JBCFORM No. 1
Revised May 2013
2x2 I.D. Picture
PERSONAL DATA SHEET
PLEASE FILL OUT THIS FORM BY PRINTING OR TYPING THE REQUIRED INFORMATION.
DO NOT LEAVE ANY ITEM UNANSWERED. IF NOT APPLICABLE, WRITE “NA.”
PERSONAL BACKGROUND
1.
Roll of Attorneys’ Number
2. NAME
First Name
2a. Full Maiden Name, if married
5. TAXPAYER’S IDENTIFICATION NUMBER (TIN)
7. AGE
8. DATE AND PLACE OF BIRTH
11. ADDRESSES
Middle Name
Surname
3. SEX
4. CIVIL STATUS

Male

Single

Widowed

Female

Married

Separated
6. CITIZENSHIP
Natural-born
 Naturalized
9. HEIGHT (meters)
10. WEIGHT (kilos)
12. TELEPHONE NUMBERS
a.
Residence:
a.
Residence:
b.
Office:
b.
Office:
c.
E-mail:
c.
Cellular:
d.
Provincial Address:
d.
Fax:
13. NAME OF FATHER
PLACE OF BIRTH
14. NAME OF MOTHER
15. NAME OF SPOUSE
PLACE OF BIRTH
OCCUPATION
16. CHILDREN
NAME
AGE
NAME
AGE
EDUCATION
17.
Level
School/College/University
Inclusive Period
Degree/Units
Earned
Honors/Awards/
Distinctions
Post Graduate
Bachelor of Laws
College
Vocational
Secondary
Elementary
ELIGIBILITY
18. CIVIL SERVICE ELIGIBILITY/
BOARD/BAR EXAMINATION
TAKEN
No. of
Times
Taken
Rating
Date of
Examination
Place of Examination
Page 1 of 6
(including
failed rating if
applicable)
Year Admitted to
the Bar / IBP
Chapter
19. PREJUDICATURE PROGRAM
Inclusive Dates of Attendance
Rating
RELEVANT TRAININGS
20. SEMINARS, TRAININGS, SCHOLARSHIPS, AND FELLOWSHIP GRANTS (in inverse chronological order)
Inclusive
Course Title
Place
Conducted by
Period
(continue on separate sheet if necessary)
PROFESSIONAL EXPERIENCE
21. SERVICE RECORD (include services in both private & government sectors in inverse chronological order)
Nature of
Inclusive Period
Supervisor
No.
Department/Agency
Work
Salary
(include current
Position
of
(include
current
address
&
(e.g. judicial, legal,
From
To
address & phone
Grade
phone no.)
administrative,
Years
(mm/dd/yy)
(mm/dd/yy)
no.)
corporate)
22. BRIEF JOB DESCRIPTION OF EACH OF THE POSITIONS HELD
(continue on separate sheet if necessary)
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23. PRACTICE OF LAW (including the holding of an office which requires admission to the bar as a pre-requisite)
a. Number of Years of b. Nature of Current
c. Latest MCLE Compliance or Exemption Certificate No. with
Practice of Law:
Practice:
Compliance Period:
24.
LITIGATION EXPERIENCE
a. Number of Years of Civil Litigation Experience:
b.
Number of Years of Criminal Practice Experience:
c.
Number and Nature of Cases Handled in the Past 5
Years:
d.
Number and Nature of Cases Won in the Past 5
Years:
e.
Number and Nature of Cases Lost in the Past 5
Years:
f.
Number of Cases Handled in the Appellate Courts in
the Past 5 Years:
g. Significant Cases Handled in the Past 5 Years:
Court
Case Title/Docket No.
Type of Case
Date
Filed
(indicate if
special court)
Date
Decided
Names, Current Addresses & Tel.
Nos. of Counsel for the other Parties
25. PROSECUTION EXPERIENCE
a. Number of complaints/inquests handled which are pending
preliminary investigation as of date of application:
b. Number of complaints/inquests submitted for resolution as
of date of application:
c. Number of resolutions affirmed by superiors for the past
five (5) years:
d. Number of resolutions reversed by superiors for the past
five (5) years:
26. JUDICIAL EXPERIENCE
a. Current Caseload: (with cut-off date)
b.
Average Monthly Output:
as of:
c.
Number and Percentage of Cases Disposed of in the
Past 5 Years:
d.
Number of Decisions Appealed or Pending Appeal:
e.
Percentage of Affirmances in the Past 5 Years:
f.
Percentage of Reversals in the Past 5 Years:
g. Performance Rating in the past 3 Years:
h. Cases Undecided or Unresolved within the Reglementary Period:
Have you failed to decide cases or resolve motions within the reglementary period?
 
No 
Yes
Case Title
If Yes, give particulars.
Docket No.
Type of Case
Date Filed
(continue on separate sheet if necessary)
Page 3 of 6
Date Submitted
for Decision or
Resolution
Date Extension of
Time was Requested
& Granted
27. TEACHING EXPERIENCE
School
Inclusive Period
Nature of Appointment
Courses Taught
28. OTHER CREDENTIALS (Include awards received; special skills; law books or other legal articles written, edited, or
published with citations, dates and general description of the subject matter; and membership in professional, civic, or
other organizations or committees)
RECORD OF CASES FILED AGAINST YOU
29. FORMAL OR INFORMAL COMPLAINTS FILED AGAINST YOU (Civil, Criminal, or Administrative including
disbarment and contempt of court)
Have you ever been charged with violation of any law, decree, ordinance, administrative issuance, or regulation by any
court, prosecution office, tribunal, or any other government office, agency or instrumentality in the Philippines or in any
foreign country?
 
No 
Yes
Case Title/Docket No.
If Yes, give particulars:
Date Filed
Complainant’s Name, Address
& Tel. No.
Type of
Complaint
Court
Disposition
30. PENDING CASES OR COMPLAINTS AGAINST YOU
Is there any pending civil, criminal, or administrative (including disbarment and contempt of court) case or complaint
against you for violation of any law, decree, ordinance, administrative issuance, or regulation before any court,
prosecution office, any other office, agency or instrumentality of the government, or the Integrated Bar of the Philippines
or in any foreign country?
 
No 
Yes
Case Title/Docket No.
If Yes, give particulars:
Date Filed
Complainant’s Name, Address
& Tel. No.
Page 4 of 6
Type of
Complaint
Court
Status
31. DECIDED CASES AGAINST YOU
Have you been found liable for, guilty of, or imposed a sanction or penalty for violation of any law, decree, ordinance,
administrative issuance, or regulation by any court, tribunal, bar association, disciplinary committee, or any other
government office, agency or instrumentality in the Philippines or any foreign country?
 
No 
Yes
If Yes, give particulars:
Case Title/Docket No.
Complainant’s Name, Address
& Tel. No.
Date Filed
Type of
Complaint
Court
Date Decided /
Disposition
OTHER MATTERS
32. TERMINATION OF EMPLOYMENT
Have you been retired, dismissed, or forced to resign from employment? 

Yes

No
If yes, state particulars:
33. CANDIDACY FOR ELECTIVE OFFICE
Have you been a candidate for any elective office in any election?

Yes
No
If yes, when and for what position?
34. RELATIVES in Government Service in the Region where you seek to be appointed
Name
Position
Place of Assignment
Nature of Employment
Relationship
REFERENCES
35. Persons not related to you by consanguinity or affinity who have knowledge of your personal or professional background
Name
Address
Page 5 of 6
Tel. No.
AGREEMENT
I declare under oath that the answers given above are true and correct to the best of my knowledge and belief. I
bind myself to inform the Judicial and Bar Council (JBC) of any material changes that may arise in the future affecting the
information contained herein.
Likewise, I authorize the JBC and its agents or representatives to verify the truth of any of the above information
or to conduct investigation on my background and qualifications from any and all available sources. In this regard, I
authorize any government or law enforcement agency and its representatives or agents, as well as private individuals or
entities, to release any document, record or information they may have about me that the JBC may request. I agree that
the information contained herein and public documents submitted by me or gathered by the JBC, except personal
information such as those under numbers 11 to 16, the addresses and telephone numbers of other persons, shall be open to
the public.
Furthermore, I am willing to be nominated for appointment to any of the vacancies which I applied for. If I am
not nominated at all, the JBC is not obliged to disclose the reason. In the event that I decide to withdraw my application
or decline my nomination, I shall immediately notify the JBC in writing. Should I be appointed to the position I am
applying for, I am committed to assume the duties and functions of the said office.
__________________________
Signature
__________________________
Date
JURAT
SUBSCRIBED AND SWORN to before me in the City/Municipality of _______________________, this
_____ day of ________________________ 20___, affiant exhibiting to me his/her Community Tax Certificate No.
__________________________ issued at _____________________________ on _________________________.
__________________________
Notary Public
Doc. No. _______;
Page No. _______;
Book No. _______;
Series of 20 _____.
PDS-Form-May 2013
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