JBCFORM No.

1
Amended: February 2015

PERSONAL DATA SHEET

PLEASE FILL OUT THIS FORM BY PRINTING OR TYPING THE REQUIRED INFORMATION.
DO NOT LEAVE ANY ITEM UNANSWERED. IF NOT APPLICABLE, WRITE NA.

Personal Background
1. Roll of Attorneys Number

2. NAME

First Name
2a. Full Maiden Name, if married

Middle Name
3. SEX M/F
4. CIVIL STATUS Single/Married/Sepa

5. TAXPAYERS IDENTIFICATION NUMBER (TIN)

6. CITIZENSHIP (Natural-Born/Naturalized)

7. AGE

9. HEIGHT (meters)

8. DATE

AND

PLACE OF BIRTH

10. WEIGHT (ki

11. ADDRESSES
a. Residence:

12. TELEPHONE NUMBERS

a. Residence:

b. Office:

b. Office:

c. E-mail:

c. Cellular:

d. Provincial
Address:
13. NAME OF FATHER

d. Fax:
13a. PLACE OF BIRTH

14. NAME OF MOTHER

15. NAME OF SPOUSE

15a. OCCUPATION OF SPOUSE

16. CHILDREN
NAME

AGE

NAME

Education
17.

Level

School/College/University

Inclusive Period

Degree/Units Earned

Post Graduate
Bachelor of Laws
College
Vocational
Secondary
Elementary

Eligibility
18. CIVIL SERVICE ELIGIBILITY/
BOARD/BAR EXAMINATION TAKEN

No. of Times
Taken

Date of
Examination

Page 1 of 12

Place of Examination

Rating (including failed rating if

applicable)

19. PREJUDICATURE PROGRAM

Inclusive Dates of Attendan

Relevant Trainings
20. SEMINARS, TRAININGS, SCHOLARSHIPS, AND FELLOWSHIP GRANTS (in inverse chronological order)
Inclusive Period

Course Title

from
to

Place

(continue on separate sheet if necessary)

Professional Experience
21. SERVICE RECORD (include services in both private & government sectors in inverse chronological order)
Inclusive Period

Position

From

To

(mm/dd/yy)

(mm/dd/yy)

22. BRIEF JOB DESCRIPTION OF EACH OF THE POSITIONS HELD

Page 2 of 12

No. Of
years

Salary Department/ Agency (include

current address & phone no)
Grade

Nature of Work

(e.g. judicial, lega

administrative,
corporate)

(continue on separate sheet if necessary)

23. PRACTICE OF LAW (including the holding of an office which requires admission to the bar as a pre-requisite)
a. Number of Years of Practice of
Law:

b. Nature of Current Practice:

c. Latest MCLE Compliance or Exemption Certificate No. with C

24. LITIGATION EXPERIENCE

a. Number of Years of Civil Litigation Experience:

b. Number of Years of Criminal Practice Experience:

c. Number and Nature of Cases Handled in the Past 5 Years:

d. Number and Nature of Cases Won in the Past 5 Years:

e. Number and Nature of Cases Lost in the Past 5 Years:

f. Number of Cases Handled in the Appellate Courts in the Past 5

g. Significant Cases Handled in the Past 5 Years:

Case Title/Docket No.

Type of Case

Court

(indicate if
special court)

Date Filed

Date Decided

25. PROSECUTION EXPERIENCE

a. Number of complaints/inquests handled which are pending
preliminary investigation as of date of application:

b. Number of complaints/inquests submitted for resolutio

date of application:

c. Number of resolutions affirmed by superiors for the past

five (5) years:

d. Number of resolutions reversed by superiors for the pa

five (5) years:

26. JUDICIAL EXPERIENCE

a. Current Caseload: (with cut-off date)

b. Average Monthly Output:

as of:

c. Number and Percentage of Cases Disposed of in the

past 5 Years:
e. Percentage of Affirmances in the Past 5 Years:

d. Number of Decisions Appealed or Pending Appeal:

f. Percentage of Reversals in the Past 5 Years:

g. Performance Rating in the past 3 Years:

h. Cases Undecided or Unresolved within the Reglementary Period:
Have you failed to decide cases or resolve motions within the reglementary period? Yes or No
If Yes, give particulars.

Case Title

Docket No.

Page 3 of 12

Type of Case

Date Filed

Date Submitted for

Decision or Resolutio

(continue on separate sheet if necessary)

27. TEACHING EXPERIENCE

School

Inclusive Period

Nature of Appointment

28. OTHER CREDENTIALS (Include awards received; special skills; law books or other legal articles written, edited, or published with citations, dates and g
subject matter; and membership in professional, civic, or other organizations or committees)

Record of Cases Filed Against You

29. FORMAL OR INFORMAL COMPLAINTS FILED AGAINST YOU (Civil, Criminal, or Administrative Have you ever been charged with violation
administrative issuance, or regulation by any court, prosecution office, tribunal, or any other government office, agency or instrumentality in the Philippines or in
disbarment and contempt of court)

Yes or No?
Case Title/Docket No.

If Yes, give particulars:

Date Filed

Complainants Name, Address & Tel. No.

Type of Complaint

Court

30. PENDING CASES OR COMPLAINTS AGAINST YOU

Is there any pending civil, criminal, or administrative (including disbarment and contempt of court) case or complaint against you for violation of any
administrative issuance, or regulation before any court, prosecution office, any other office, agency or instrumentality of the government, or the Integ
or in any foreign country?
Yes or No?
Case Title/Docket No.

If Yes, give particulars:

Date Filed

Complainants Name, Address & Tel. No.

Page 4 of 12

Type of Complaint

Court

31. DECIDED CASES AGAINST YOU

Have you been found liable for, guilty of, or imposed a sanction or penalty for violation of any law, decree, ordinance, administrative issuance, or reg
tribunal, bar association, disciplinary committee, or any other government office, agency or instrumentality in the Philippines or any foreign country?
Yes or No?

If Yes, give particulars:

Case Title/Docket No.

Date Filed

Complainants Name, Address & Tel. No.

Type of Complaint

Court

Other Matters
32. TERMINATION OF EMPLOYMENT
Have you been retired, dismissed, or forced to resign from employment?

Yes or No?

If yes, state particula

Yes or No?

If yes, when and for

33. CANDIDACY FOR ELECTIVE OFFICE

Have you been a candidate for any elective office in any election?
34. RELATIVES in Government Service in the Region where you seek to be appointed
Name

Position

Place of Assignment

Nature of Employment

References
35. Persons not related to you by consanguinity or affinity who have knowledge of your personal or professional background
Name

Address

Page 5 of 12

Page 6 of 12

2x2 I.D. Picture

Surname

le/Married/Separated/Widowed

zed)

WEIGHT (kilos)

14a. PLACE OF BIRTH

its Earned

ng failed rating if
able)

AGE

Honors/ Awards /
Distinctions

Year Admitted to the Bar /

IBP Chapter

Page 7 of 12

Rating

es of Attendance

ce

ure of Work

e.g. judicial, legal,

dministrative,
corporate)

Conducted by

Supervisor

(include
current address & phone no.)

Page 8 of 12

ate No. with Compliance Period:

ears:
in the Past 5 Years:

Names, Current Addresses & Tel.

Nos. of Counsel for the other Parties

d for resolution as of

iors for the past

ng Appeal:

rs:

te Submitted for
sion or Resolution

Date Extension of Time was

Requested & Granted

Page 9 of 12

Courses Taught

ns, dates and general description of the

d with violation of any law, decree, ordinance,

ilippines or in any foreign country?including

Court

Disposition

iolation of any law, decree, ordinance,

t, or the Integrated Bar of the Philippines

Court

Status

Page 10 of 12

suance, or regulation by any court,

eign country?

Court

Date Decided/
Disposition

, state particulars:

s, when and for what position?

mployment

Relationship

Tel. No.

Page 11 of 12

Page 12 of 12