PDS-ODPRM FORM 96-1

Republic of the Philippines

Department of the nterior and Local Government
National Police Commission
NATIONAL HEADQUARTERS PHILIPPINE NATIONAL POLICE
CampCrame, Quezon City




Warning : The correctness of all statements or entries made herein is subject to verification and any
deliberate omission or distortion of information may give sufficient cause for investigation

Date Accomplished : April 13, 2011


I. GENERAL INFORMATION
1. Name (Last Name, First Name, Middle Name, Qualifier)
BULAOAT ERLINDO BISENIO JR
. RANK
Police Officer 3
3. DESGNATON
Police Security Personnel
4.DATE DESGNATED
January 11, 2007
5. UNT/STATON/ADDRESS
PSPG-PEU Camp Crame, Quezon City
6. TELEPHONE NO

7. HOME ADDRESS (House Nr/Street/Mun/City/Prov)
Cagmanaba, OcampoCamarines Sur
. TELEPHONE NO.
09286331313
9. DATE OF BRTH
September 15, 1979
10. PLACE OF BRTH :
Santa, Ilocos Sur
11. SEX
] Male ] Female
1. CVL STATUS ] Single
] Married ] Widower
13. RELGON
Roman CathoIic
14. COLOR OF HAR
Black
15. COLOR OF EYES
Black
16. HEGHT (cm)
173 cm
17. WEGHT (Kg)
83kgs
1. BLOOD TYPE
] A ] AB
] B ] O
19. BULD
] Light ] Medium
] Heavy
0. COMPLEXON
] Light ] Fair
] Dark
1. DENTFYNG MARKS
Scar on left hand
.LANGUAGE/DALECT(Read.Write,Speak)
English, Tagalog, Ilocano
3. ETHNC GROUP
N/A
4. NAME OF SPOUSE OR NEAREST KN/ADDRESS
IRENE C BULAOAT / OCAMPO CAMARINES SUR
5. OCCUPATON
N/A
6. DEPENDENTS
Name Date of Birth Relationship Address
SAMANTHA QUIENA August 28,2008 Dauther Ocampo, Camarines Sur


7. HOUSNG DATA

[ ] OWN HOUSE & LOT [ ] RENT HOUSE [ ] OCCUPYNG GOV'T QTRS
[ ] OWN HOUSE ONLY [ ] RENT ROOM ] OTHERS: Living With Parents


___________________
Signature



Badge Nr : 157341

TN : 34-75-156

Phil Health No :03-0000606-0


X
PCTURE

. APPONTMENT DATA
. EFFECTVTY DATE OF
PRESENT APPONTMENT
December 31, 2008

9. STATUS OF PRESENT
APPONTMENT

] Perm ] Temp
30. F TEMPORARY, STATE
REASON
[ ] Eligibility [ ] TG
[ ] Training [ ] Others (Specify)
31. CHARACTER OF PRESENT ASSGNMENT
] Original ] Reinstatement ] Reemployment ] Regular Promotion
] Special Promotion ] Rank Adjustment ] Absorption ] Change of Status
3. ORGNAL RANK
Police Officer 3
33. NAME OF ORGNAL ASSGNMENT
Police Security And Protection Group
34.DATE OF ORGNAL APPONTMENT/ENLSTMENT
October 01, 2002
35. ORGNAL APPONTMENT STATUS
Permanent
36. SOURCE OF COMMSSONSHP/ENTRY TO THE PNP
] AFP Regular ] AFP Reserve ] PNP ] NAPOLCOM
] Special Promotion ] Lateral Entry ] Original PNP ] PNPA Graduate



. EDUCATONAL BACKGROUND

LEVEL

NAME OF SCHOOL

LOCATON
NCLUSV
E DATES
DEGREE
COMPLETED

HONOR
RCVD
Elementary Santa Central School Santa, Ilocos Sur 1986-1992
Secondary Santa High School Santa, Ilocos Sur 1992-1996
Vocational
College University of
Northern Philippines
Vigan City,
Ilocos Sur
1996-2001 BS in
Criminology

Masteral
Doctorate


V. POLCE/MLTARY TRANNGS, SCHOLARSHP GRANTS
COURSE
TAKEN
SCHOOL LOCATON NCLUSVE DATES TRNG
HOUR
CONDUCTED
BY
PSBRC PNTI Camp Vicente Lim 10/09/02 - 01/15/03 640 PPSC
SAFOOC SAFTS Sta. Rosa Laguna 02/05/03 05/05/03 600 PNP-SAF
PSJLC ITG PSPG 02/16/09 - 06/17/10 720 PPSC



V. POLCE/CVL SERVCE ELGBLTES
TTLE OF EXAMNATON DATE TAKEN WHERE TAKEN RATNG
OBTANED
PNP Entrance Exam April 29, 2001 San Fernando City, La Union 75.21
Police Officer Exam April 24, 2005 National Capital Region 70.63
Senior Police Officer Exam Oct. 25,2009 National Capital Region 75.89


V. PNP OCCUPATONAL SPECALTY (POS) QUALFCATON/SKLLS
POS NR OF YEARS
EXPERENCE
UNT/ASSGNMENT/
PLACE OF PRACTCE
RELEVANT
COURSE/TRANNG
N/A N/A N/A N/A





________________
Signature



OTHER QUALFCATONS/SKLLS(nclude membership in association/civic clubs)
"&ALIFICATIONS AND SKILLS MEMBERSHIP IN ASSOCIATION AND CIVIC
GRPS
Professional Driver N/A








V. SERVCE RECORDS
nclusive Dates Position Department/Agency Monthly
Salary
Status of
Appointment
Oct. 01, 2002 to Dec. 28, 2004 PO1 Philippine National Police 8,605 Permanent
Dec. 29, 2004 to June 13, 2005 PO2 Philippine National Police 9,668 Temporary
June 14, 2005 to Dec. 30, 2008 PO2 Philippine National Police 9,668 Permanent
Dec. 31, 2008 to date PO3 Philippine National Police 11,949 Permanent








V. PROMOTON RECORDS
OLD RANK NEW RANK EFF DATE PROMOTON
STATUS
AUTHORTY
PO2 PO3 December 31, 2008 Permanent PSPG Promotional Board




X. MEDALS/AWARDS/COMMENDATONS RECEVED
NATURE OF AWARD DATE
AWARDED
AUTHORTY AWARDED BY

















___________________
Signature





X. FREARMS RECORDS
LC/MR NR KND MAKE CALBER SERAL NR AMMO SSUNG UNT
F8753 Pistol Taurus 9mm TZC02191 28 ODL




X. PHYSCAL AND MEDCAL RECORDS
DATE OF LAST PHYSCAL MEDCAL EXAM
March 22, 2011
WHERE TAKEN
PNP Clinic
DATE OF LAST DENTAL TAKEN

WHERE TAKEN

DATE OF LAST NP MEDCAL EXAM
December 05, 2009
WHERE TAKEN
PNP General Hospital
DATE OF LAST DRUG TEST
December 03, 2009
WHERE TAKEN
Crame, Quezon City

II. OFFENSE DATA

OFFENSE COMMTTED AS
CHARGE
TYPE OF CHARGE
(State whether admin or
criminal)
DSPOSTON
(Exonerated,, convicted,
pending) State penalty if
convicted
N/A N/A N/A




III. PERFORMANCE EVALUATION RATING
RATNG PEROD RATNG RATER
July to December 2010 VS PSI BONIFACIO C ESTRELLA JR




IV. DATA ON PREVIOUS RETIREMENT/DISMISSAL/RESIGNATION/OTHERS
Have you ever been retired, forced to resign or suspended from any employment for reason other
than lack of funds? [ ] Yes [ x] No f yes, give particulars
POSTON PLACE DATE
N/A N/A N/A


Have you ever been a candidate in a national or local election (including Barangay election)?
[ ] Yes [ x ] No f yes, give particulars
POSTON PLACE DATE
N/A N/A N/A


V. REFERENCES (persons not reIated by consanguinity or affinity)
NAME ADDRESS
VITA SALVACION AFPOVAI, TAGUIG CITY
JESUS BUENO SANTA, ILOCOS SUR
SIMPLICIO CABALQUINTO OCAMPO, CAMARINES SUR



___________________
Signature



VI. PLEASE COPY IN OWN HANDWRITING
Our London Business is good but Vienna and Berlin are "uiet Mr. D Lord has gone to Switzerland
and I hope for goodness.. He will be there for a week at 1946 Zernatt St, and then goes to Turnie and
Rome and will join Col. Perry.









VII. CERTIFICATION


THS S TO CERTFY that the answers given above are true and correct to the best of my
knowledge and belief.





PO3 ERLINDO B BULAOAT JR
SGNATURE OVER PRNTED NAME













THUMBMARK



SUBSCRBED AND SWORN TO before me this 13th dayApril of 2011at
Camp Crame Quezon, City









______________________________
Administering Officer

LEFT

RGHT