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 DIGON
NAME EXTENSION (JR., SR)
FIRST NAME REDEN

MIDDLE NAME GONZALES

3. DATE OF BIRTH
MARCH 24, 1980 16. CITIZENSHIP Dual
(mm/dd/yyyy) ✘ Filipino by by
Citizenship
birt naturalizatio
4. PLACE OF BIRTH TANZA BAYBAY, ILOILO CITY If holder of dual citizenship, Pls. h n
indicate country:
please indicate the details.
5. SEX ✘ Male Femal
Single ✘
e
Marrie 17. RESIDENTIAL ADDRESS 227
6 CIVIL STATUS
House/Block/Lot No. Street
Widow Separ
d TANZA BAYBAY
Other/
ed ated Subdivision/Village Barangay

7. HEIGHT (cm)
s: 160 ILOILO CITY ILOILO
City/Municipality Province
8. WEIGHT (kg) 69 ZIP CODE 5000

18. PERMANENT ADDRESS 227

9. BLOOD TYPE AB
House/Block/Lot No. Street
TANZA BAYBAY
10. GSIS ID NO. N/A
Subdivision/Village Barangay
ILOILO CITY ILOILO
11. PAG-IBIG ID NO. N/A
City/Municipality Province

12. PHILHEALTH NO. 112013043348 ZIP CODE 5000

13. SSS NO. 003394698439 19. TELEPHONE NO. N/A

14. TIN NO. 228-317-407-000 20. MOBILE NO. 09638078220

15. AGENCY EMPLOYEE NO. N/A 21. E-MAIL ADDRESS (if any) N/A

II. FAMILY BACKGROUND

22. SPOUSE'S SURNAME DAMPOG 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)

FIRST NAME ELVIE

NAME EXTENSION (JR., SR) JAZMINE GRACE DIGON JULY 9, 2007

MIDDLE NAME DELA CRUZ NEDER ACE DIGON APRIL 13, 2011

OCCUPATION NONE JANEZZA BLISS DIGON MARCH 3, 2019

EMPLOYER/BUSINESS NAME N/A

BUSINESS ADDRESS N/A

TELEPHONE NO. N/A

24. FATHER'S SURNAME DIGON

NAME EXTENSION (JR., SR)
FIRST NAME EDISON

MIDDLE NAME PANELO

25. MOTHER'S MAIDEN NAME GONZALES

SURNAME DIGON

FIRST NAME RUTH

MIDDLE NAME SANTOS (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

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

ELEMENTARY ILOILO CENTRAL ELEMENTARY SCHOOL ELEMENTARY 1986 1992 GRADUATED 1992 N/A

SECONDARY UNIVERSITY OF ILOILO HIGH SCHOOL

VOCATIONAL /

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

TRADE
COURSE
COLLEGE UNIVERSITY OF SAN AGUSTIN COMPUTER ENGINEERING 1998 2001 UNDERGRAD N/A N/A

GRADUATE STUDIES N/A N/A N/A N/A N/A N/A N/A

(Continue on separate sheet if necessary)

SIGNATURE DATE December 21, 2023

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

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

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

2001 2004 SET-MAN CREATIVE CREATURES INC. N/A N/A N/A N

2004 2007 SET-MAN DREAM WEAVER VISUAL EXPONENT N/A N/A N/A N

2015 2019 SECURITY SUPPORT NATIONAL BUREAU OF INVESTIGATION VOLUNTEER N/A N/A N

2019 PRESENT SECURITY NATIONAL BUREAU OF INVESTIGATION 10000.00 N/A N/A N/A

XXXXXXX XXXXXXXXX XXXXXXXXXXXXX XXXXXXXXXXXXXXX XXXXXX XXXX XXXX XXXXXXX

(Continue on separate sheet if necessary)

SIGNATURE DATE December 21, 2023

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

(Continue on separate sheet if necessary)

VII. LEARNING AND DEVELOPMENT (L&D) INTERVENTIONS/TRAINING PROGRAMS ATTENDED
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

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

(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)

ELECTRICAL N/A N/A

COOKING

PLUMBING

PAINTER

(Continue on separate sheet if necessary)

SIGNATURE DATE December 21, 2023

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?
YE ✘
b. within the fourth degree (for Local Government Unit - Career Employees)? S
YE ✘
If YES,
S give details:
________________________________

35. a. Have you ever been found guilty of any administrative offense?
YE ✘
If YES, NO
S give details:
________________________________
________________________________

b. Have you been criminally charged before any court? YE ✘

If YES, NO
S 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? YE ✘
If YES, NO
S 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 YE ✘
If YES, give details: NO
out (abolition) in the public or private sector? S
________________________________
________________________________
38. a. Have you ever been a candidate in a national or local election held within the last year (except
Barangay election)? YE ✘ NO
If YES,
S give details:
b. Have you resigned from the government service during the three (3)-month period before the last YE ✘ NO
election to promote/actively campaign for a national or local candidate?
S give details:
If YES,

39. Have you acquired the status of an immigrant or permanent resident of another country?
YE ✘ NO
If YES,
S 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?
YE ✘ NO
If YES, please specify:
S
b. Are you a person with disability?
YE ✘ NO
If YES, please specify ID No:
S
c. Are you a solo parent?
YE ✘ NO
If YES, please specify ID No:
S
41. REFERENCES (Person not related by consanguinity or affinity to applicant /appointee)

NAME ADDRESS TEL. NO.

ID picture taken within
the last 6 months
ATTY. JEREMIAH D. SARGADO, CPA ILOILO CITY 9297877773 4.5 cm. X 3.5 cm
(passport size)
ATTY. ARNOLD DIAZ ILOILO CITY 9399177654
Computer generated
or photocopied picture
SI III ARISTEDES A. BANARES ILOILO CITY 9173046585 is not acceptable

42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and
complete statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the
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: TIN ID

ID/License/Passport No.: 288-317-407-000

Signature (Sign inside the box)
December 21, 2023
Date/Place of Issuance: JAN 7 2004 - QUEZON CITY
Date Accomplished Right Thumbmark

SUBSCRIBED AND SWORN to before me this , affiant exhibiting his/her validly issued government ID as indicated above.

ATTY. JEREMIAH D. SARGADO, CPA

Acting Regional Director - NBI WEVRO
Person Administering Oath

CS FORM 212 (Revised 2017), Page 4 of 4