Region : Region V Division : School ID: Name of Office / School :

To be Encoded Manually Total no. of Authorized Positions (per PSI-POP): Total no. of Filled-up Plantilla Positions: Total no. of Personnel Reassigned to: Total no. of Personnel reassigned from: Total no. of contractual employees: Total no. of casual employees: Total no. of locally funded employees:

Summary from I.Personal

0 0 0

UNIQUE ITEM NUMBER

POSITION TITLE PER PLANTILLA

PARENTHETICAL TITLE

SALARY GRADE

SALARY STEP

NAME OF PERSONNEL

LAST NAME

FIRST NAME

MIDDLE NAME

NAME EXTENSION

SEX

DATE OF BIRTH (MM-DD-YYYY)

TIN

DATE OF ORIGINAL APPOINTMENT (AS NATIONAL) (MM-DD-YYYY)

DATE OF LAST PROMOTION / APPOINTMENT (MM-DD-YYYY)

EMPLOYMENT STATUS

07-15-2013

08-31-2013

FUNDING

PLACE OF BIRTH (TOWN, PROVINCE OR CITY)

CIVIL STATUS

Height (m)

Weight (kg)

Blood Type

PAG-IBIG PHILHEALTH No. (Inc GSIS BP No. No. (Inc but SSS No. but not not required) required)

Residential Add Address (House No, Street Name, Village/Subd)

Region

Residential Address (Inc but not required)

Province / District / City

City/ Municipality

Barangay

Telephone No.

Permanent Address (Required) Address (House No, Street Name, Village/Subd)

Region

Province / District / City

City / Municipality

s (Required) Email Address (preferably @deped.gov.ph) Cellphone No. (if any)

Barangay

Telephone No.

Reassigned From
Reassigned From: Region/ Division/ District Reassigned From: School ID Languages/Dialect Spoken

NAME (LAST NAME, FIRST NAME MIDDLE NAME NAME EXTENSION)

RELATIONSHIP

LAST NAME

FIRST NAME

MIDDLE NAME

FOR CHILD ONLY DATE OF BIRTH (MM-DD-YYYY)

FOR SPOUSE ONL OCCUPATION

FOR SPOUSE ONLY EMPLOYER/BUS. NAME BUSINESS ADDRESS

TELEPHONE NO.

EDUCATIO
NAME (LAST NAME, FIRST NAME MIDDLE NAME NAME EXTENSION)

LAST NAME 1, FIRST NAME 1 MIDDLE NAME 1

EDUCATIONAL BACKGROUND INCLUSIVE YEAR

LEVEL

Name of School

From

To

ELEMENTARY

Year Graduated

Highest Grade/Level/Units Earned (if not graduated)

Course

Major

Minor

Honors Received

NAME (LAST NAME, FIRST NAME MIDDLE NAME NAME EXTENSION) LAST NAME 1, FIRST NAME 1 MIDDLE NAME 1

ELIGIBILITY

RATING

DATE OF EXAM/ PLACE OF EXAM / CONFERMENT CONFERMENT (MM-DD-YYYY)

LICENSE NUMBER ISSUE DATE (MM-DD-YYYY)

WOR
NAME (LAST NAME, FIRST NAME MIDDLE NAME NAME EXTENSION)

INCLUSIVE DATE (MM-DD-YYYY) FROM

LAST NAME 1, FIRST NAME 1 MIDDLE NAME 1 NAME EXTENSION 1

WORK EXPERIENCES
INCLUSIVE DATE (MM-DD-YYYY) TO POSITION TITLE DEPARTMENT / AGENCY / OFFICE MONTHLY SALARY

SALARY RANGE/GRADE

STEP INCREMENT

STATUS OF APPOINTMENT

Enter trainings within the last five years starting with the most recent
NAME (LAST NAME, FIRST NAME MIDDLE NAME NAME EXTENSION)

TITLE OF SEMINAR

AREA OF TRAINING

INCLUSIVE DATES (MM-DD-YYYY) FROM TO

NO. OF HOURS

CONDUCTED BY

PLACE OF TRAINING