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 PAPIO
NAME EXTENSION (JR., SR)
FIRST NAME CHARLMAGNE

MIDDLE NAME PEREZ

3. DATE OF BIRTH
(mm/dd/yyyy) 2/22/1992 16. CITIZENSHIP
✘ Filipino Dual Citizenship
✘ by birth
by
4. PLACE OF BIRTH BAYAMBANG, PANGASINAN If holder of dual citizenship, Pls. indicate country: naturalization
please indicate the details.
5. SEX
✘ Male Female
17. RESIDENTIAL ADDRESS 70 PRIMICIAS ST.
6 CIVIL STATUS ✘ Single House/Block/Lot No. Street
Widowed Married
Separat CADRE SITE
Other/s: ed Subdivision/Village Barangay
BAYAMBANG PANGASINAN
7. HEIGHT (m) 1.7399 m
City/Municipality Province
8. WEIGHT (kg) 71 kg ZIP CODE

18. PERMANENT ADDRESS 70 PRIMICIAS ST.

9. BLOOD TYPE A+
House/Block/Lot No. Street
CADRE SITE
10. GSIS ID NO.
Subdivision/Village Barangay
BAYAMBANG PANGASINAN
11. PAG-IBIG ID NO. 12117098-2220
City/Municipality Province

12. PHILHEALTH NO. ZIP CODE

13. SSS NO. 19. TELEPHONE NO. n/a

14. TIN NO. 321-345-518-000 20. MOBILE NO. 0928 504 0202

15. AGENCY EMPLOYEE NO. 21. E-MAIL ADDRESS (if any) papio.law@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 n/a

MIDDLE NAME

OCCUPATION

EMPLOYER/BUSINESS NAME

BUSINESS ADDRESS

TELEPHONE NO.

24. FATHER'S SURNAME PAPIO

NAME EXTENSION (JR., SR)
FIRST NAME
RICARDO
MIDDLE NAME VINLUAN

25. MOTHER'S MAIDEN NAME

SURNAME PEREZ

FIRST NAME FILOMENA

MIDDLE NAME BELTRAN (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

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

ELEMENTARY PANGASINAN STATE UNIVERSITY KD-ELEMENTARY

LABORATORY SCHOOL, BAYAMBANG

SECONDARY PANGASINAN STATE UNIVERSITY LABORATORY

VOCATIONAL / HIGH SCHOOL, BAYAMBANG

N/A
TRADE
COURSE BACHELOR OF SCIENCE IN INFORMATION
COLLEGE SAINT LOUIS UNIVERSITY, BAGUIO CITY TECHNOLOGY 6/1/2009 10/28/2013 2013

GRADUATE STUDIES UNIVERSITY OF PANGASINAN, DAGUPAN CITY BACHELOR OF LAWS / JURIS DOCTOR 6/1/2019 3/28/2023 2023
(Continue on separate sheet if necessary)

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

CIVIL SERVICE (PROFESSIONAL) 4/17/2016 BAGUIO CITY NATIONAL HIGH SCHOOL

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

8/1/2014 6/30/2015 TECHNICAL SUPPORT NANOX PHIL. INC. CONTRACTUAL N

2/1/2016 6/30/2016 DATA ANALYST iQOR INC. REGULAR N

7/23/2016 PRESENT PARALEGAL (INFORMATION SYSTEMS LEGAL OFFICE REGULAR Y

ANALYST I)

(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
INCLUSIVE DATES
29. NAME & ADDRESS OF ORGANIZATION
(Write in full) (mm/dd/yyyy) NUMBER OF HOURS POSITION / NATURE OF WORK
From To

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

N/A

(Continue on separate sheet if necessary)

VII. LEARNING AND DEVELOPMENT (L&D) INTERVENTIONS/TRAINING PROGRAMS ATTENDED
INCLUSIVE DATES OF
30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS ATTENDANCE Type of LD
NUMBER OF HOURS
( Managerial/ CONDUCTED/ SPONSORED BY
(Write in full) (mm/dd/yyyy) Supervisory/ (Write in full)
Technical/etc)
From To

ISO 9001:2015 (QMS) Strategic Planning and Risk Management Workshop 2/15/2019 2/16/2019 16 hours TECHNICAL LGU BAYAMBANG

BASIC RECORDS MANAGEMENT 10/29/2021 10/29/2021 8 hours DEVELOPMENTAL

HRMO - LGU Bayambang NORA ZAFRA

PERSONALITY DEVELOPMENT 11/18/2021 11/18/2021 8 hours DEVELOPMENTAL

HRMO - LGU Bayambang NORA ZAFRA

Training of Supervisors on Individual Performance Management 1/10/2022 1/10/2022 8 hours DEVELOPMENTAL

ICT - LGU Bayambang RICKY BULALAKAW

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

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

N/A N/A PHILIPPINE EAGLES CLUB

(Continue on separate sheet if necessary)

SIGNATURE DATE
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
b. within the fourth degree (for Local Government Unit - Career Employees)?
YES
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 any court or tribunal? YES NO
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 YES NO
out (abolition) in the public or private sector? If YES, give details:
________________________________
________________________________
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
election to promote/actively campaign for a national or local candidate? NO
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 specify:
If YES, please NO
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
4.5 cm. X 3.5 cm
(passport size)

Computer generated
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 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. PHOTO

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

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

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

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