National Headquarters Philippine National Police

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Republic of the Philippines

Department of the Interior and Local Government


NATIONAL POLICE COMMISSION
NATIONAL HEADQUARTERS PHILIPPINE NATIONAL POLICE
Camp Crame, Quezon City

PNP Badge No.

POLICE PERSONNEL FILE


T I N:

Phil Health No.

WARNING:

The correctness of all statements or entries made herein is subject to verification and any deliberate
correction and distortion of information may give sufficient cause for investigation.

Date Accomplished: _____________________________

I. GENERAL INFORMATION
1. NAME ( Last Name First Name Middle Name Qualifier)

2. RANK 3. UNIT/STATION-NSU / PRO / NHQ

4. HOME ADDRESS ( House No. / Street / City / Province )

5. PLACE OF BIRTH 6. DATE OF BIRTH

7. SEX 8. CIVIL STATUS 9. RELIGION

12. COLOR OF HAIR 12. COLOR OF EYES 12. HEIGHT (cm) 13. WEIGHT (kg)

13. BLOOD TYPE 15. BUILD 16. COMPLEXION

17. LANGUAGES 18. IDENTIFYING MARKS 19. ETHNIC GROUP

20. NAME OF SPOUSE OR NEAREST KIN/ADDRESS 21. OCCUPATION

22. DEPENDENTS

NAME DATE OF BIRTH RELATIONSHIP ADDRESS

23. HOUSING DATA


( ) OWN HOUSE & LOT ( ) RENT HOUSE ( ) OCCUPYING GOV’T QTRS
( ) OWN HOUSE ONLY ( ) RENT ROOM ( ) OTHERS (Specify)

____________________________
Signature
II. APPOINTMENT AND EXPERIENCE/TIG DATA

EFFECTIVE DATE OF APPOINTMENT OF EFFECTIVE DATE OF PROMOTIONS OF PREVIOUS


PREVIOUS RANK BY CSC RANK PER PNP SO/GO
STATUS DATE STATUS DATE AUTHORITY
TEMPORARY TEMPORARY _________ ________________
______________________ PERMANENT __________ _____________________

PERMANENT
______________________
EFFECTIVE DATE OF APPOINTMENT OF EFFECTIVE DATE OF PROMOTION OF PRESENT RANK
PRESENT RANK BY CSC PER PNP SO/GO
STATUS DATE STATUS DATE AUTHORITY
TEMPORARY TEMPORARY _________ ________________
______________________ PERMANENT _________ _______________________

PERMANENT _____________________
IF PRESENT RANK PASSED TEMPORARY, STATE DATE SATISFIED THE DEFICIENCY:
REASON
( ) Eligibility ( ) TIG DEFICIENCY: __________________ (specify)
( ) Training ( ) Others MONTH/YEAR: __________________
FOR POLICE COMMISSIONED OFFICERS ONLY

SOURCE OF COMMISSION/ENTRY TO THE PNP YEAR YEAR


( ) AFP Regular ( ) AFP Reserve ( ) SPO4-PINSP PROM ______ ( ) PMA ______
( ) CIS ( ) INP ( ) NAPOLCOM ( ) Lateral Entry ____ ( ) PNPA______

III. EDUCATIONAL BACKGROUND


NAME OF DEGREE HONORS
LEVEL SCHOOL LOCATION YEAR COMPLETED/UNITS RECEIVED
ELEMENTARY
HIGH SCHOOL

COLLEGE
POST
GRADUATE

IV. POLICE/MILITARY TRAINING CAREER COURSES


CLASS STANDING
COURSE SCHOOL/LOCATION INCLUSIVE DATE TRAINING HONORS
TAKEN HOURS RECEIVED
PSSLC
PSJLC
PSBRC

V. NAPOLCOM/CIVIL SERVICE/PRC ELIGIBILITIES


TITLE OF EXAMINATION DATE TAKEN WHERE TAKEN RATING OBTAINED

________________________________
Signature

VI. PERFORMANCE EVALUATION RATING


(Immediately preceding two (2) semesters)
RATING PERIOD RATING RATER

VII. PHYSICAL FITNESS TEST RATING


(Immediately preceding two (2) semesters)
FITNESS PERIOD RATING CONDUCTED BY

VIII. STATEMENT OF ASSETS & LIABILITIES, NETWORTH


(Immediately preceding three (3) Fiscal years)
THIS WILL BE COMPARED TO THE SUBMITTED SALNs AND VERIFIED BY RMD,DPRM.)
FISCAL YEAR TOTAL ASSETS TOTAL LIABILITIES NET WORTH

IX. INDIVIDUAL INCOME TAX RECORDS


(Immediately preceding three(3) Fiscal Years)
FISCAL YEAR GROSS INCOME TAXABLE INCOME INCOME TAX PAID

X. OFFENSE DATA
OFFENSE COMMITTED AS CHARGED TYPE OF CHARGE STATUS/DISPOSITTION
(State whether Administrative or Criminal) (Principal or What) ((Exonerated, etc.,-
Penalty)

XI. DATA ON PREVIOUS RETIREMENT/DISMISSAL/SUSPENSION

Have you ever been retired, dismissed, forced to resign or suspended from any employment for
reasons other than lack of funds?
Have you ever been a candidate in a national or local election (including barangay election)
POSITION PLACE DATE

XII. PHYSICAL AND MEDICAL RECORD


DATE OF LAST PHY/MED EXAM: WHERE TAKEN –
DATE OF LAST DENTAL EXAM WHERE TAKEN -
DATE OF LAST NP EXAM WHERE TAKEN -
DATE OF LAST DRUG TEST WHERE TAKEN –
DATE OF LAST PHY FITNESS TEST WHERE TAKEN –

______________________________
Signature
XIII. POLICE/MILITARY MAJOR DESIGNATIONS
(FOR PCOs, AS PLTN LDR, COP,BN/CPS/CPO/PPO/PRO/SNU STAFF/MG COMDR,CD/PD)
POSITION DESIGNATION UNIT INCLUSIVE DATES

XIV. PROMOTION RECORDS

OLD RANK NEW RANK EFF DATE PROM STATUS AUTHORITY

XV. OTHER COURSES/TRAININGS/SEMINARS (IN PRESENT RANK)

INCLUSIVE TRAINING
TITLE CONDUCTED BY PLACE
DATES HOURS

XVI. FIREARMS RECORD


LICENSE NO. KIND MAKE CALIBER AMMO ISSUING UNIT

____________________________
Signature
XVII. AWARDS AND RECOGNITIONS RECEIVED (IN PRESENT RANK)

INDIVIDUAL MEDALS/RIBBONS
NATURE OF AWARD DATE AWARDED AUTHORITY

INDIVIDUAL AND UNIT CITATION BADGE

INDIVIDUAL AND UNIT AWARDS/STREAMERS

LETTERS OF COMMEMDATIONS/PALQUES/CERTIFICATES OF
APPRECIATION/COMMENDATIONS/MERITS (NOT YET CONVERTED TO PNP MEDALS)

ACADEMIC AWARDS
NATURE OF AWARD DATE INSTITUTION

____________________________
Signature
XVIII. CERTIFICATION

THIS IS TO CERTIFY that the answers given above are true and correct to the best of my knowledge
and belief.

I COMMIT MYSELF TO BE LIABLE for perjury and/or dishonesty as result of any false,
misrepresentation or omission in this Personal Data Sheet.

Community Tax Certificate #:_______________


Issued on: ___________________
Issued at: ___________________

LEFT RIGHT
THUMBMARK

SUBSCRIBED AND SWORN TO before me this ______________________________at


___________________________________________________________, Philippines

_____________________________________
(Administering Officer)

NHQ/NSU/PRO
Official seal

Not valid without Notarial Seal

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