pds cynthia.xls

CS FORM 212 (Revised 2005)

PERSONAL DATA SHEETPrint legibly. Mark appropriate boxes with " " and use separate sheet if necessary. 1. CS ID No. (to be filled up by CSC)

I. PERSONAL INFORMATION

2. SURNAME A P O S T O L

FIRST NAME CYNTHIA

MIDDLE NAME CATUDAY 3. NAME EXTENSION (e.g. Jr., S N/A

4. DATE OF BIRTH (mm/dd/yyyy) 04/05/1967 16. RESIDENTIAL ADDRESS

5. PLACE OF BIRTH DOLORES, EASTERN SAMAR

6. SEX

7. CIVIL STATUS ZIP CODE 6500

17. TELEPHONE NO. 053 530 1814

18. PERMANENT ADDRESS 609 EMILIO ASTORGA ST., BARUGO, LEYTE8. CITIZENSHIP FILIPINO

9. HEIGHT (m) 1.55 (m.)

10. WEIGHT (kg) 52 (kgs.) ZIP CODE 6519

11. BLOOD TYPE "A" 19. TELEPHONE NO. N/A

GSIS ID NO. CRN 006-0018-0705-7 20. E-MAIL ADDRESS (if any)

13. PAG-IBIG ID NO. 0005-016511-09 21. CELLPHONE NO. (if any) 09173219339

14. PHILHEALTH NO. 13-000100076-5 22. AGENCY EMPLOYEE NO. N/A

15. SSS NO. N/A 23. TIN 926-681-751

II. FAMILY BACKGROUND

24.SPOUSE'S SURNAME APOSTOL 25. NAME OF CHILD (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)

FIRST NAME EDGARDO

MIDDLE NAME EMNAS HARLENE DEMETRIA 02/12/1989

OCCUPATION ELECTION OFFICER HAROLD EDGAR 12/23/1989

EMPLOYER/BUS. NAME COMMISSION ON ELECTION MA. HARRIETTE 09/14/1992

BUSINESS ADDRESS INTRAMUROS,MANILA EDGARDO, JR. 11/27/1993

TELEPHONE NO. (02)521-2408 MA. HAZEL ROSARY 10/07/1995

(Continue on separate sheet if necessary) NOTHING FOLLOWS NOTHING FOLLOWS

26. FATHER'S SURNAME CATUDAY

FIRST NAME AMADOR

MIDDLE NAME BALACA

27. MOTHER'S MAIDEN NAME

SURNAME VILLARAZO

FIRST NAME VIRGINIA

MIDDLE NAME OLEGARIO (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

28.LEVEL

From To

ELEMENTARY DOLORES ELEMENTARY SCHOOL GRADUATED 1980 GRADE VI 1974 1980

SECONDARY GRADUATED 1984 1980 1984

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

COLLEGEDIVINE WORD UNIVERSITY 1988 GRADUATE 1984 1988 DEAN'S LISTER

GRADUATE STUDIES BACHELOR OF LAWS 1998 GRADUATE 1988 1998 NONE

NOTHING FOLLOWS NOTHING FOLLOWS NOTHING FOLLOWS NOTHING FOLLOWS

(Continue on separate sheet if necessary)

of 4

BLK.13,LOT 4,5&6,VILLA LOLITA SUBD.,COGON,SAN JOSE, TACLOBAN CITY

12. [email protected]

NAME OF SCHOOL

(Write in full)DEGREE COURSE

(Write in full)

YEAR GRADUATED (if graduated)

HIGHEST GRADE/

LEVEL/ UNITS

EARNED (if not

graduated)

INCLUSIVE DATES OF ATTENDANCE

SCHOLARSHIP/ ACADEMIC HONORS

RECEIVED

FIRST HON.MENTION

ASSUMPTION ACADEMY OF SAMAR,GUIUAN EASTERN SAMAR

FOURTH YEAR

FIRST HON.MENTIONVOCATIONAL /

TRADE COURSE BACHELOR OF ARTS

IN POLITICAL SCIENCE

SAN BEDA COLLEGE OF LAW/ARELLANO LAW SCHOOL

Annulled Others, specify ___________

Single Married

Widowed Separated

X

Male Fem ale X

mailto:[email protected]

IV. CIVIL SERVICE ELIGIBILITY

29.RATING PLACE OF EXAMINATION / CONFERMENT

LICENSE (if applicable)

NUMBER

75.24% 07/26/1987 TACLOBAN CITY

82.97%08/18/1998

TACLOBAN CITY


V. WORK EXPERIENCE (Include private employment. Start from your current work)

30.

From To

01/05/2015 PRESENT LEGAL ASSISTANT DENR-CENRO, Palo 19,980.00 Contractual YES

02/2/2014 12/31/2014 LEGAL ASSISTANT DENR-CENRO, Palo 19,980.00 Contractual YES

03/18/2002 02/1/2014 ATTORNEY II 31,351.00 18 TEMPORARY YES

NOTHING FOLLOWS NOTHING FOLLOWS


CS FORM 212 (Revised 2005), of 4

CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER SPECIAL LAWS/ CES/ CSEE

DATE OF EXAMINATION / CONFERMENT DATE OF

RELEASE

CAREER SERVICE SUB-PROFESSIONAL EXAMINATION

CAREER SERVICE PROFESSIONAL EXAMINATION

INCLUSIVE DATES (mm/dd/yyyy) POSITION TITLE

(Write in full)

DEPARTMENT / AGENCY / OFFICE / COMPANY

(Write in full)MONTHLY SALARY

SALARY GRADE & STEP

INCREMENT (Format "00-0")

STATUS OF APPOINTMENT

GOV'T SERVICE

(Yes / No)

DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES,R8,TAC.CITY

VI. VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S

31.POSITION / NATURE OF WORK

From To

NONE N/A N/A N/A N/A

.

VII. TRAINING PROGRAMS (Start from the most recent training.)

32. CONDUCTED/ SPONSORED BY (Write in full)

From To

DENR ORIENTATION & SERVICE EFFECTIVENESS SEMINAR 09/1802002 09/20/2002 24 hours DENR,HUMAN RESOURCES MANAGEMENT DIVISION

10/09/2005 10/21/2005 24 HOURS DENR-LAND MANAGEMENT BUREAU

SEMINAR ON CLEAN WATER ACT (RA 9275) 10/25/2005 10/26/2005 16 HOURS

LEGAL PRACTITIONER'S ORIENTATION COURSE 11/24/2005 10/25/2005 16 HOURS CIVIL SERVICE COMMISSION,REG.8,PALO,LEYTE

FRONTLINERS MANAGEMENT TRAINING 11/29/2005 11/30/2005 16 HOURS DENR-LAND MANAGEMENT BUREAU

GAD PLANNING WORKSHOP 03/02/2006 03/02/2006 8 HOURS DENR,REG.8,TACLOBAN CITY

TRAINING OF WILDLIFE ENFORCEMENT OFFICERS 05/03/2006 05/03/2006 8 HOURS DENR,REG.8,TACLOBAN CITY

CONFERENCE OF HRM OFFICERS 11/07/2006 11/07/2006 8 HOURS DENR,REG.8,TACLOBAN CITY

TRAINING ON STATEMENT OF ASSETS & LIABILITIES & NETWORTH 06/20/2007 06/20/2007 24 HOURS CIVIL SERVICE COMMISSION,REG.8,PALO,LEYTE

DENR-CARP FORUM,ASSESSMENT 7 REPROGRAMMING WORKSHOP 07/13/2011 07/15/2011 16 HOURS DENR-LAND MANAGEMENT SERVICE

FORUM ON LAND MANAGEMENT & DISPOSITION 10/27/2011 10/28/2011 16 HOURS DENR-LAND MANAGEMENT SERVICE

PHIL.ASSOCIATION OF ASSESSING OFFICERS CONVENTION (PAAO,INC.) 06/18/2013 06/21/2013 32 HOURS PHILIPPINE REGULATION COMMISSION (PRC)


VIII. OTHER INFORMATION

33. SPECIAL SKILLS / HOBBIES: 34. 35.

COMPUTER LITERATE NONE EVDENREU MEMBER-REG.8 CHAPTER



NAME & ADDRESS OF ORGANIZATION (Write in full)

INCLUSIVE DATES

(mm/dd/yyyy) NUMBER OF HOURS

TITLE OF SEMINAR/CONFERENCE/WORKSHOP/SHORT COURSES (Write in full)

INCLUSIVE DATES OF ATTENDANCE

(mm/dd/yyyy) NUMBER OF HOURS

DENR REGIONAL FORUM ON PUBLIC LAND DISPOSITION AND MANAGEMENT OF FORESHORE AREAS

ENVIRONMENTAL MANAGEMENT BUREAU & POLLUTION CONTROL ASSOCIATION OF THE PHILS.(PCAP 8)

NON-ACADEMIC DISTINCTIONS / RECOGNITION: (Write in full)

MEMBERSHIP IN ASSOCIATION/ORGANIZATION (Write in full)

36. Are you related by consanguinity or affinity to any of the following :

a.

b.

37 a. Have you ever been formally charged?

b. Have you ever been guilty of any administrative offense?

38.

39.

40. Have you ever been a candidate in a national or local election (except Barangay election)?

41.

a. Are you a member of any indigenous group?If YES, please specify: ____________________

b. Are you differently abled?If YES, please specify: ____________________

c. Are you a solo parent?If YES, please specify: ____________________

42.

NAME ADDRESS TEL. NO.

ESMERAL B. ORTEGA DAGAMI. LEYTE 9173241447

ATTY. EDGAR T. OCTA ATTY. III, DENR, LEGAL DIV. 325-2255

ATTY. ANTONIO PAGATPAT 9196119889

43.

PHOTO

COMMUNITY TAX CERTIFICATE NO.

ISSUED AT

02/09/2015ISSUED ON (mm/dd/yyyy) DATE ACCOMPLISHED RIGHT THUMBMARK


Within the third degree (for National Government Employees): appointing authority, recommending authority, chief of office/bureau/department or person who has immediate supervision over you in the Office, Bureau or Department where you will be appointed?

If YES, give details: _____________________________________ _____________________________________ _____________________________________

Within the fourth degree (for Local Government Employees): appointing authority or recommending authority where you will be appointed? If YES, give details:

_____________________________________ _____________________________________ _____________________________________

If YES, give details: ________________________________ ________________________________


Have you ever been convicted of any crime or violation of any law, decree, ordinance or regulation by any court or tribunal? If YES, give details:

________________________________ ________________________________

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, AWOL or phased out, in the public or private sector?



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:

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

NATIONAL BUREAU OF INVESTIGATION

I declare under oath that this Personal Data Sheet has been accomplished by me, and is a true, correct and complete statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the Philippines.

I also authorize the agency head / authorized representative to verify / validate the contents stated herein. I trust that this information shall remain confidential.

SIGNATURE (Sign inside the box)

ID picture taken within the last 6 months3.5 cm. X 4.5 cm(passport size)

Computer generated or xerox copy of picture

is not acceptable

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

continuation from V. WORK EXPERIENCE (Include private employment. Start from your current work)

30.

From To

INCLUSIVE DATES (mm/dd/yyyy) POSITION TITLE

(Write in full)



SALARY GRADE & STEP



GOV'T SERVICE

(Yes / No)

From To

02-25-92 PRESENT ELECTION OFFICER II COMMISSION ON ELECTION P 17,391 15 PERM. YES

NOTHING FOLLOWS NOTHING FOLLOWS

POSITION TITLE

(Write in full)



SALARY GRADE & STEP



GOV'T SERVICE

(Yes / No)

pds cynthia.xls

Documents