CS Form No. 212
PERSONAL DATA SHEET
Revised 2017
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
BELVESTRE
2. SURNAME
FIRST NAME
ROCHELL
MIDDLE NAME
BITONG
3. DATE OF BIRTH
(mm/dd/yyyy)
NAME EXTENSION (JR., SR)
N/A
OCTOBER 21, 1993
16. CITIZENSHIP
Filipino
Dual Citizenship
by birth
5. SEX
Male
Female
6 CIVIL STATUS
Single
Married
Widowed
Separated
please indicate the details.
17. RESIDENTIAL ADDRESS
Other/s:
7. HEIGHT (m)
1.62m
8. WEIGHT (kg)
58kg
ZIP CODE
House/Block/Lot No.
Street
San Sebastian
Subdivision/Village
Samboan
Barangay
Cebu
City/Municipality
Province
6027
18. PERMANENT ADDRESS
O+
9. BLOOD TYPE
Pls. indicate country:
If holder of dual citizenship,
4. PLACE OF BIRTH
by naturalization
House/Block/Lot No.
10. GSIS ID NO.
N/A
11. PAG-IBIG ID NO.
1211-3111-7758
12. PHILHEALTH NO.
1202-5403-7694
13. SSS NO.
14. TIN NO.
Street
Mangaco
Subdivision/Village
Ginatilan
Barangay
Cebu
City/Municipality
Province
ZIP CODE
6026
06-3605138-4
19. TELEPHONE NO.
N/A
319-821-257-000
20. MOBILE NO.
0956 556 1105
21. E-MAIL ADDRESS (if any)
Rochellbelvestre21@gmail.com
15. AGENCY EMPLOYEE NO.
II. FAMILY BACKGROUND
23. NAME of CHILDREN (Write full name and list all)
22. SPOUSE'S SURNAME
NAME EXTENSION (JR., SR)
FIRST NAME
DATE OF BIRTH (mm/dd/yyyy)
Matthew Lei V. Belvestre
June 21, 2016
MIDDLE NAME
OCCUPATION
EMPLOYER/BUSINESS NAME
BUSINESS ADDRESS
TELEPHONE NO.
24. FATHER'S SURNAME
Belvestre
FIRST NAME
Leonardo
MIDDLE NAME
Gorrero
25. MOTHER'S MAIDEN NAME
NAME EXTENSION (JR., SR)
Bitong
SURNAME
Belvestre
FIRST NAME
Narcisa
MIDDLE NAME
Damuag
(Continue on separate sheet if necessary)
III. EDUCATIONAL BACKGROUND
26.
NAME OF SCHOOL
(Write in full)
LEVEL
PERIOD OF ATTENDANCE
BASIC EDUCATION/DEGREE/COURSE
(Write in full)
From
To
HIGHEST
LEVEL/
UNITS
EARNED
(if not
YEAR
GRADUATED
ELEMENTARY
Mangaco Elementary School
2000
2006
2006
SECONDARY
Holy Trinity College
2006
2010
2010
VOCATIONAL /
TRADE COURSE
N/A
N/A
N/A
COLLEGE
Cebu Technological UniversitySamboan Extension Campus
2015
2019
N/A
N/A
SCHOLARSHIP/
ACADEMIC
HONORS
RECEIVED
N/A
Vocational
Aptitude
Awardee
N/A
2019
Cum Laude
GRADUATE STUDIES
(Continue on separate sheet if necessary)
SIGNATURE
ROCHELL BELVESTRE
DATE
April 06, 2021
CS FORM 212 (Revised 2017), Page 1 of 4
IV. CIVIL SERVICE ELIGIBILITY
27.
CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER
SPECIAL LAWS/ CES/ CSEE
BARANGAY ELIGIBILITY / DRIVER'S LICENSE
RATING
(If Applicable)
DATE OF
EXAMINATION /
CONFERMENT
LICENSE (if applicable)
PLACE OF EXAMINATION / CONFERMENT
NUMBER
Date of
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.
INCLUSIVE DATES
(mm/dd/yyyy)
28.
From
POSITION TITLE
(Write in full/Do not abbreviate)
DEPARTMENT / AGENCY / OFFICE / COMPANY
(Write in full/Do not abbreviate)
SALARY/ JOB/
PAY GRADE (if
MONTHLY
applicable)& STEP
SALARY
(Format "00-0")/
To
STATUS OF
APPOINTMENT
INCREMENT
February
07,2029
January 08,
2021
Corporate I.T.
Solea Hotel and Resorts
15,000
Regular
January 13,
2021
February 17,
2021
I.T. Officer
Golden Sands Destination Resorts
15,000
Prabationary
GOV'T
SERVICE
(Y/ N)
(Continue on separate sheet if necessary)
SIGNATURE
ROCHELL BELVESTRE
DATE
April 06, 2021
CS FORM 212 (Revised 2017), Page 2 of