Professional Documents
Culture Documents
Print legibly. Mark appropriate boxes with check ( ) and use separate sheet if necessary 1. CS ID No. (to be filled up by CSC)
I.PERSONAL INFORMATION
2. SURNAME
N A V A L T A
FIRST NAME
A N T O N I O
MIDDLE NAME
F O N A C I E R 3. NAME EXTENSION (e.g. Jr.,, Sr. N/A
4. DATE OF BIRTH (mm/dd/yyyy) 10/25/1965 16. RESIDENTIAL
5. PLACE OF BIRTH ADDRESS Camp Bado Dangwa, La Trinidad, Benguet
Dalayap, Langiden, Abra
6. SEX Male Female
24. SPOUSES SURNAME 25. NAME OF CHILD (Write full name and list
N/A all)
DATE OF BIRTH (mm/dd/yyyy)
FIRST NAME
N/A Ysrael Anthony B Castillo 10/25/2002
MIDDLE NAME N/A Denmark Anthony C Navalta 07/07/2006
OCCUPATION
N/A
EMPLOYER/BUS
NAME N/A
BUSINESS ADDRESS
N/A
TELEPHONE NO.
N/A
26. FATHERS SURNAME
Navalta 05/16/1928
FIRST NAME
Honorato
MIDDLE NAME
Papagayo
27. MOTHERS MAIDEN NAME
GRADUATE
STUDIES N/A N/A N/A N/A N/A N/A N/A
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IV. CIVIL SERVICE ELIGIBILITY
01/26/2011 Present Mobility PNCO RLRDD, PRO Cordillera P 25,394.00 18 Permane Yes
nt
04/18/2005 04/19/2005 Operations ROPD, PRO Cordillera P 16,552.00 17 Permane Yes
PNCO nt
09/21/2002 04/17/2005 Operations Langiden MPS, Abra P 12,375.00 16-2 Permane Yes
PNCO PPO nt
09/20/2002 05/29/2005 Operations PHQ, Abra PPO P 10,875.00 14-2 Permane Yes
PNCO nt
07/15/1994 05/28/2002 Plans PNCO ROPD, PRO Cordillera P 8,758.00 12-1 Permane Yes
nt
04/11/1992 07/14/1994 Rifleman RMG, PRO Cordillera P 1,800.00 10-1 Permane Yes
nt
09/16/1991 04/10/1992 Police Trainee PNP Training Command P 1,000.00 10-1 Permane Yes
nt
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Medalya ng Kasanayan - 13
Medalya ng Papuri - 17
Medalya ng Pakikipaglaban sa
Manliligalig - 3
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38. Have you ever been convicted of any crime or violation of any law, decree, ordinance YES NO
or regulations by any court or tribunal? If YES, give details:
39. Have you ever been forced to retired/resign or dropped from employment in the public YES NO
or private sector? If YES, give details:
40. Have you ever been a candidate in a national or local election (except Barangay YES NO
election)? If YES, give details:
41. Pursuant to: (a) Indigenous Peoples Act (RA 8371); (b) Magna Carta for Disabled
Persons (RA 7277); and (c) Solo Parents Welfare Act of 2000 (8972)*; please answer the
following items:
YES NO
a. Are you a member of any indigenous group? If YES, give details: Tingguian
YES NO
b. Are you differently abled? If YES, give details:
YES NO
c. Are you a solo parent?
If YES, give details:
42. I declare under oath the penalties of perjury that this Personal Data Sheet has been accomplished in good faith, verified by me and to
the best of my knowledge and belief is a true, correct and complete statement pursuant to the provisions of pertinent laws, rules and
regulations of the Republic of the Philippines. Computer generated
Or Xerox copy of picture
I also authorize the agency/authorized representative to verify/validate the contents stated herein. I trust that this information shall Is not acceptable
remain confidential.
PHOTO
06455818
LA TRINIDAD, BENGUET
ISSUED AT SIGNATURE
11/13/2013 12/02/2013
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