)
From To

NATIONAL POLICE COLLEGE, SILANG

PUBLIC SAFETY OFFICERS BASIC COURSE 12/21/2021 8/16/2022 750 TECHNICAL
CAVITE

PUBLIC SAFETY JUNIOR LEADERSHIP COURSE 09/14/2020 01/29/2021 720 TECHNICAL REGIONAL TRAINING CENTER 6

PNP FIELD TRAINING PROGRAM 07/14/2009 01/24/2010 960 TECHNICAL POLICE REGIONAL OFFICE 6

PUBLIC SAFETY BASIC RECRUIT COURSE 01/05/2009 07/01/2009 960 TECHNICAL REGIONAL TRAINING SCHOOL 6

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

MEMBERSHIP IN ASSOCIATION/ORGANIZATION
NON-ACADEMIC DISTINCTIONS / RECOGNITION
. SPECIAL SKILLS and HOBBIES 32. 33.
(Write in full)
(Write in full)
PUBLIC SAFETY MUTUAL BENEFIT FUND
COMPUTER LITERATE MEDALYA NG PAPURI - 59 INCORPORATED
PUBLIC SAFETY SAVINGS AND LOAN
DRIVING MEDALYA NG PAGKIKIPAGLABAN SA MANLILIGALIG SA VISAYAS- 1 ASSOCIATION, INCORPORAED
ARMED FORCES AND POLICE SAVINGS AND
PLAYING BASKETBALL MEDALYA NG PAGLILINGKOD SA VISAYAS- 4 LOAN ASSOCIATION, INCORPORATED

SWIMMING MEDALYA NG KAGALINGAN- 14

MEDALYA NG KASANAYAN- 10

MEDALYA NG PAGTULONG SA NASALANTA- 1

BEST POLICE NON COMMISSIONED OFFICER IN THE FIELD OF OPERATION 2016

(Continue on separate sheet if necessary)

SIGNATURE DATE NOVEMBER 10, 2022

CS FORM 212 (Revised 2017), Page 3 of 4

S
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
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 items:
a. 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:

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

NAME ADDRESS TEL. NO.

ID picture taken within
HIMAMAYLAN CITY, NEGROS the last 6 months
PCOL ANTONIETTO Y CANETE 09209495727 3.5 cm. X 4.5 cm
OCCIDENTAL (passport size)
KABANKALAN CITY, NEGROS
REV FR SABINIANO M. PINSOY JR 09391293316 With full and handwritten
OCCIDENTAL name tag and signature over
printed name
HIMAMAYLAN CITY, NEGROS
PLTCOL ROMEO M VARGAS 09985987422
OCCIDENTAL Computer generated
or photocopied picture
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and 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 (i.e.Passport, GSIS, SSS, PRC, Driver's License, etc.)

PLEASE INDICATE ID Number and Date of
Issuance
Government Issued ID: PNP ID
ID/License/Passport No.: 22A0500260 Signature (Sign inside the box)
NOVEMBER 10, 2022
Date/Place of Issuance: 01/05/2022/QUEZON CITY Date Accomplished Right Thumbmark

SUBSCRIBED AND SWORN to before me this , affiant exhibiting his/her validly issued government ID as indicated above.

PMAJ RAMEL T SARONA

Person Administering Oath

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