CS FORM 212 (Revised 2005)

PERSONAL DATA SHEET

Print legibly. Mark appropriate boxes with " " and use separate sheet if necessary. 1. CS ID No. (to be filled up by CSC)

I. PERSONAL INFORMATION
2. SURNAME I | L |A | G | A | N | | | | | | | | | | | | | | | | | | | |

FIRST NAME R | O | S | E | M | A | R | I | E | | | | | | | | | | | | | | | | |

MIDDLE NAME C | A | L | A | M | P | I | A | N | O | | | | | | | | 3. NAME

| |EXTENSION
| | (e.g. |Jr., Sr.)| | | N/A
4. DATE OF BIRTH (mm/dd/yyyy) 06/07/1963 16. RESIDENTIAL ADDRESS

5. PLACE OF BIRTH SAN PABLO CITY

6. SEX Male Female 218 P. ALCANTARA ST., SAN PABLO CITY
7. CIVIL STATUS
Single Widowed ZIP CODE 4000
Married Separated 17. TELEPHONE NO. (049) 562-7114
Annulled Others, specify ___________ 18. PERMANENT ADDRESS

8. CITIZENSHIP FILIPINO
9. HEIGHT (m) 1.6 METERS 218 P. ALCANTARA ST., SAN PABLO CITY
10. WEIGHT (kg) 57 KILOGRAMS ZIP CODE 4000
11. BLOOD TYPE O 19. TELEPHONE NO. (049) 562-7114
12. GSIS ID NO. 63060700798 20. E-MAIL ADDRESS (if any) rosemarie_ilagan@yahoo.com
13. PAG-IBIG ID NO. 10-70-0014-6596 21. CELLPHONE NO. (if any) 09198290142
14. PHILHEALTH NO. 19-000097577-3 22. AGENCY EMPLOYEE NO. COA ID 188581
15. SSS NO. 04-1058474-7 23. TIN 131-952-187
II. FAMILY BACKGROUND
24. SPOUSE'S SURNAME N/A 25. NAME OF CHILD (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)

FIRST NAME N/A N/A / /

MIDDLE NAME N/A / /
OCCUPATION N/A / /
EMPLOYER/BUS. NAME N/A / /
BUSINESS ADDRESS N/A / /
TELEPHONE NO. N/A / /
(Continue on separate sheet if necessary) / /
26. FATHER'S SURNAME ILAGAN / /
FIRST NAME LORENZO / /
MIDDLE NAME MENDOZA / /
27. MOTHER'S MAIDEN NAME PURIFICACION / /
SURNAME CALAMPIANO / /
FIRST NAME PURIFICACION / /
MIDDLE NAME RODELAS (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND YEAR

GRADUATED
HIGHEST GRADE/ INCLUSIVE DATES OF
28. NAME OF SCHOOL DEGREE COURSE SCHOLARSHIP/
LEVEL/ ATTENDANCE
LEVEL (Write in (Write in full) ACADEMIC HONORS
UNITS EARNED
full) From To RECEIVED
(if not graduated)

SAN PABLO CENTRAL ELEMENTARY (if graduated)

ELEMENTARY INTERMEDIATE 1976 GRADUATED 1971 1976 NONE
SCHOOL
SAN PABLO CITY SCHOOL OF ARTS &
SECONDARY SECONDARY 1980 GRADUATED 1976 1980 VALEDICTORIAN
TRADES
VOCATIONAL /

N/A
TRADE COURSE
COLLEGE BACHELOR OF
LAGUNA COLLEGE
SCIENCE IN
COMMERCE -
1984 GRADUATED 1980 1984 CUM LAUDE
ACCOUNTING
GRADUATE STUDIES MASTER IN
SAN PABLO COLLEGES
BUSINESS
ADMINISTRATION
1998 GRADUATED 1995 1998
(MBA)
(Continue on separate sheet if necessary)
Page 1 of 4
IV. CIVIL SERVICE ELIGIBILITY
29. DATE OF LICENSE (if applicable)
CAREER SERVICE/ RA 1080 (BOARD/ BAR)
RATING EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
UNDER SPECIAL LAWS/ CES/ CSEE NUMBER DATE OF
CONFERMENT
RELEASE

CAREER SERVICE SUB-PROFESSIONAL 79.00% 07/17/1983 LUCENA CITY N/A

CAREER SERVICE PROFESSIONAL P.D.907 HONOR GRADUATE N/A
CPA BOARD EXAMINATION 75.00% 10/24/1984 MANILA 63689 06/06/85

(Continue on separate sheet if necessary)

V. WORK EXPERIENCE (Include private employment. Start from your current work) GOV'T
SERVICE
30. INCLUSIVE DATES POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY SALARY GRADE
(mm/dd/yyyy) MONTHLY & STEP STATUS OF
SALARY INCREMENT APPOINTMENT
(Write in full) (Write in full) (Format "00-0")
From To
(Yes / No)

1/1/2016 Present STATE AUDITOR IV COMMISSION ON AUDIT 24-1 PERMANENT YES

09/15/2014 12/31/2015 STATE AUDITOR IV COMMISSION ON AUDIT 24-1 PERMANENT YES

06/01/2012 09/14/2014 STATE AUDITOR III COMMISSION ON AUDIT 46,047.00 22-8 PERMANENT YES

06/01/2011 05/31/2012 STATE AUDITOR III COMMISSION ON AUDIT 41,457.00 22-8 PERMANENT YES
06/24/2010 05/31/2011 STATE AUDITOR III COMMISSION ON AUDIT 36,867.00 22-8 PERMANENT YES

07/01/2009 06/23/2010 STATE AUDITOR III COMMISSION ON AUDIT 32,278.00 22-8 PERMANENT YES

07/01/2008 06/30/2009 STATE AUDITOR III COMMISSION ON AUDIT 27,688.00 22-8 PERMANENT YES

07/01/2007 06/30/2008 STATE AUDITOR III COMMISSION ON AUDIT 25,171.00 22-8 PERMANENT YES

11/15/2003 06/30/2007 STATE AUDITOR III COMMISSION ON AUDIT 22,883.00 22-8 PERMANENT YES

07/01/2001 11/14/2003 STATE AUDITOR III COMMISSION ON AUDIT 22,325.00 22-7 PERMANENT YES

01/01/2000 06/30/2001 STATE AUDITOR III COMMISSION ON AUDIT 21,262.00 22-7 PERMANENT YES

06/01/1998 12/31/1999 STATE AUDITOR III COMMISSION ON AUDIT 19,329.00 22-7 PERMANENT YES

11/01/1997 05/31/1998 STATE AUDITOR III COMMISSION ON AUDIT 16,667.00 22-1 PERMANENT YES

02/01/1997 10/31/1997 STATE AUDITOR III COMMISSION ON AUDIT 14,316.00 22-1 PERMANENT YES

01/01/1997 01/31/1997 STATE AUDITOR II COMMISSION ON AUDIT 13,328.00 19-6 PERMANENT YES

01/01/1996 12/31/1996 STATE AUDITOR II COMMISSION ON AUDIT 10,207.00 PERMANENT YES

01/01/1995 12/31/1995 STATE AUDITOR II COMMISSION ON AUDIT 8,215.00 PERMANENT YES

01/01/1994 12/31/1994 STATE AUDITOR II COMMISSION ON AUDIT 7,150.00 PERMANENT YES

01/01/1993 12/31/1993 STATE AUDITOR II COMMISSION ON AUDIT 6,450.00 PERMANENT YES

01/01/1992 12/31/1992 STATE AUDITOR II COMMISSION ON AUDIT 6,323.00 PERMANENT YES

07/01/1989 12/31/1992 STATE AUDITOR II COMMISSION ON AUDIT 6,199.00 N/A PERMANENT YES

01/01/1988 06/30/1989 STATE AUDITING EXAMINER COMMISSION ON AUDIT 2,672.00 N/A PERMANENT YES

10/01/1986 12/31/1987 STATE AUDITING EXAMINER COMMISSION ON AUDIT 2,429.00 N/A PERMANENT YES

06/19/1986 09/30/1986 AUDITING EXAMINER III COMMISSION ON AUDIT 1,715.00 N/A PERMANENT YES

12/13/1985 06/18/1986 AUDITING EXAMINER III COMMISSION ON AUDIT 1,477.00 N/A PERMANENT YES

(Continue on separate sheet if necessary)

CS FORM 212 (Revised 2005), Page 2 of 4
VI. VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S
INCLUSIVE DATES
31. NAME & ADDRESS OF ORGANIZATION NUMBER OF
(Write in full) (mm/dd/yyyy) POSITION / NATURE OF WORK
HOURS
From To
NONE / / / / N/A N/A
(Continue on separate sheet if necessary)

VII. TRAINING PROGRAMS (Start from the most recent training.)

INCLUSIVE DATES OF ATTENDANCE
32. TITLE OF SEMINAR/CONFERENCE/WORKSHOP/SHORT COURSES (Write NUMBER OF CONDUCTED/ SPONSORED BY
in full) (mm/dd/yyyy) HOURS (Write in full)
From To

IMPLEMENTING THE GOV'T ACCOUNTING MANUAL 1/18/16 1/22/16 40 COA, Region IV-B
PICPA ANNUAL NATIONAL CONVENTION 11/25/15 11/28/15 32 PICPA NATIONAL CHAPTER
INTEGRATED RESULTS AND RISK BASED AUDIT SOFTWARE (IRRBAS) 9/21/15 9/28/15 40 COA, Region IV-B
INTEGRATED RESULTS AND RISK BASED AUDIT (IRRBA) 6/30/15 7/9/15 64 COA, Region IV-B
UNIFIED ACCOUNTING CODE AND STRUCTURES (UACS) 11/11/14 11/14/14 40 COA, Region IV-B
GUIDE IN AUDIT OF PROCUREMENT 10/27/14 10/30/14 32 COA, Region IV-B
PHIL.PUBLIC SECTOR ACCTG STANDARDS & REV, CHART OF ACCTS 10/13.14 10/17/14 40 COA, Region IV-B
SEMINAR ON CASH EXAMINATION (Revised) 8/26/2014 8/28/2014 24 COA, Region IV-B
UPDATES ON RA 9184 7 PHIL. BIDDING DOCUMENTS 11/13/2007 11/15/2007 24 COA, Region IV
RBFAM and VFM 07/17/2006 07/28/2006 80 NPC/TRANSCO
BASIC INFORMATION AND COMMUNICATION Technology 05/22/2006 05/26/2006 40 COA, Region IV
GENDER & DEVELOPMENT 09/29/2005 09/30/2005 16 COA, Region IV
FORUM WITH THE EXAMINERS Board of Accountancy 8/26/2005 4 PICPA ,SAN PABLO CHAPTER
E-FILING, TAX UPDATES & ANTI-MONEY LAUNDERING LAW 02/19/2005 02/19/2005 8 PICPA ,SAN PABLO CHAPTER
COMPUTER ASSISTED AUDIT TECHNIQUES 04/19/2005 04/22/2005 40 COA, Region IV
FINANCIAL AUDIT (RISK-BASED AUDIT APPROACH) 08/23/2004 08/27/2004 40 CGS CLUSTER III
NEW GOVERNMENT ACCOUNTING SYSTEM (NGAS) CORPORATE 12/14/2004 12/16/2004 24 COA, Region IV
RISK-BASED AUDIT APPROACH 08/23/2004 08/27/2004 40 COA-Cluster III-Corp.
FRAUD INVESTIGATION AND LEGAL EVIDENCE 06/21/2004 06/25/2004 40 COA, Region IV
HUMAN RELATIONS IN WRITING 06/02/2004 06/03/2004 16 COA, Region IV
R.A.9184 & ITS IMPLEMENTING RULES& REGULATIONS 05/26/2004 05/28/2004 24 COA, Region IV
NEW GOVERNMENT ACCOUNTING SYSTEM (NGAS) 05/21/2003 05/23/2003 24 COA, Region IV
GOVERNMENT ELECTRONIC PROCUREMENT SYSTEM (GPES) 03/20/2002 03/20/2002 4 DBM-Procurement Service

INFORMATION SYSTEM AUDIT ( ON THE JOB TRAINING) 10/01/2001 11/06/2001 200 COA, Region IV

INFORMATION SYSTEM AUDIT ( MODULE 2) 09/10/2001 09/21/2001 80 COA, Region IV

INFORMATION SYSTEM AUDIT ( MODULE 1) 08/20/2001 08/24/2001 40 COA, Region IV

ANNUAL AUDIT REPORT WRITING 08/06/2001 08/10/2001 40 COA, Region IV

GACPA 23TH ANNUAL NATIONAL CONVENTION 10/03/2000 10/06/2000 32 GACPA

INTERNAL CONTROL SYSTEM EVALUATION 09/18/2000 09/22/2000 40 COA, Region IV

VOW/TEAM BUILDING /ATAP UPDATES 07/10/2000 07/14/2000 40 COA, Region IV

AUDIT SAMPLING 06/14/2000 06/15/2000 16 COA, Region IV

MICROSOFT OFFICE '97 05/15/2000 05/19/2000 40 COA, Region IV

AUDIT TEAM APPROACH ORIENTATION 07/161999 07/18/1998 16 COA, Region IV

UPDATES ON COMPREHENSIVE AUDIT 11/11/1996 11/15/1996 40 COA, Region IV

GACPA 19TH ANNUAL NATIONAL CONVENTION 10/03/1996 10/05/0996 24 GACPA

REFRESHER COURSE 10/02/1995 10/06/1995 40 COA, Region IV

TECHNICAL RESEACH & THESIS WRITING 09/17/1995 09/17/1995 8 GRADUATED STUDIES, SNPABLOCOLLEGES

NEW CERT. OF SETTLEMENT & BALANCES 07/27/1994 07/29/1994 24 COA, Region IV

AUDIT WORKING PAPER DEVELOPMENT 10/06/1991 10/08/1991 24 COA, Region IV

BARANGAY HIGH SCHOOL ACCOUNTING 07/30/1986 07/31/1986 16 COA, PAO Batangas
ORIENTATION SEMINAR 04/07/1986 04/11/1986 40 COA, Region IV
(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

MEMBERSHIP IN
NON-ACADEMIC DISTINCTIONS / RECOGNITION: ASSOCIATION/ORGANIZATION
33. SPECIAL SKILLS / HOBBIES: 34. 35.
(Write in full)
(Write in full)
PHIL.INSTITUTE OF CERTIFIED PUBLIC
SPECIAL SKILL: KNOWLEDGE OF SYSTEMS AUDIT N/A
ACCOUNTANT
GOVERNMENT ASSOCIATION OF CERTIFIED
PUBLIC ACCOUNTANT
(Continue on separate sheet if necessary)
CS FORM 212 (Revised 2005), Page 3 of 4
36. Are you related by consanguinity or affinity to any of the following :

a. Within the third degree (for National Government Employees): YES / NO

appointing authority, recommending authority, chief of office/bureau/department or person who has If YES, give details:
immediate supervision over you in the Office, Bureau or Department where you will be appointed? _____________________________________
_____________________________________
_____________________________________

b. Within the fourth degree (for Local Government Employees): YES NO

appointing authority or recommending authority where you will be appointed? If YES, give details:
_____________________________________
_____________________________________
_____________________________________
a. Have you ever been formally charged? YES
37
/ NO
If YES, give details:
________________________________
________________________________
b. Have you ever been guilty of any administrative offense? YES / NO
If YES, give details:
________________________________
________________________________
38. Have you ever been convicted of any crime or violation of any law, decree, ordinance or regulation YES / NO
by any court or tribunal? If YES, give
? details:
________________________________
________________________________
39. Have you ever been separated from the service in any of the following modes: resignation, YES NO
retirement, dropped from the rolls, dismissal, termination, end of term, finished contract, AWOL or
phased out, in the public or private sector? If YES, give details:
________________________________
________________________________

40. Have you ever been a candidate in a national or local election (except Barangay election)? YES / NO
If YES, give details:
________________________________
________________________________
41. 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. Are you a member of any indigenous group? YES / NO

If YES, please specify: ____________________
b. Are you differently abled? YES / NO
If YES, please specify: ____________________
c. Are you a solo parent? YES / NO
If YES, please specify: ____________________
42. REFERENCES (Person not related by consanguinity or affinity to applicant / appointee)

NAME ADDRESS TEL. NO.

ELIZABETH T. JOYAS COA REGION IV-B, Quezon City 09298557339 I

NATIVIDAD S.GARCIA (Retired COA Supervising Aud) Muntinlupa City 09291405279

CELIA D. FUENTES COA REGION IV, Quezon City 09178671285

43. I declare under oath that this Personal Data Sheet has been accomplished by me, and is a true, correct and complete
statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the Philippines.

I also authorize the agency head / authorized representative to verify / validate the contents stated herein. I trust that
this information shall remain confidential. PHOTO

14215200
COMMUNITY TAX CERTIFICATE NO.

SAN PABLO CITY

ISSUED AT SIGNATURE (Sign inside the box)

03/04/2014 10/10/2014
ISSUED ON (mm/dd/yyyy) DATE ACCOMPLISHED RIGHT THUMBMARK

CS FORM 212 (Revised 2005), Page 4 of 4