CS Form No.

212
Revised 2018
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 Tutin
NAME EXTENSION (JR., SR) N/A
FIRST NAME Sahara

MIDDLE NAME Ayao

3. DATE OF BIRTH
16. CITIZENSHIP
(mm/dd/yyyy) 6/26/1974

4. PLACE OF BIRTH Datu Odin Sinsuat, Maguindanao If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Female

17. RESIDENTIAL ADDRESS

6 CIVIL STATUS Married
House/Block/Lot No. Street
Making
Subdivision/Village Barangay

7. HEIGHT (m) 1.63 Parang Maguindanao

City/Municipality Province
8. WEIGHT (kg) ZIP CODE 9604
18. PERMANENT ADDRESS
9. BLOOD TYPE "A"
House/Block/Lot No. Street

10. GSIS ID NO. N/A Poblacion 8

Subdivision/Village Barangay

11. PAG-IBIG ID NO. 91-4256005773 Midsayap North Cotabato

City/Municipality Province

12. PHILHEALTH NO. 17-050355967-9 ZIP CODE 9410

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

14. TIN NO. 463-278-908 20. MOBILE NO. 09064606781/09072203300

15. AGENCY EMPLOYEE NO. 284987 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 Estanda

NAME EXTENSION (JR., SR)
FIRST NAME Alex SR.
MIDDLE NAME Pareño

25. MOTHER'S MAIDEN NAME

SURNAME Canaway

FIRST NAME Zoila

MIDDLE NAME Cabalfin (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

NAME OF SCHOOL BASIC EDUCATION/DEGREE/COURSE HIGHEST LEVEL/ SCHOLARSHIP
26. PERIOD OF ATTENDANCE YEAR
UNITS / ACADEMIC
LEVEL (Write in (Write in full) EARNED
GRADUATED
HONORS
full) (if not graduated) RECEIVED
From To
ELEMENTARY Lt. Andres Calungsud Elementary School Primary Education 1999 2005 N/A 2005 N/A

SECONDARY
VOCATIONAL / Villarica High School High School 2005 2009 N/A 2009 N/A

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

TRADE
COURSE
COLLEGE i-Link College of Science and Technology Bachelor of Science in Criminology 2009 2013 N/A 2013 N/A

GRADUATE STUDIES N/A N/A N/A N/A N/A N/A N/A

(Continue on separate sheet if necessary)

SIGNATURE DATE 7/26/2019

CS FORM 212 (Revised 2018), 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
University of Mindanao Matina Davao
Criminology Board Exam 82.95 04/1/2014
City
0098956 04/12/2021

(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) STATUS OF
(Write in full/Do not MONTHLY SALARY applicable)& STEP
APPOINTMENT
(Format "00-0")/
abbreviate) (Write in full/Do not abbreviate) INCREMENT
From To
(Y/ N)

01/01/2018 Present Patrolman Philippine National Police 29,668.00 10-0 Permanent Y

11/02/15 12/31/17 Patrolman Philippine National Police 14,834.00 10-0 Permanent Y

06/13/14 11/01/15 Patrolman Philippine National Police 14,834.00 10-0 Temporary Y

 (Continue on separate sheet if necessary)

SIGNATURE DATE July 26, 2019

CS FORM 212 (Revised 2018), 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

i-Link College of Science and Technology 06/01/14 03/30/16 N/A Criminology Instructor

(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
Autonomous Region and Muslim
Public Safety Basic Recruit Course 07/04/16 01/16/2017 960 Basic
Mindanao Training Center

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

MEMBERSHIP IN
NON-ACADEMIC DISTINCTIONS / RECOGNITION ASSOCIATION/ORGANIZATION
31. SPECIAL SKILLS and HOBBIES 32. 33.
(Write in full) (Write in
full)
Profissional Criminology Association of the
Computer Literate Medalya ng Papuri-7 Philippines
 (Continue on separate sheet if necessary)

SIGNATURE DATE July 26, 2019

CS FORM 212 (Revised 2018), 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?
b. within the fourth degree (for Local Government Unit - Career Employees)?
If YES, give details:
________________________________

35. a. Have you ever been found guilty of any administrative offense?
If YES, give details:
________________________________
________________________________
b. Have you been criminally charged before any court?
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?
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, dismissal, termination, end of term, finished contract or phased If YES, give details:
out (abolition) in the public or private sector? Resignation in i-Link College
of Science and Technology
38. a. Have you ever been a candidate in a national or local election held within the last year (except
Barangay election)?
If YES, give details:
b. Have you resigned from the government service during the three (3)-month period before the last
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?
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?
If YES, please specify:
b. Are you a person with disability?
If YES, please specify ID No:
c. Are you a solo parent?
If YES, please specify ID No:

41. REFERENCES (Person not related by consanguinity or affinity to applicant /appointee)

ID picture taken within
NAME ADDRESS TEL. NO. the last 6 months
3.5 cm. X 4.5 cm
PCPT YAZID S ABDULLA Parang, Maguindanao 09157030560 (passport size)

PCPT STEPHEN C BONIBA Parang, Maguindanao 09751250791 With full and handwritten
name tag and signature over
PLT CRISANTO I MANGUBAT Midayap, North Cotabato 09393488911 printed name

42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and Computer generated
or photocopied picture
complete statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the is not acceptable
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: PNP ID
ID/License/Passport No.: 17F020553 Signature (Sign inside the box)
 July 26, 2019
Date/Place of Issuance: June 2, 2017 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 2018), Page 4 of 4