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 DESO-ASIDO

FIRST NAME PAUL JULIUS N/A

MIDDLE NAME LICARDO

3. DATE OF BIRTH
16. CITIZENSHIP
(mm/dd/yyyy) 07 / 15 / 1992 ✘ Filipino Dual Citizenship
✘ by birth by naturalization
4. PLACE OF BIRTH LIDE HOSPITAL If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX ✘ Male Female

6 CIVIL STATUS Single ✘ Married 17. RESIDENTIAL ADDRESS 475 SIMANGAN

Widowed Separated House/Block/Lot No. Street
N/A STO. NINO
Other/s:
Subdivision/Village Barangay
7. HEIGHT (m) 5' 3'' ISABEL LEYTE
City/Municipality Province
8. WEIGHT (kg) 57 KG ZIP CODE 06539

9. BLOOD TYPE O+
18. PERMANENT ADDRESS 475 SIMANGAN
House/Block/Lot No. Street

10. GSIS ID NO. 2005-792-619 N/A STO.NINO

Subdivision/Village Barangay

11. PAG-IBIG ID NO. 121-261-6689-76 ISABEL LEYTE

City/Municipality Province

12. PHILHEALTH NO. 130252054902 ZIP CODE 06539

13. SSS NO. 345-621-7114 19. TELEPHONE NO. n/a

14. TIN NO. 325-467-596 20. MOBILE NO. 09473973242

15. AGENCY EMPLOYEE NO. VIJ 289 21. E-MAIL ADDRESS (if any) [email protected]
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME CAÑETE 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)

FIRST NAME KEOMARIE N/A DAVID C. DESO-ASIDO AUGUST 5,2017

MIDDLE NAME AÑES
OCCUPATION PURCHASER
EMPLOYER/BUSINESS NAME PASAR
BUSINESS ADDRESS LIBERTAD, ISABEL LEYTE
TELEPHONE NO. N/A
24. FATHER'S SURNAME DESO-ASIDO
FIRST NAME PABLO JR
MIDDLE NAME INTE
25. MOTHER'S MAIDEN NAME AMELIA
SURNAME LICARDO
FIRST NAME AMELIA
MIDDLE NAME DURIA (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

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

ELEMENTARY ISABEL CENTRAL SCHOOL PRIMARY JUNE 1997 MARCH 2001 GRADUATED 2001 1ST HONOR

VOCATIONAL
SECONDARY / EAST VISAYAN ADVENTIST ACADEMY SECONDARY JUNE 2001 MARCH 2005 GRADUATED 2005 DEANS LIST

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

TRADE BACHELOR OF SCIENCE IN
COLLEGE
COURSE CEBU INSTITUTE OF TECHNOLOGY - UNIVERSITY
CIVIL ENGINEERING
JUNE 2005 APRIL 2014 GRADUATED 2014 N/A

EASTERN VISAYAS STATE

GRADUATE STUDIES
UNIVERSITY
MASTER OF CIVIL ENGINEERING Aug-20 PRESENT 9 units N/A N/A

(Continue on separate sheet if necessary)

SIGNATURE DATE 04/22 /2021 CS FORM 212 (Revised 2017), Page 1 of 4

IV. CIVIL SERVICE ELIGIBILITY
27. CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER DATE OF LICENSE (if applicable)
RATING
SPECIAL LAWS/ CES/ CSEE EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
(If Applicable) NUMBER Date of
BARANGAY ELIGIBILITY / DRIVER'S LICENSE CONFERMENT
Validity

PRC CIVIL ENGINEER LICENSE 0.7 5/12/2015 CEBU CITY 0134675 7/15/2020

DRIVER'S LICENSE PASS 12/14/2018 ORMOC CITY HO3-18-00024 7/15/2022

(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
POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY GRADE (if
(mm/dd/yyyy) MONTHLY STATUS OF
(Write in full/Do not (Write in SALARY
applicable)& STEP
APPOINTMENT
(Format "00-0")/
abbreviate) full/Do not abbreviate) INCREMENT
From To
(Y/ N)
INSTRUCTOR 1 TEMPORARY/
4/22/2021 PRESENT VISAYAS STATE UNIVERSITY - ISABEL 24495.00 N/A SUBSTITUTE
Y
INSTRUCTOR 1 TEMPORARY/
1/1/2021 02/28/2021 VISAYAS STATE UNIVERSITY - ISABEL 24495.00 N/A SUBSTITUTE
Y

INSTRUCTOR 1
08/19/2019 12/31/2020 VISAYAS STATE UNIVERSITY - ISABEL 24495.00 N/A CONTRACTUAL Y

PART-TIME INSTRUCTOR
01/13/2019 05/30/2020 VISAYAS STATE UNIVERSITY - ISABEL 156 PER HR. N/A JOB ORDER Y

INSTRUCTOR 1
08/22/2019 12/31/2019 VISAYAS STATE UNIVERSITY - ISABEL 24495.00 N/A CONTRACTUAL Y
PROJECT ENGINEER
1/8/2018 2/15/2019 WARSKY VENTURES INCORPORATED 26000.00 N/A CONTRACTUAL N
SITE ENGINEER
10/9/2017 2/6/2018 D' CHENG CONSTRUCTION 25000.00 N/A CONTRACTUAL N
QA/QC ENGINEER IN CHARGE
5/6/2017 8/25/2018 POWER DIMENSION INCORPORATED 24000.00 N/A CONTRACTUAL N
PROJECT ENGINEER OPTIMUS ENGINEERING AND
9/2/2017 06/15/2017 23000.00 N/A CONTRACTUAL N
CONSTRUCTION
OFFICE ENGINEER
2/5/2015 11/28/2015 CM PANCHO CONSTRUCTION 22000.00 N/A CONTRACTUAL N
(MAY 2015- NOVEMBER 2015)
FIELD ENGINEER
04/25/2014 04/25/2015 JAM ENGINEERING AND SERVICES 15000.00 N/A JOB ORDER N

(Continue on separate sheet if necessary)

SIGNATURE DATE 04/ 22 / 2021 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

(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/ SPONSORED BY
NUMBER OF HOURS
(Write in full) (mm/dd/yyyy) Supervisory/ (Write in full)
Technical/etc)
From To

CAPABILITY BUILDING ON LAND USE DEVELOPMENT AND INFRASTRUCTURE PLANNING 12/9/2019 12/13/2019 40 technical VSU MAIN- BAYBAY, LEYTE

VSUCC BASIC COOPERATIVE COURSE SEMINAR 11/16/2019 11/16/2019 8 technical VSU MAIN- BAYBAY, LEYTE

Title: Outstanding per Teaching Performance Evaluation by Students (TPES) 9/30/2020 9/30/2021 8 technical VSU MAIN- ISABEL CAMPUS, LEYTE

Certificate of Passing Civil Engineering Board Exam 3/2/2016 3/3/2016 8 technical CEBU,CITY

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

MEMBERSHIP IN ASSOCIATION/ORGANIZATION
NON-ACADEMIC DISTINCTIONS / RECOGNITION
31. SPECIAL SKILLS and HOBBIES 32. 33. (Write
(Write in full)
in full)

biking n/a

autocad

painting

(Continue on separate sheet if necessary)

SIGNATURE DATE 04 / 22 / 2021 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 ✘ 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? ________________________________
Finished Contract
________________________________
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
ALBERTO S. PASANA PALOMPON, LEYTE 9275915290 3.5 cm. X 4.5 cm
(passport size)

DARRY MHEI L. MORALES ISABEL, LEYTE 9061077471 With full and handwritten
name tag and signature over
printed name
RICHARD C. ABALLE ISABEL, LEYTE 9157598112
Computer generated
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and complete or photocopied picture
is not acceptable
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 PHOTO
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: PRC ID

ID/License/Passport No.: 0134675

Signature (Sign inside the box)
04/ 22 / 2021
Date/Place of Issuance: 12/15/2014-Ormoc
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