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 ABAD
NAME EXTENSION (JR., SR) N/A
FIRST NAME JOHN CARLO

MIDDLE NAME CANABATUAN

3. DATE OF BIRTH
(mm/dd/yyyy) AUGUST 25, 2000 16. CITIZENSHIP
✘ Filipino Dual Citizenship

by birth by naturalization
4. PLACE OF BIRTH If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX
✘ Male Female
17. RESIDENTIAL ADDRESS 487 E. TIBAY ST.
6 CIVIL STATUS Single
✘ Married House/Block/Lot No. Street
Widowed Separate WAWA
Other/s: d Subdivision/Village Barangay
PILILLA RIZAL
7. HEIGHT (m) 5'7
City/Municipality Province
8. WEIGHT (kg) 69 kg ZIP CODE 1910

18. PERMANENT ADDRESS 487 E. TIBAY ST.

9. BLOOD TYPE AB+
House/Block/Lot No. Street
WAWA
10. GSIS ID NO. N/A
Subdivision/Village Barangay

11. PAG-IBIG ID NO. 121323695448 PILILLA RIZAL

City/Municipality Province

12. PHILHEALTH NO. 03-250546493-0 ZIP CODE 1910

13. SSS NO. 3526588605 19. TELEPHONE NO. N/A

14. TIN NO. 638-282-776-00000 20. MOBILE NO. 09560842407

15. AGENCY EMPLOYEE NO. 02-0138-0023 21. E-MAIL ADDRESS (if any) abadjohncarlo8320@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 N/A

NAME EXTENSION (JR., SR) N/A N/A
MIDDLE NAME N/A N/A N/A
OCCUPATION N/A N/A N/A
EMPLOYER/BUSINESS NAME N/A N/A N/A
BUSINESS ADDRESS N/A N/A N/A
TELEPHONE NO. N/A N/A N/A
24. FATHER'S SURNAME ABAD PAUL JAKE N. ABAD JUNE 11, 2012

FIRST NAME EDUARDO JR. N/A N/A

MIDDLE NAME ALCANTARA N/A N/A

25. MOTHER'S MAIDEN NAME ELECCION N/A N/A

SURNAME ABAD N/A N/A

FIRST NAME LEONILA N/A N/A

MIDDLE NAME CANABATUAN (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

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

ELEMENTARY
VIRGILIO B. MELENDRES MEMORIAL PRIMARY EDUCATION 2007' 2013' GRADUATED 2013
ELEMENTARY SCHOOL

WITH HIGH
SECONDARY
VOCATIONAL /
TOMAS CLAUDIO COLLEGES SENIOR HIGH SCHOOL 2017' 2019' GRADUATED 2019 HONORS

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

TRADE BACHELOR IN SECONDARY
COURSE UNIVERSITY OF RIZAL SYSTEM - 2019' 2023' GRADUATED 2023 SERVICE
COLLEGE
PILILLA CAMPUS EDUCATION MAJOR IN SOCIAL AWARD
STUDIES
GRADUATE STUDIES
UNIVERSITY OF RIZAL SYSTEM - MASTER OF ARTS IN TEACHING 2024' Present 15 UNITS 2024 -
PILILLA CAMPUS MAJOR IN SOCIAL STUDIES Present
(Continue on separate sheet if necessary)

SIGNATURE DATE APRIL 22, 2025

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

LICENSURE EXAMINATION FOR TEACHER 82.0 09/23/23 MANILA 2193993 08/25/2027

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

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(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 (Write in SALARY
applicable)& STEP
APPOINTMENT
in full/Do not abbreviate) full/Do not abbreviate) (Format "00-0")/
INCREMENT
From To (Y/ N)

BLESSED HOPE CHRISTIAN SCHOOL OF TANAY,

1/8/2023 04/15/25 TEACHER II INC.
11,500.00 N/A CONTRACTUAL N

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(Continue on separate sheet if necessary)

SIGNATURE DATE APRIL 22, 2025

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

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(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
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
ELTECH LEARNING HUB - UPLAND
BASIC COMPUTER LITERACY 09/21/24 2/10/2024 80 TECHNICAL POBLACION,DANAO CITY, CEBU
MMSU-COLLEGE OF TEACHER EDUCATION AND
C-TALKS:ELEVATING TEACHING EXCELLENCE ON THE TOPIC CULTIVATING THE 21ST CENTER FOR TEACHING EXCELLENCE - MMSU-
CENTURY SKILLS THAT PROMOTES GENDER-EQUITY 05/17/24 05/17/24 4 WITH 3 CPD UNITS TECHNICAL CTEx HALL, LAOAG CITY, ILOCOS NORTE

ATENEO DE NAGA UNIVERSITY - CENTER FOR

EMPOWERHER: GENDER EQUALITY AND WOMEN'S EMPOWERMENT IN GOVERNANCE 03/22/24 03/22/24 3 TECHNICAL LOCAL GOVERNANCE

OUTREACH 2: OPPORTUNITIES WITHIN REACH FOR THE COMMUNITY CHAMPIONS - UNIVERSITY OF RIZAL SYSTEM TANAY CAMMPUS,
SESSION 8 "LIVELIHOOD OPPURTUNITIES FROM HAND-MADE CRAFTS 07/28/23 07/28/23 4 TECHNICAL TANAY,RIZAL
DEPARTMENT OF THE INTERIOR AND LOCAL
GOVERNMENT - PUERTO DE SAN JUAN BEACH
PILILLA BADAC PLAN OF ACTION AND BARANGAY PEACE AND ORDER AND PUBLIC 05/19/23 05/21/23 24 SUPERVISORY RESORT AND HOTEL, SAN JUAN LA UNION
SAFETY PLAN FORMULATION

SEMINAR SA KORESPONDENSIYA OPISYAL AT IMPLEMENTASYON NG KAUTUSANG KOMISYON SA WIKANG FILIPINO AT

BLG. 335 08/17/22 08/18/22 16 MANAGERIAL PAMAHALAANG BAYAN NG PILILLA

EXPLORING, DISCOVERING,AND SEARCHING FOR ONE'S PURPOSE: A GUIDE TO POWER OF FILIPINO YOUTH
KNOWING YOUR SELF 11/13/22 11/13/22 4 TECHNICAL

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(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)

Leadership Skill Service Award Lectors and Commentators Ministry

Community Service and Volunteering N/A Catholic Faith Defenders

Computer Literacy N/A N/A

Cooking N/A N/A

Singing N/A N/A

Public Speaking N/A N/A

N/A N/A N/A

(Continue on separate sheet if necessary)

SIGNATURE DATE APRIL 22, 2025

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:
________________________________
END OF CONTRACT
________________________________
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 ✘ 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
the last 6 months
Sean Garnet V. Cordero Cardona, Rizal 9452400713 3.5 cm. X 4.5 cm
(passport size)
Geraldine I. Reyes Hulo Pililla, Rizal 09153820501 With full and handwritten
name tag and signature over
printed name
Vilma C. Enriquez Bagumbayan Pililla, Rizal 9688831942
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
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: PRC ID

ID/License/Passport No.: 2193993

Signature (Sign inside the box)

Date/Place of Issuance: 05/29/2024 - Lucky Chinatown Mall, Metro

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