Page 1761 - AACCUP Accreditation_AreaIV

CS Form No. 212
PERSONAL DATA SHEET
Revised 2017

WARNING: Any misinterpretation 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 SANCHEZ
NAME EXTENSION (JR., SR)
FIRST NAME LILIBETH
MIDDLE NAME LORETO
3. DATE OF BIRTH
(mm/dd/yyyy) 1/6/81 16. CITIZENSHIP Filipino Dual Citizenship
by birth by naturalization
4. PLACE OF BIRTH BRGY. TUGUEGARAO, ECHAGUE, ISABELA If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male Female
6 CIVIL STATUS Single Married 17. RESIDENTIAL ADDRESS
Widowed Separated House/Block/Lot No. Street
Other/s: TUGUEGARAO
Subdivision/Village Barangay
7. HEIGHT (m) 1.54 ECHAGUE ISABELA
City/Municipality Province
8. WEIGHT (kg) 64 ZIP CODE 3309
9. BLOOD TYPE 18. PERMANENT ADDRESS
House/Block/Lot No. Street
10. GSIS ID NO. O2003950556 TUGUEGARAO
Subdivision/Village Barangay
11. PAG-IBIG ID NO. 20137433501 ECHAGUE ISABELA
City/Municipality Province
12. PHILHEALTH NO. 60500582912 ZIP CODE 3309
13. SSS NO. 118206602 19. TELEPHONE NO. N/A

14. TIN NO. 408-295-696 20. MOBILE NO.
15. AGENCY EMPLOYEE NO. LLS010681 21. E-MAIL ADDRESS (if any) l.sanchez2013@yahoo.com.ph
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME SANCHEZ 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
FIRST NAME JOSEPH GIL NAME EXTENSION (JR., SR) 11 / 19 / 2009
KARLYLE L. SANCHEZ
MIDDLE NAME PASCUAL KARLEEN L. SANCHEZ 12/04/2014
OCCUPATION Area Supervisor
EMPLOYER/BUSINESS NAME iRekrut Manpower Agency
BUSINESS ADDRESS 4th floor Casman Building 1198, Quezon Avenue, Quezon City
TELEPHONE NO. (02)4154871
24. FATHER'S SURNAME LORETO

FIRST NAME WINIFREDO SR.
MIDDLE NAME MAGTURO
25. MOTHER'S MAIDEN NAME
SURNAME LIGGAYU
FIRST NAME TERESITA
MIDDLE NAME GAMMAD (Continue on separate sheet if necessary)
III. EDUCATIONAL BACKGROUND
HIGHEST SCHOLARSHIP/
26. NAME OF SCHOOL LEVEL/ ACADEMIC
PERIOD OF ATTENDANCE

ON
I
AT
/
R
EG
D
C
SI
BA

C
U
ED

C
/
EE
OU
SE
R
YEAR
LEVEL UNITS
(Write in full) (Write in full) GRADUATED HONORS
EARNED
From To (if not RECEIVED
TUGUEGARAO - STO DOMINGO ELEMENTARY
ELEMENTARY ELEMENTARY Jun-05 1993 1993
SCHOOL
SECONDARY SCHOOL OF ST. JOSEPH THE WORKER SECONDARY 1993 1997 1997