Are you related by consanguinity or affinity to the appointing or recommending authority, or to thechief of bureau or office or to the person who has immediate supervision over you in the Office, b. within the fourth degree (for Local Government Unit - Career Employees)?If YES, give details: ________________________________ If YES, give details: ________________________________ b. Have you been criminally charged before any court?If YES, give details: ________________________________ Filed: 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: ________________________________ 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 out (abolition) in the public or private sector? 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. b. REFERENCES (Person not related by consanguinity or affinity to applicant /appointee) I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and complete statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the 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 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 YESNOYESNO YESNOYESNOYESNO YESNOYESNO YESYESYESNONO NOYESNOYESNO
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- Fall '12