Beruflich Dokumente
Kultur Dokumente
1
Revised: August 2018
b. Office: b. Office:
c. E-mail: c. Cellular:
13. NAME OF FATHER 13a. PLACE OF BIRTH 14. MOTHER’S MAIDEN NAME 14a. PLACE OF BIRTH
EDUCATION
17. Degree/Units Honors/Awards/
Level School/College/University Inclusive Period
Earned Distinctions
Post Graduate
Law
College
Vocational
Secondary
Elementary
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ELIGIBILITY
18. CIVIL SERVICE Rating
No. of Year IBP Chapter
ELIGIBILITY/ Date of (including
Times Examination
Place of Examination Admitted (& Number, if
BOARD/BAR failed rating if
Taken applicable) to the Bar applicable)
EXAMINATION TAKEN
RELEVANT TRAININGS
20. SEMINARS, TRAININGS, SCHOLARSHIPS, AND FELLOWSHIP GRANTS (start from most recent seminar)
Inclusive
Course Title Place Conducted by
Period
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23. PRACTICE OF LAW (including the holding of an office which requires admission to the bar as a prerequisite)
a. Number of Years of b. Nature of Current c. Latest MCLE Compliance or Exemption Certificate No. with
Practice of Law: Practice: Compliance Period:
c. Number and Nature of Cases Handled in the Past 5 d. Number of Cases Handled in the Appellate Courts in
Years: the Past 5 Years:
25. JUDICIAL EXPERIENCE (separately indicate caseload performance in acting, assisting, or pairing capacities, if applicable)
a. Current Caseload: (with cut-off date) b. Average Monthly Output:
as of:
c. Number and Percentage of Cases Disposed of in the d. Number of Decisions Appealed or Pending Appeal:
Past 5 Years:
26. EXPERIENCE IN OTHER GOVERNMENT AGENCIES (e.g., Office of the Solicitor General, Office of the Ombudsman,
National Prosecution Service, Public Attorney’s Office)
a. Number of complaints/cases handled which are pending as b. Number of complaints/cases submitted for resolution as of
of the date of application: the date of application:
c. Number of resolutions affirmed by superiors for the past d. Number of resolutions reversed by superiors for the past
five (5) years: five (5) years:
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27. TEACHING EXPERIENCE
Indicate whether the
Inclusive subjects are taught
Period Nature of Law Subjects in Undergraduate,
School
(mm/dd/yy to Appointment Taught Law School, or
mm/dd/yy) Master of Laws
level
28. OTHER CREDENTIALS (Include awards received; expertise in field/fields of law pertinent to the specific field of the
special court being applied for; special skills; law books or other legal articles written, edited, or published with citations,
dates and general description of the subject matter; lectures, seminars, or trainings given; and membership in professional,
civic, or other organizations or committees)
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OTHER MATTERS
30. TERMINATION OF EMPLOYMENT
Have you been retired, dismissed, or forced to resign from employment?
Yes
No If yes, state particulars:
32. RELATIVES in Government Service (within the fourth degree of consanguinity or affinity, including “Bilas,” “Balae,” and “Inso”)
Name Position Place of Assignment Nature of Employment Relationship
33. REFERENCES (Persons not related to you by consanguinity or affinity who have knowledge of your personal or professional
background)
Name Address Tel. No.
AGREEMENT
I declare that the answers given above are true, correct, and complete based on my personal knowledge and
authentic records. I bind myself to inform the Judicial and Bar Council (JBC) of any development that may affect any of
the information contained herein.
Likewise, I fully consent and authorize the JBC and any of its duly authorized representatives to verify the truth
and veracity of all the information provided herein.
In this regard, I authorize any government agency and instrumentality, law enforcement agencies, private entities
and individuals, or any of their duly authorized representatives to release any document, record, or information, financial
or otherwise, they may possess in relation to my application as requested by the JBC.
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My co-depositor/s and I consent and signify our waiver in favor of the JBC of our right of confidentiality under
bank secrecy laws, including but not limited to Republic Act No. 1405 or the Law on Secrecy of Bank Deposits, Republic
Act No. 6426 or the Foreign Currency Deposit Act, and Republic Act No. 8791 or the General Banking Law of 2000, as
amended in each case, of our local or foreign currency bank deposits and any other investments of whatever nature,
whether in my name or held jointly with my spouse, children below 18 years old, and other persons or entities, to wit:
Amount of Deposits/Investments
Name of Bank/Financial Institution Address of Bank/Financial Institution
as of the Application Period
This waiver of our right of confidentiality of our bank deposits or investments and other financial records is
executed on the condition that the JBC or its duly authorized representatives shall make use of it, as well as any and all
information or data obtained by virtue thereof, for the exclusive and sole purpose of evaluating my qualifications for the
position/s I am applying for.
I agree that the information contained in this Personal Data Sheet and public documents submitted by me or
gathered by the JBC, except the abovementioned bank deposits or investments and personal information, such as those
under numbers 11 to 16 and the addresses and telephone numbers of other persons, shall be open to the public.
In the event that I decide to withdraw my application, I shall immediately notify the JBC in writing.
_____________________________________ _____________________________________
Signature of Applicant / Date Signed Signature of Co-Depositor / Date signed
JURAT
__________________________
Notary Public
Doc. No. _______;
Page No. _______;
Book No. _______;
Series of 20 _____.
PDS-Form-August 2018
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