Ponsica Pds
Ponsica Pds
Ponsica Pds
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 PONSICA
N/A
FIRST NAME EMERSON
4. PLACE OF BIRTH DAVAO CITY If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX MALE
15. AGENCY EMPLOYEE NO. N/A 21. E-MAIL ADDRESS (if any) emersonponsica@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)
FIRST NAME
NAME EXTENSION (JR., SR) N/A
MIDDLE NAME
OCCUPATION
EMPLOYER/BUSINESS NAME
BUSINESS ADDRESS
TELEPHONE NO.
SURNAME BERENGUEL
ELEMENTARY ALASKA ELEMENTARY SCHOOL ELEMENTARY 2000 2005 GRADUATED 2005 WITH HONORS
WITH
SECONDARY /
VOCATIONAL SANTA CRUZ NATIONAL HIGH SCHOOL HIGH SCHOOL 2007 2010 GRADUATED 2010
HONORS
N/A
TRADE
COURSE
COLLEGE UNIVERSITY OF MINDANAO DIGOS COLLEGE BACHELOR OF SCIENCE IN CRIMINOLOGY 2015 2010 GRADUATED 2018 CUM LAUDE
1stAttritionCY2022_2022_941AMU
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
REGISTERED CRIMINOLOGIST 86.8 JUNE 2019 UNIVERSITY OF MINDANAO MATINA 0190283 2025
1stAttritionCY2022_2022_941AMU
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
UM AND PUBLIC SAFETY AGENCY PARTNERSHIP 2018 2018 4.0 hours EDUCATIONA RESEARCH AND PUBLICATION UM DAVAO
DEPARTMENT OF CRIMINAL JUSTICE
THE BASICS OF RESEARCH 2017 2017 8.0 hours EDUCATIONA EDUCATION
SIGNATURE
1stAttritionCY2022_2022_941AMU DATE 10/14/2022
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, NO
a. within the third degree?
b. within the fourth degree (for Local Government Unit - Career Employees)?
If YES, give details:
________________________________
35. a. Have you ever been found guilty of any administrative offense? NO
If YES, give details:
________________________________
________________________________
b. Have you been criminally charged before any court? 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 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,
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? ________________________________
RESIGNATION
________________________________
38. a. Have you ever been a candidate in a national or local election held within the last year (except NO
Barangay election)?
If YES, give details:
b. Have you resigned from the government service during the three (3)-month period before the last 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? 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: NO
a. Are you a member of any indigenous group?
If YES, please specify:
b. Are you a person with disability?
If YES, please specify ID No:
c. Are you a solo parent?
If YES, please specify ID No:
PAUL R. OLVIS DIGOS CITY DAVAO DEL SUR 9154139333 With full and handwritten
name tag and signature over
printed name
REV. FATHER JERIC C. BARIQUIT MATANAO DAVAO DEL SUR 9456775099
Computer generated
42. or photocopied picture
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.
SUBSCRIBED AND SWORN to before me this , affiant exhibiting his/her validly issued government ID as indicated above.
1stAttritionCY2022_2022_941AMU
Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.
Alternative Proxies: