cs 12

1. Print legibly. Tick appropriate boxes ( ) and use separate sheet if necessary. Indicate N/A if not applicable. DO NOT ABBREVIATE. 1. CS ID No.
2.
EDGARDO
NABOS
3.
16. CITIZENSHIP
4. PLACE OF BIRTH
5. SEX
17. RESIDENTIAL ADDRESS
8.
18. PERMANENT ADDRESS
BATAAN
12. PHILHEALTH NO.
13. SSS NO. 19. TELEPHONE NO.
20. MOBILE NO.
15. AGENCY EMPLOYEE NO. 21. E-MAIL ADDRESS (if any)
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME
FIRST NAME
MIDDLE NAME
OCCUPATION
EMPLOYER/BUSINESS NAME
BUSINESS ADDRESS
TELEPHONE NO.
24. FATHER'S SURNAME
FIRST NAME
MIDDLE NAME
25.
SURNAME
FIRST NAME
MIDDLE NAME
III. EDUCATIONAL BACKGROUND
From To
ELEMENTARY 6/1/1998 4/7/2004 GRADUATE 2004
10TH
HONOR
SECONDARY 6/4/2004 4/15/2008 GRADUATE 2008 N/A
VOCATIONAL /
TRADE COURSE
N/A N/A N/A N/A N/A
COLLEGE 6/7/2008 4/2/2014 GRADUATE 2014 N/A
GRADUATE STUDIES N/A N/A N/A N/A N/A
BACHELOR OF SECONDARY EDUCATION
MAJOR IN PHYSICS
NA
NA
NA
(Continue on separate sheet if necessary)
FEDELINO
NA
PERIOD OF ATTENDANCE
MOTHER'S MAIDEN NAME
NA
NA
NA
READ THE ATTACHED GUIDE TO FILLING OUT THE PERSONAL DATA SHEET (PDS) BEFORE ACCOMPLISHING THE PDS FORM.
Street
PUROK 5 SABANG
Subdivision/Village
10.
11.
A+
N/A
1211-2071-6291
6
MORALES
HOUSE WIFE
N/A
N/A
N/A
7.
CIVIL STATUS
DATE OF BIRTH
(mm/dd/yyyy)
NAME EXTENSION (JR., SR)
NA
NA
NA
11/4/1992
please indicate the details.
If holder of dual citizenship,
070-509-073-986
Pls. indicate country:
SBMA-MORONG ROAD
70kg
House/Block/Lot No. Street
Subdivision/Village Barangay
House/Block/Lot No.
2108
MORONG BATAAN
02-3657769-5
09494055685
angelesedardo17@gmaill.com
NA
NA
NA
1.60
9.
HEIGHT (m)
WEIGHT (kg)
BLOOD TYPE
GSIS ID NO.
PAG-IBIG ID NO.
MORONG
2108
PERSONAL DATA SHEET
I. PERSONAL INFORMATION
(Do not fill up. For CSC use only)
SCHOLARSHIP/
ACADEMIC
HONORS
RECEIVED
DATE OF BIRTH (mm/dd/yyyy)
26. YEAR
GRADUATED
ANGELES
N/A
NA
SURNAME
FIRST NAME
MIDDLE NAME
ZIP CODE
NAME EXTENSION (JR., SR)
14. TIN NO. 204-594-284-000
RAISEL
SALUDES
NA
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.
N/A
LEVEL
NAME OF SCHOOL
(Write in full)
FACUNDO ANGELES MEMORIAL ELEMENTARY
SCHOOL
MORONG NATIONAL HIGH SCHOOL
N/A
BATAAN PENINSULA STATE UNIVERSITY-
BALANGA CAMPUS
N/A
Barangay
MORONG BATAAN
Province
City/Municipality
City/Municipality Province
SBMA-MORONG ROAD
ZIP CODE
NA
N/A
PUROK 5 SABANG
23. NAME of CHILDREN (Write full name and list all)
NA
CS FORM 212 (Revised 2017), Page 1 of 4
SIGNATURE
(Continue on separate sheet if necessary)
June 22, 2021
NA
NA
NA
NA
NA
NA
NA
RAFAEL
RAMOS
EDGARDO N. ANGELES DATE
HIGHEST LEVEL/
UNITS EARNED
(if not graduated)
ELEMENTARY
ANGELES
NABOS
FERMINA
NAME EXTENSION (JR., SR)
BASIC EDUCATION/DEGREE/COURSE
(Write in full)
SECONDARY
N/A
CS Form No. 212
Revised 2017
Filipino Dual Citizenship
Male Female
Single Married
Widowed
Other/s:
Separated
by birth by naturalization