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 LUMANDAS
NAME EXTENSION (JR., SR)
FIRST NAME YA-EL

MIDDLE NAME JULIAN

3. DATE OF BIRTH
(mm/dd/yyyy) 8/19/1977 16. CITIZENSHIP ✘ Filipino Dual Citizenship
✘ by birth by naturalization
4. PLACE OF BIRTH Cardona, Rizal If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male ✘ Female

6 CIVIL STATUS Single ✘ Married 17. RESIDENTIAL ADDRESS 1907 Pasay St.,
Widowed Separated House/Block/Lot No. Street
Del Remedio
Other/s:
Subdivision/Village Barangay
Cardona Rizal
7. HEIGHT (m) 5'6
City/Municipality Province
8. WEIGHT (kg) 80kg ZIP CODE 1950

18. PERMANENT ADDRESS 1907 Pasay St.,

9. BLOOD TYPE A+
House/Block/Lot No. Street
Del Remedio
10. GSIS ID NO.
Subdivision/Village Barangay
Cardona Rizal
11. PAG-IBIG ID NO.
City/Municipality Province

12. PHILHEALTH NO. 19-025670984-1 ZIP CODE 1950

13. SSS NO. 19. TELEPHONE NO.

14. TIN NO. 259-624-209 20. MOBILE NO. 09776340027

15. AGENCY EMPLOYEE NO. 21. E-MAIL ADDRESS (if any) [email protected]
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME LUMANDAS 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
NAME EXTENSION (JR., SR) YAEL ALESSANDRA J. LUMANDAS
FIRST NAME ALEX 6/1/2005

MIDDLE NAME SALES

OCCUPATION OFW

EMPLOYER/BUSINESS NAME CUMMINS SAUDI ARABIA

BUSINESS ADDRESS SAUDI ARABIA RIYADH

TELEPHONE NO.

24. FATHER'S SURNAME JULIAN

JR
FIRST NAME MANUEL

MIDDLE NAME OCAMPO

25. MOTHER'S MAIDEN NAME GATCHALIAN

SURNAME CATALINA

FIRST NAME ANSELMO

MIDDLE NAME (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
(Write in full) HONORS
full) (if not graduated) RECEIVED
From To

ELEMENTARY MARIANO C. SAN JUAN ELEM. SCHOOL 1984 1990 1990

VOCATIONAL
SECONDARY / SAN FRANCISCO PARISH SCHOOL 1990 1994 1994

TOMAS CLAUDIO MEMORIAL COLLEGE COMPUTER SECRETARIAL 1996

TRADE
COLLEGE
COURSE TOMAS CLAUDIO MEMORIAL COLLEGE BS- COMPUTER SCIENCE 2000

GRADUATE STUDIES

(Continue on separate sheet if necessary)

SIGNATURE DATE January 4, 2022

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

(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)
4/3/1999 5/13/1999 PRACTICUM MERALCO 5,000

8/10/2001 8/7/2004 OFW ASUSTEK (Taipe, Taiwan) NT 15,840

(Continue on separate sheet if necessary)

SIGNATURE DATE January 04, 2022

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) Supervisory/ (Write in full)
(mm/dd/yyyy)
Technical/etc)
From To

GET YOUR BUSINESS ON THE GO! WEBINAR 10/27/2021

VIA ZOOM APP

BUSINESS REGISTRATION COMPLIANCE 11/5/2021

BUSINESS NAME REGISTRATION RETOOLING 11/28/2021

CONTENT MANAGEMENT & VISUAL COMMUNICATION 9/28/2021

ONLINE NEGOSYO CENTER ZOOMINAR 5/27/2021

SKILLS TRAINING ON BAMBOO HANDICRAFTD MAKING 9/17/2021

QUEZON BAMBOO DAY CELEBRATION ACTIVITIES :SUCCESS STORIES ON BAMBOO

9/17/2021
BUSINESS ENTERPRISES WEBINAR

FINANCIAL LITERACY AND FINANCIAL DISCIPLINE 12/3/2021

BUSINESS MODEL CANVASS 12/7/2021

B.O.S.S( BUSINESS OPPORTUNITIES FOR SARI-SARI STORE) OWNERS WITH HALPINOY 8/6/2020 5 HRS
VIA ZOOM APP

EBPLS ONLINE USER'S TRAINING FOR LGU CARDONA 10/8/2020 10/9/2020 8 HRS
VIA GOOGLE MEET

ONLINE ROLL-OUT OF EODB SYSTEM 11/25/2020 5 HRS

UNDER DILG REGION IV-A

INCOME OPPORTUNITY SEMINAR 'BAKING DEMONSTRATION FOR MSME'S 7/18/2019 5 HRS

PURATOS PHILIPPINES INC.

SEMINAR ON PUTTING YOUR BUSINESS ONLINE 8/23/2019 5 HRS

NC CARDONA

BNRS NEXTGEN RETOOLING SEMINAR 11/25/2019 5 HRS

NC CARDONA

SSF COOPERATOR'S SUMMIT 12/17/2019 12/18/2019 8 HRS

DTI RIZAL

(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 in
(Write in full)
full)

(Continue on separate sheet if necessary)

SIGNATURE DATE January 04, 2022

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? ________________________________
________________________________
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
BRO. FRANCIS A. SANTIAGO CARDONA, RIZAL 3.5 cm. X 4.5 cm
(passport size)

NELDA B. ANIANA CARDONA, RIZAL With full and handwritten

name tag and signature over
printed name

Computer generated
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and or photocopied picture
is not acceptable
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 PHOTO
administrative/criminal case/s 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: Driver's License

ID/License/Passport No.: D19-13-004701

Signature (Sign inside the box)

Date/Place of Issuance: 8/19/2024

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