Republic of the Philippines Department of the
Interior and Local government NATIONAL
POLICE COMMISSION
NATIONAL HEADQUARTERS PHILIPPINE NATIONAL POLICE
Camp Crame, Quezon City
PNP Badge No:
POLICE PERSONAL FILE TIN:
2 X 2 PICTURE
Phil. Health No:
WARNING:
The correctness of all statements or entries made herein is subject to verification and any deliberate
correction and distortion of information may give sufficient cause for Investigation.
Date Accomplished:
I. GENERAL INFORMATION
1. NAME ( Last Name First Name Middle Name Qualifier)
2. RANK 3. UNIT/ STATION – NSU / PRO / NHQ
4. HOME ADDRESS (House No / Street / Mun / City / Province)
5. PLACE OF BIRTH: 6. DATEOF BIRTH:
7. SEX: 8. CIVIL STATUS: 9. RELIGION:
10. COLOR OF HAIR: 11. COLOR OF EYES 12. HEIGHT (CM) 13. WEIGHT (KG)
14. BLOOD TYPE : 15. BUILD: 16. COMPLEXION:
17. LANGUAGES 18. IDENTIFYING MARKS 19. ETHNIC GROUP
20. NAME OF SPOUSE OR NEAREST KIN/ADDRESS: 21. OCCUPATION:
22. DEPENDENTS:
NAME DATE OF BIRTH RELATIONSHIP ADDRESS
23. HOUSING DATA:
[ ] OWN HOUSE & LOT [ ] RENT HOUSE [ ] OCCUPYING GOV’T QRTS
[ ] OWN HOUSE ONLY [ ] RENT ROOM [ ] OTHERS (Specify):
Signature
II. APPOINTMENT AND EXPERIENCE/TIG DATA
EFFECTIVE DATE OF APPOINTMENT OF EFFECTIVE DATE OF PROMOTION OF
PREVIOUS RANK BY CSC PREVIOUS RANK PER PNP SO/GO
STATUS DATE STATUS DATE AUTHORITY
TEMPORARY: TEMPORARY:
PERMANENT: PERMANENT:
EFFECTIVE DATE OF APPOINTMENT OF EFFECTIVE DATE OF PROMOTION OF
PRESENT RANK BY CSC PRESENT RANK PER PNP SO/GO
STATUS DATE STATUS DATE AUTHORITY
TEMPORARY: TEMPORARY:
PERMANENT: PERMANENT:
IF PRESENT RANK PASSED DATE SATISFIED THE DEFICIENCY:
TEMPORARY, STATE REASON
[ ] Eligibility [ ] TIG DEFICIENCY: (specify)
[ ] Training [ ] Others MONTH/YEAR:
FOR POLICE COMMISSIONED OFFICERS ONLY
SOURCE OF COMMISSION/ENTRY TO THE PNP
YEAR YEAR
[ ] AFP Regular [ ] AFP Reserve [ ] SPO4-PINSP PROM [ ] PMA
[ ] CIS [ ] INP [ ] NAPOLCOM [ ] Lateral Entry: [ ] PNPA
III. EDUCATIONAL BACKGROUND
DEGREE
HONORS
LEVEL NAME OF SCHOOL LOCATION YEAR COMPLETED /
RECEIVED
UNITS
COLLEGE
POST
GRADUATE
IV. POLICE/MILITARY TRAINING CAREER COURSES
CLASS STANDING
COURSE SCHOOL / INCLUSIVE - TRAINING
HONORS
TAKEN LOCATION DATE HOUR
RECEIVED
Signature
V. NAPOLCOM/CIVIL SERVICE/PRC ELIGIBILITIES
TITLE OF EXAMINATION DATE TAKEN WHERE TAKEN RATING OBTAINED
VI. PERFORMANCE EVALUATION RATING
(Immediately preceding two (2) semesters)
RATING PERIOD RATING RATER
VII. PHYSICAL FITNESS TEST RATING
(Immediately preceding two (2) semesters)
FITNESS PERIOD RATING CONDUCTED BY
VIII. STATEMENT OF ASSETS & LIABILITIES, NETWORTH
(Immediately preceding Three (3) Fiscal Years)
THIS WILL BE COMPARED TO THE SUBMITTED SALNs AND VERIFIED BY RMD, DPRM.
FISCAL YEAR TOTAL ASSETS TOTAL LIABILITIES NET WORTH
IX. INDIVIDUAL INCOME TAX RECORDS
(Immediately preceding Three (3) Fiscal Years)
FISCAL YEAR GROSS INCOME TAXABLE INCOME INCOME TAX PAID
X. OFFENSE DATA
OFFENSE COMMITTED AS CHARGED TYPE OF CHARGE STATUS / DISPOSITION
(State whether Administrative or Criminal) (Principal or what) (Exonerated, etc., - Penalty)
XI. DATA ON PREVIOUS RETIREMENT/DISMISSAL/SUSPENSION
Have you ever been retired, dismissed, forced to resign or suspended from any employment
for reasons other than lack of funds?
Have you ever been a candidate in a national or local election (including barangay election?)
POSITION PLACE DATE
XII. PHYSICAL AND MEDICAL RECORD
DATE OF LAST PHY/MEDICAL EXAMTN - WHERE TAKEN -
DATE OF LAST DENTAL EXAMINATION - WHERE TAKEN -
Signature
DATE OF LAST NP EXAMINATION - WHERE TAKEN -
DATE OF LAST DRUG TEST - WHERE TAKEN -
DATE OF LAST PHY FITNESS TEST - WHERE TAKEN -
XIII. POLICE/MILITARY MAJOR DESIGNATIONS
(FOR PCOs: AS PLTN LDR, COP, BN/CPS/CPO/PPO/PRO/NSU STAFF, MG COMDR, CD/PD)
POSITION/DESIGNATION UNIT INCLUSIVE DATES
XIV. PROMOTION RECORDS
OLD RANK NEW RANK EFF DATE PROM STATUS AUTHORITY
XV. OTHER COURSES/TRAININGS/SEMINARS (IN PRESENT RANK)
CLASS
SCHOOL / TRAINING STANDING
COURSE TAKEN INCLUSIVE -DATE HONORS
LOCATION HOURS
RECEIVED
Signature
XVI. FIREARMS RECORD
LICENSE NO. KIND MAKE CALIBER AMMO ISSUING UNIT
XVII. AWARDS AND RECOGNITIONS RECEIVED (IN PRESENT RANK)
INDIVIDUAL MEDALS/RIBBONS
NATURE OF AWARD DATE AWARDED AUTHORITY
INDIVIDUAL AND UNIT CITATION BADGE
INDIVIDUAL AND UNIT AWARDS/STREAMERS
LETTERS OF COMMENDATIONS/PLAQUES/CERTIFICATE OF
APPRECIATION/COMMENDATION/MERITS (NOT YET CONVERTED TO PNP MEDALS)
NATURE OF AWARD DATE AWARDED AWARDED BY
ACADEMIC AWARDS
NATURE OF AWARDS DATE INSTITUTION
Signature
XVIII. CERTIFICATION
THIS IS TO CERTIFY that the answers given above are true and correct to the best of
my knowledge and belief.
I COMMIT MYSELF TO BE LIABLE for perjury and/or dishonesty as result of any false,
misrepresentation or omission in this Personal Data Sheet.
LEFT RIGHT Community Tax Certificate No:
THUMBMARK Issued on:
Issued at :
SUBSCRIBED AND SWORN TO before me this at
,Philippines.
NHQ/NSU/PRO
Official Seal
* Not valid without Notarial Seal
Signature
