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CS Form No.

212
Revised 2018
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 ag
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 no

I. PERSONAL INFORMATION
2. SURNAME Estanda
NAME EXTENSION (JR., SR)
FIRST NAME Alexis

MIDDLE NAME Canaway


3. DATE OF BIRTH
16. CITIZENSHIP
(mm/dd/yyyy) 04/12/1992 ✘ Filipino Dual Citizenship
✘ by birth by
4. PLACE OF BIRTH Midsayap, North Cotabato If holder of dual citizenship, Pls. indicate coun
please indicate the details.
5. SEX ✘ Male Female

✘ Single Married 17. RESIDENTIAL ADDRESS


6 CIVIL STATUS
Widowed Separated House/Block/Lot No. Str

Other/s:
Mak
Subdivision/Village Bara
7. HEIGHT (m) 1.67 Parang Maguin
City/Municipality Prov
8. WEIGHT (kg) 72kgs ZIP CODE 9604
18. PERMANENT ADDRESS
9. BLOOD TYPE "A"
House/Block/Lot No. Str

10. GSIS ID NO. N/A Poblac


Subdivision/Village Bara

11. PAG-IBIG ID NO. 91-4256005773 Midsayap North C


City/Municipality Prov

12. PHILHEALTH NO. 17-050355967-9 ZIP CODE 9410

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

14. TIN NO. 463-278-908 20. MOBILE NO. 09064606781/09072203300

15. AGENCY EMPLOYEE NO. 284987 21. E-MAIL ADDRESS (if any) alexis_estanda@yahoo.com
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME N/A 23. NAME of CHILDREN (Write full name and list all)

NAME EXTENSION (JR., SR)


FIRST NAME N/A N/A N/A

MIDDLE NAME N/A

OCCUPATION N/A

EMPLOYER/BUSINESS NAME N/A

BUSINESS ADDRESS N/A

TELEPHONE NO. N/A

24. FATHER'S SURNAME Estanda


NAME EXTENSION (JR., SR)
FIRST NAME Alex SR.
MIDDLE NAME Pareño
25. MOTHER'S MAIDEN NAME

SURNAME Canaway

FIRST NAME Zoila

MIDDLE NAME Cabalfin (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND


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

Lt. Andres Calungsud Elementary


ELEMENTARY Primary Education 1999 2005 N/A
School

SECONDARY /
VOCATIONAL Villarica High School High School 2005 2009 N/A

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


TRADE
i-Link College of Science and Bachelor of Science in
COURSE
COLLEGE 2009 2013 N/A
Technology Criminology
GRADUATE STUDIES N/A N/A N/A N/A N/A
(Continue on separate sheet if necessary)

SIGNATURE DATE 7/26/


CS FORM 21
L DATA SHEET
Experience Sheet shall cause the filing of administrative/criminal case/s against the person

) BEFORE ACCOMPLISHING THE PDS FORM.


(Do not fill up. For CSC use only)

NAME EXTENSION (JR., SR) N/A

Dual Citizenship

by naturalization

Pls. indicate country:

Street
Making
Barangay
Maguindanao
Province
9604

Street
Poblacion 8
Barangay
North Cotabato
Province

9410

N/A

09064606781/09072203300

alexis_estanda@yahoo.com

DATE OF BIRTH (mm/dd/yyyy)


(Continue on separate sheet if necessary)

SCHOLARSHI
YEAR
P/ ACADEMIC
GRADUATED
HONORS
RECEIVED

2005 N/A

2009 N/A

N/A N/A

2013 N/A

N/A N/A
eparate sheet if necessary)

7/26/2019
CS FORM 212 (Revised 2018), Page 1 of 4
IV. CIVIL SERVICE ELIGIBILITY
27. CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER DATE OF LICENSE (if ap
RATING
SPECIAL LAWS/ CES/ CSEE EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
(If Applicable) NUMBER
BARANGAY ELIGIBILITY / DRIVER'S LICENSE CONFERMENT

University of Mindanao Matina Davao


Criminology Board Exam 82.95 04/1/2014
City
0098956

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

01/01/2018 Present Patrolman Philippine National Police 29,668.00 10-0 Permanent

11/02/15 12/31/17 Patrolman Philippine National Police 14,834.00 10-0 Permanent

06/13/14 11/01/15 Patrolman Philippine National Police 14,834.00 10-0 Temporary


(Continue on separate sheet if necessary)

SIGNATURE DATE July 26, 2019

CS FORM 212 (Revised 20


LICENSE (if applicable)

Date of
Validity

04/12/2021

arate sheet if necessary)

GOV'T
SERVICE

(Y/
N)
Y

Y
arate sheet if necessary)

July 26, 2019

CS FORM 212 (Revised 2018), 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 / NA
From To

i-Link College of Science and Technology 06/01/14 03/30/16 N/A Criminolog

(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
ATTENDANCE Type of LD
30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS ( Managerial/ CONDUCTED/
NUMBER OF HOURS
(Write in full) Supervisory/
(mm/dd/yyyy)
Technical/etc)
From To
Autonomo
Public Safety Basic Recruit Course 07/04/16 01/16/2017 960 Basic
Mindanao
(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

NON-ACADEMIC DISTINCTIONS / RECOGNITION ASSOCIAT


31. SPECIAL SKILLS and HOBBIES 32. 33.
(Write in full)

Profissional
Computer Literate Medalya ng Papuri-7

(Continue on separate sheet if necessary)

SIGNATURE DATE
CS FO
NT / PEOPLE / VOLUNTARY ORGANIZATION/S

POSITION / NATURE OF WORK

Criminology Instructor

eparate sheet if necessary)


PROGRAMS ATTENDED
last five (5) years for Division Chief/Executive/Managerial positions)

CONDUCTED/ SPONSORED BY
(Write in full)

Autonomous Region and Muslim


Mindanao Training Center
eparate sheet if necessary)

MEMBERSHIP IN
ASSOCIATION/ORGANIZATION
(Write in
full)
Profissional Criminology Association of the
Philippines

eparate sheet if necessary)

July 26, 2019


CS FORM 212 (Revised 2018), 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 ✘ NO
b. within the fourth degree (for Local Government Unit - Career Employees)? YES ✘ NO
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
YES ✘ 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, ✘ YES NO
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 in i-Link College
of Science and Technology
38. a. Have you ever been a candidate in a national or local election held within the last year (except YES ✘ NO
Barangay election)?
If YES, give details:
b. Have you resigned from the government service during the three (3)-month period before the last YES ✘ 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?
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
PCPT YAZID S ABDULLA Parang, Maguindanao 09157030560 3.5 cm. X 4.5 cm
(passport size)
PCPT STEPHEN C BONIBA Parang, Maguindanao 09751250791
With full and handwritten
PLT CRISANTO I MANGUBAT Midayap, North Cotabato 09393488911 name tag and signature over
printed name
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and
Computer generated
complete statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the or photocopied picture
Philippines. I authorize the agency head/authorized representative to verify/validate the contents stated herein. is not acceptable
I agree that any misrepresentation made in this document and its attachments shall cause the filing of PHOTO
administrative/criminal case/s against me.
Government Issued ID (i.e.Passport, GSIS, SSS, PRC, Driver's License, etc.)
PLEASE INDICATE ID Number and Date of
Issuance
Government Issued ID: PNP ID
ID/License/Passport No.: 17F020553 Signature (Sign inside the box)
July 26, 2019
Date/Place of Issuance: June 2, 2017 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 2018), Page 4 of 4