CS FORM 212 (Revised 2005)

PERSONAL DATA SHEET

Print legibly. Mark appropriate boxes q with "P " and use separate sheet if necessary.

1. CS ID No.

(to be filled up by CSC)

I. PERSONAL INFORMATION
ABELLA

2. SURNAME
FIRST NAME

EMILIO

MIDDLE NAME

ROMERO
05/05/1971

4. DATE OF BIRTH (mm/dd/yyyy)

5. PLACE OF BIRTH

SR.

3. NAME EXTENSION (e.g. Jr., Sr.)

16. RESIDENTIAL ADDRESS

# 02 LIBERTAD STREET, CENTRO SOUTHWEST, SOLANA,

CAGAYAN

SOLANA,CAGAYAN

6. SEX

Single
Married
Annulled

7. CIVIL STATUS

Widowed
ZIP CODE 3505
Separated

N/A
17. TELEPHONE NO.
___________Others, specify18. PERMANENT ADDRESS
# 02 LIBERTAD STREET, CENTRO SOUTHWEST, SOLANA,
CAGAYAN

8. CITIZENSHIP

FILIPINO

9. HEIGHT (m)

1.62 M.

10. WEIGHT (kg)

75 KGS.

11. BLOOD TYPE

"O"

19. TELEPHONE NO.

N/A

12. GSIS ID NO.

71050501668

20. E-MAIL ADDRESS (if any)

emlioabella_sr@yahoo.com

13. PAG-IBIG ID NO.

020124065506

21. CELLPHONE NO. (if any)

09175909578

14. PHILHEALTH NO.

06-000004682-8

22. AGENCY EMPLOYEE NO.

15. SSS NO.

N/A

23. TIN

ZIP CODE

3505

96DO001
193-926-180

II. FAMILY BACKGROUND

24. SPOUSE'S SURNAME

25. NAME OF CHILD (Write full name and list all)

ABELLA

DATE OF BIRTH (mm/dd/yyyy)

FIRST NAMECHEERIL

EMERIO MONICO A. ABELLLA

12/31/1994

MIDDLE NA

ANINAG

MARIA CHEMIL A. ABELLA

01/25/1997

OCCUPATION

N/A

EMILIO A. ABELLA, JR.

05/04/2000

EMPLOYER/BUS. NAME

N/A

MILLIE CHE A. ABELLA

04/05/2001

BUSINESS ADDRESS

N/A

EMIL BENEDICT A. ABELLA

08/27/2012

TELEPHONE NO.

N/A
(Continue on separate sheet if necessary)

26. FATHER'S SURNAME

ABELLA

12/08/1941

FIRST NAME

EMITERIO

MIDDLE NAME

MANUEL

27. MOTHER'S MAIDEN NAME

SURNAME

ROMERO

FIRST NAME

RUFINA

MIDDLE NAME

QUILANG

12/25/1952
/
(Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

28.

YEAR
GRADUATED

NAME OF SCHOOL

DEGREE COURSE
(Write in
(Write in full)

LEVEL
full)

(if
graduated)

HIGHEST GRADE/
LEVEL/
UNITS EARNED
(if not graduated)

INCLUSIVE DATES OF
ATTENDANCE
From

To

SCHOLARSHIP/
ACADEMIC HONORS
RECEIVED

ELEMENTARY

SOLANA SOUTH CENTRAL

SCHOOL

ELEMENTARY

1984

GRADUATED

06/5/78

3/26/84

NONE

SECONDARY
VOCATIONAL /

CAGAYAN STATE UNIVERSITY AT

TUGUEGARAO CITY

SECONDARY

1988

GRADUATED

6/4/84

3/30/88

NONE

SAINT LOUIS COLLEGE OF

TUGUEGARAO CITY

B.S.
ARCHITECTURE

1993

GRADUATED

6/6/88

4/5/1993

LEADERSHIP
AWARD

COLLEGE
TRADE
COURSE

GRADUATE STUDIES

(Continue on separate sheet if necessary)

Page 1 of 4

IV. CIVIL SERVICE ELIGIBILITY

29.

CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER

SPECIAL LAWS/ CES/ CSEE

BOARD OF ARCHITECTURE

LICENSE (if applicable)

RATING

DATE OF
EXAMINATION /
CONFERMENT

PLACE OF EXAMINATION / CONFERMENT

70.90%

January-96

MLQU, SAMPALOC MANILA

NUMBER
0012773

DATE OF
RELEASE
03/07/1996

(Continue on separate sheet if necessary)

V. WORK EXPERIENCE (Include private employment. Start from your current work)
INCLUSIVE DATES
(mm/dd/yyyy)

30.

From

POSITION TITLE

DEPARTMENT / AGENCY / OFFICE / COMPANY

(Write in full)

To

(Write in full)

GOV'T
SERVICE
MONTHLY
SALARY

SALARY GRADE
& STEP
INCREMENT
(Format "00-0")

STATUS OF
APPOINTMENT
(Yes /
No)

07/11/2015

Present

ARCHITECT II

DPWH-CAGAYAN 2ND DISTRICT ENGINEERING

OFFICE

07/11/2012

07/10/2015

ARCHITECT II

DPWH-CAGAYAN 2ND DISTRICT ENGINEERING

OFFICE

26,878.00

16-1

PERMANENT

YES

06/01/2011

07/10/2012

ARCHITECT I

DPWH-CAGAYAN 2ND DISTRICT ENGINEERING

OFFICE

18,805.00

12-3

PERMANENT

YES

06/24/2010

05/31/2011

ARCHITECT I

DPWH-CAGAYAN 2ND DISTRICT ENGINEERING

OFFICE

17,269.00

12-3

PERMANENT

YES

07/01/2009

06/23/2010

ARCHITECT I

DPWH-CAGAYAN 2ND DISTRICT ENGINEERING

OFFICE

15,422.00

12-3

PERMANENT

YES

07/01/2008

06/30/2009

ARCHITECT I

DPWH-CAGAYAN 2ND DISTRICT ENGINEERING

OFFICE

13,850.00

12-2

PERMANENT

YES

07/01/2007

06/30/2008

ARCHITECT I

DPWH-CAGAYAN 2ND DISTRICT ENGINEERING

OFFICE

12,591.00

12-2

PERMANENT

YES

08/14/2006

06/30/2007

ARCHITECT I

DPWH-CAGAYAN 2ND DISTRICT ENGINEERING

OFFICE

11,446.00

12-2

PERMANENT

YES

08/14/2003

08/13/2006

ARCHITECT I

DPWH-CAGAYAN 2ND DISTRICT ENGINEERING

OFFICE

11,167.00

12-1

PERMANENT

YES

07/01/2001

08/13/2003

DRAFTSMAN

DPWH-REGIONAL OFFICE O2

8,705.00

8-1

PERMANENT

YES

04/02/2001

06/30/2001

DRAFTSMAN

DPWH-REGIONAL OFFICE O2

8,294.00

8-1

PERMANENT

YES

01/01/2000

04/04/2001

ARCHITECT I

DPWH-REGIONAL OFFICE O2

483.40/DAY

CASUAL

YES

11/01/1997

12/31/1997

ARCHITECT I

DPWH-REGIONAL OFFICE O2

439.00/DAY

CASUAL

YES

01/02/1997

10/31/1997

ARCHITECT I

DPWH-REGIONAL OFFICE O2

369.00/DAY

CASUAL

YES

11/11/1996

12/31/1996

ARCHITECT I

DPWH-REGIONAL OFFICE O2

298.54/DAY

CASUAL

YES

27,174.00

16-2

PERMANENT

YES

(Continue on separate sheet if necessary)

CS FORM 212 (Revised 2005), Page 2 of 4

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

INCLUSIVE DATES
31. NAME & ADDRESS OF ORGANIZATION
(mm/dd/yyyy)

(Write in full)

UNITED ARCHITECT OF THE PHILIPPINES (UAP)

From

To

12/01/1996

PRESENT

NUMBER OF
HOURS

POSITION / NATURE OF WORK

MEMBER

(Continue on separate sheet if necessary)

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

INCLUSIVE DATES OF ATTENDANCE
32. TITLE OF SEMINAR/CONFERENCE/WORKSHOP/SHORT COURSES (Write
in full)

(mm/dd/yyyy)

NUMBER OF
HOURS

CONDUCTED/ SPONSORED BY
(Write in full)

From

To

INSTRUCTIONAL MEETING ON THE PROPER OPERATION OF THE NEWLY

PROCURED AUTOMATIC TRAFFIC CLASSIFIERS (ATC) AND RTIA-TRAFFIC
DATA ENTRY APPLICATION (TDEA)

02/13/2012

02/16/2012

32

DPWH-REGIONAL OFFICE 02

SEMINAR ON MATERIALS ENGINEERING AND QUALITY CONTROL

11/14/2011

11/18/2011

40

DPWH-REGIONAL OFFICE 02

10/11/2011

10/13/2011

24

DPWH-REGIONAL OFFICE 02

03/19/2010

03/19/2010

DPWH-REGIONAL OFFICE 02

06/26/2007

06/26/2007

32

DPWH-REGIONAL OFFICE 02

09/28/2006

09/29/2006

16

DPWH-REGIONAL OFFICE 02

12TH NATIONAL CONFERENCE OF ARCHITECTURE

10/16/2003

10/18/2003

24

UNITED ARCHITECTS OF THE PHILIPPINESTAGAYTAY CITY

SEMINAR ON TEAM BUILDING

08/05/2002

08/06/2002

16

DPWH-REGIONAL OFFICE 02

28TH UNITED ARCHITECTS OF THE PHILIPPINES NATIONAL CONVENTION

AND ANNUAL BUSINESS MEETING

04/18/2002

04/20/2002

24

UNITED ARCHITECTS OF THE PHILIPPINESMANILA MIDTOWN HOTEL, MALATE, MANILA

SEMINAR/WORKSHOP ON MATERIALS TESTING & TECHNOLOGY

11/19/2001

11/30/2001

72

DPWH-REGIONAL OFFICE 02

DPWH FIELD ENGINEERS TRAINING

10/18/1999

11/12/1999

208

DPWH-REGIONAL OFFICE 02

7th NATIONAL CONFERENCE OF ARCHITECT

10/15/1998

10/18/1998

32

UNITED ARCHITECTS OF THE PHILIPPINESWATERFRONT HOTEL, CEBU CITY

8th NATIONAL CONFERENCE OF ARCHITECTURE

10/15/1997

10/19/1997

40

UNITED ARCHITECTS OF THE PHILIPPINESSUBIC BAY FREEPORT ZONE, OLONGAPO

CITY

23RD ANNUAL NATIONAL CONVENTION

04/03/1997

04/05/1997

24

UNITED ARCHITECHTS OF THE

PHILIPPINES-MANILA MIDTOWN HOTEL,
MALATE, MANILA

AREA A-1 ASSEMBLY

03/07/1997

03/08/1997

16

UNITED ARCHITECTS OF THE PHILIPPINESPORT ILOCANDIA RESORT HOTEL LAOAG

CITY

16TH UNITED ARCHITECTS OF THE PHILIPPINES NATIONAL CONVENTION &

UAP MEETING

10/15/1990

10/20/1990

48

UNITED ARCHITECTS OF THE PHILIPPINESPHILIPPINE INTERNATIONAL CONVENTION

CENTER

DPWH-GAD TOLL KIT: MAKING ROAD INFRASTRUCTURE

AND RELATED FACILITIES GENDER RESPONSIVE
ORIENTATION TRAINING ON INSPECTION OF BUILDINGS AND BRIDGES
SEMINAR-WORKSHOP ON BENEFIT MONITORING EVALUATION (BME) OF
COMPLETED INFRA- PROJECTS
LECTURE/FORUM ON EARTHQUAKE HAZARDS ASSESSMENT OF BUILDINGS

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

33.

SPECIAL SKILLS / HOBBIES:

34.

NON-ACADEMIC DISTINCTIONS / RECOGNITION:

(Write in full)

35.

MEMBERSHIP IN
ASSOCIATION/ORGANIZATION
(Write in full)

DESIGN & ESTIMATE OF BUILDINGS

NONE

UNITED ARCHITECTS OF THE PHILIPPNESCAGAYAN NORTH CHAPTER

SUPERVISE INFRASTRUCTURE PROJECT

COMPUTER LITERATE/AUTOCAD(2D)

(Continue on separate sheet if necessary)

CS FORM 212 (Revised 2005), Page 3 of 4

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

a. 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:

_____________________________________
_____________________________________
_____________________________________

b. Within the fourth degree (for Local Government Employees):

appointing authority or recommending authority where you will be appointed?

If YES, give details:

_____________________________________
_____________________________________
_____________________________________

37 a. Have you ever been formally charged?

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

38. Have you ever been convicted of any crime or violation of any law, decree, ordinance or

regulation by any court or tribunal?

39. 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?

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

41. 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?

b.

Are you differently abled?

c.

Are you a solo parent?

If YES, give details:

_______________________________
_
_______________________________
_
If YES, give details:
_______________________________
_
_______________________________
_
If YES, give details:
_______________________________
_
_______________________________
_
If YES, give details:
_______________________________
_
_______________________________
_
If YES, give details:
_______________________________
_
_______________________________
_

If YES, please specify: ____________________

If YES, please specify: ____________________
If YES, please specify: ____________________
42. REFERENCES (Person not related by consanguinity or affinity to applicant / appointee)
NAME

ADDRESS

ENGR. JOSELITO T. ARAO (DISTRICT ENGINEER)

ENGR. VIRGILIO L. GARCIA
ASST.DISTRICT ENGINEER)
ENGR. JAIME P. CATOLOS, JR.

TEL. NO.

DPWH-CAGAYAN 2ND DEO, ABULUG CAGAYAN

(OIC-

DPWH-CAGAYAN 2ND DEO, ABULUG CAGAYAN

DPWH-CAGAYAN 2ND DEO, ABULUG CAGAYAN

43. I declare under oath that this Personal Data Sheet has been accomplished by me, and is a true, correct and

ID picture taken within

the last 6 months
3.5 cm. X 4.5 cm
(passport size)
Computer generated
or xerox copy of picture
is not acceptable

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.

PHOTO

25557456
COMMUNITY TAX CERTIFICATE NO.

ABULUG, CAGAYAN
ISSUED AT

SIGNATURE (Sign inside the box)

January 13, 2014

01/21/2014

ISSUED ON (mm/dd/yyyy)

DATE ACCOMPLISHED

RIGHT THUMBMARK

CS FORM 212 (Revised 2005), Page 4 of 4