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 Amoc
FIRST NAME Djon Scottie NAME EXTENSION (JR., SR)

MIDDLE NAME Cinco

3. DATE OF BIRTH
(mm/dd/yyyy)
05/08/1993 16. CITIZENSHIP Filipino Dual Citizenship
by birth by naturalization
4. PLACE OF BIRTH Butuan City If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male Female

Single Married 17. RESIDENTIAL ADDRESS 3108 Phase 1 St. Michael st.
6 CIVIL STATUS
Widowed Separated House/Block/Lot No. Street
National Housing Authority Brgy. Kauswagan
Other/s:
Subdivision/Village Barangay
Cagayan de Oro City Misamis Oriental
7. HEIGHT (m) 1.73 M
City/Municipality Province
8. WEIGHT (kg) 71kg ZIP CODE 1004

18. PERMANENT ADDRESS 349 Veterans St.

9. BLOOD TYPE A+
House/Block/Lot No. Street
Barangay Diego Silang Brgy. 6
10. GSIS ID NO. N/A
Subdivision/Village Barangay
Butuan City CARAGA Region
11. PAG-IBIG ID NO. 121085722966
City/Municipality Province

12. PHILHEALTH NO. 180251752808 ZIP CODE 8600

13. SSS NO. 3437648058 19. TELEPHONE NO. N/A

14. TIN NO. 314094805 20. MOBILE NO. 09457030746

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

II. FAMILY BACKGROUND

22. SPOUSE'S SURNAME N/A 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
NAME EXTENSION (JR., SR)
FIRST NAME N/A N/A N/A

MIDDLE NAME N/A

OCCUPATION N/A

EMPLOYER/BUSINESS NAME N/A

BUSINESS ADDRESS N/A

TELEPHONE NO. N/A

24. FATHER'S SURNAME Amoc

NAME EXTENSION (JR., SR)
FIRST NAME Raul
MIDDLE NAME Operiano
25. MOTHER'S MAIDEN NAME

SURNAME Cinco
FIRST NAME Zenaida
MIDDLE NAME Mata (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

26. PERIOD OF ATTENDANCE HIGHEST LEVEL/ SCHOLARSHIP/

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

ELEMENTARY Butuan Central Elementary School Primary Education 2000 2006 2006

SECONDARY Agusan National High School Secondary Education 2006 2010 2010 N/A

VOCATIONAL /
TRADE COURSE
N/A N/A

Bachelor of Science in Business

COLLEGE Far Eastern University Administration Major in Business 2012 2017 2017 N/A
Economics
College of Law - Lyceum of the
GRADUATE STUDIES Juris Doctor 2019 Present N/A N/A
Philippines
(Continue on separate sheet if necessary)

SIGNATURE DATE
CS FORM 212 (Revised 2017), Page 1 of 4
IV. CIVIL SERVICE ELIGIBILITY
27. CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER SPECIAL DATE OF LICENSE (if applicable)
RATING
LAWS/ CES/ CSEE EXAMINATION / PLACE OF EXAMINATION / CONFERMENT Date of
(If Applicable) NUMBER
BARANGAY ELIGIBILITY / DRIVER'S LICENSE CONFERMENT Validity

Career Service Professional Examination 81% March 18, 2018 Quezon City

(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.
INCLUSIVE DATES SALARY/ JOB/ PAY
28.
GRADE (if
(mm/dd/yyyy) POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY STATUS OF GOV'T SERVICE
MONTHLY SALARY applicable)& STEP
(Write in full/Do not abbreviate) (Write in full/Do not abbreviate) (Format "00-0")/ APPOINTMENT (Y/ N)
From To INCREMENT

Co-founder/Business Development
4/20/20 Present Homegrown Digital Advertising N/A N/A Regular N
Head

1/31/2020 Present Business Development Head AgriKulturashop.online/Sprout Lab N/A N/A Regular N
Risk and Operation
03/02/2019 1/16/2020 Research Officer Department/Acudeen Technologies 22,000.00 N/A Regular N
Inc
Investor Relation and Business
09/13/2018 03/02/2019 Investor Relation Officer Development Department/Acudeen 20,000.00 N/A Regular N
Technologies Inc
Business Development and
01/22/2018 06/21/2018 Operation Analyst Operations Department/Seven Seas 20,000.00 N/A Regular N
Properties Corp
Associate Financial Services Operation Department/E*Trade
08/11/2017 12/23/2017 20,000.00 N/A Probation N
Representative Securities

(Continue on separate sheet if necessary)

SIGNATURE DATE
CS FORM 212 (Revised 2017), Page 2 of 4
VI. VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S
NAME & ADDRESS OF ORGANIZATION INCLUSIVE DATES
29.
(Write in full) (mm/dd/yyyy) NUMBER OF HOURS POSITION / NATURE OF WORK
From To

N/A

(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 Type of LD

30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS ATTENDANCE ( Managerial/ CONDUCTED/ SPONSORED BY
NUMBER OF HOURS
(Write in full) (mm/dd/yyyy) Supervisory/ (Write in full)
Technical/etc)
From To

HP LIFE e-Learning Course on "IT for Business Success" 05/07/2019 05/07/2019 1 Technical HP Life Program

HP LIFE e-Learning Course on "Profit and Loss" 05/07/2019 05/07/2019 1 Technical HP Life Program

HP Life e-Learning Course on "Social Entrepreneurship" 05/07/2019 05/07/2019 1 Technical HP Life Program

HP Life e-Learning Course on "Strategic Planning" 05/07/2019 05/07/2019 1 Technical HP Life Program

HP LIFE e-Learning Course on "Finding Funding" 05/06/2019 05/06/2019 1 Technical HP Life Program

Securities Industry Essentials Examination (SIE) 01/03/2018 01/03/2018 4 Technical E*TRADE Securities/FINRA

General Securities Representative Examination/ FINRA Series 7 11/06/2017 11/06/2017 4 Technical E*TRADE Securities/FINRA

Bloomberg Professional Service Training Program 04/08/2019 04/10/2019 24 Technical

Bloomberg, LP - Singapore

Bloomberg Forex and Economics Training 04/04/2017 04/07/2017 8 Technical

Bloomberg, LP - Singapore

Bloomberg News and Analytics Training 04/04/2017 04/07/2017 8 Technical

Bloomberg, LP - Singapore

Bloomberg Equities and Stock Market Training 04/04/2017 04/07/2017 8 Technical

Bloomberg, LP - Singapore
Bloomberg Commodity Trading Training 04/04/2017 04/07/2017 6 Technical
Bloomberg, LP - Singapore
Advance Technical Analysis Training 04/04/2017 04/07/2017 6 Technical
Bloomberg, LP - Singapore
Fundamentals of Practical Investing 04/04/2017 04/04/2017 2 Technical Vision One, Singapore

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

MEMBERSHIP IN
NON-ACADEMIC DISTINCTIONS / RECOGNITION
31. SPECIAL SKILLS and HOBBIES 32. 33. ASSOCIATION/ORGANIZATION
(Write in full)
(Write in full)
Hacktivist Summit Finalist (Bloomberg Mayor Hack the City Challenge)
Entries:Butuan Medical Express and ButuanOn Utility App
Sports (Football and Chess) Alpha Phi Omega
Almont Inland Resort, Butuan City
March 5, 2021
Resource Speaker during DTI MSME - Online Market Matching
Butuan Agusan Norte Football
Agricultural E-commerce Management DTI Training Room, Rudy Tiu Bldg. II, Butuan City
Association
August 4, 2020
Traveling Lions Football Club

Mountain Climbing Financial Market Professionals

Gardening/Farming FEU Economics Society

Stock Trading (Technical Analysis)

Reading Economic and Corporate News

(Continue on separate sheet if necessary)

SIGNATURE DATE
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 by any court or tribunal? YES NO
If YES, give details:
________________________________

37. Have you ever been separated from the service in any of the following modes: resignation, retirement, dropped from the rolls, YES NO
dismissal, termination, end of term, finished contract or phased out (abolition) in the public or private sector? If YES, give details:
Resignation - Career Shift and Personal Development

38. a. Have you ever been a candidate in a national or local election held within the last year (except Barangay election)? YES NO
If YES, give details:
b. Have you resigned from the government service during the three (3)-month period before the last election to YES NO
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
Genesis Tabla Butuan City, CARAGA 639177055543 3.5 cm. X 4.5 cm
(passport size)
Bryan Glenn Yu Butuan City, CARAGA 639958950420 With full and handwritten
name tag and signature over
Jhon Paul Quinal Butuan City, CARAGA 639272677689 printed name

Computer generated
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and complete statement pursuant to or photocopied picture
the provisions of pertinent laws, rules and regulations of the Republic of the Philippines. I authorize the agency head/authorized representative is not acceptable

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: Passport
ID/License/Passport No.: P1404913A Signature (Sign inside the box)

Date/Place of Issuance: December 26, 2016 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