JBCFORM No.

1
Revised December 2012

2x2 I.D. Picture

PERSONAL DATA SHEET

PERSONAL BACKGROUND
(Please print or type)
1. NAME

(Last) (First) (Middle)

2. MAIDEN NAME (If married) 3. SEX 4. CIVIL STATUS
 Male  Single  Widowed
 Female  Married  Separated
5. TAXPAYER’S IDENTIFICATION NUMBER (TIN) 6. CITIZENSHIP
Natural-born  Naturalized
7. AGE 8. DATE AND PLACE OF BIRTH 9. HEIGHT (meters) 10. WEIGHT (kilos)

11. ADDRESSES 12. TELEPHONE NUMBERS

a. Residence: a. Residence:

b. Office: b. Office:

c. E-mail: c. Cellular:

d. Provincial Address: d. Fax:

13. NAME OF FATHER PLACE OF BIRTH 14. NAME OF MOTHER PLACE OF BIRTH

15. NAME OF SPOUSE OCCUPATION

16. CHILDREN
NAME AGE NAME AGE

EDUCATION
17. Degree/Units Honors/Awards/
Level School/College/University Inclusive Period
Earned Distinctions
Post Graduate

College

Vocational

Secondary

Elementary

ELIGIBILITY
Rating Year Roll of
18. CIVIL SERVICE No. of (including
Date of Admitted Attorneys’
ELIGIBILITY/ BOARD/BAR Times Examination
Place of Examination failed
to the No. & IBP
EXAMINATION TAKEN Taken rating if
applicable)
Bar Chapter

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19. PREJUDICATURE PROGRAM Inclusive Dates of Attendance Rating

RELEVANT TRAININGS
20. SEMINARS, TRAININGS, SCHOLARSHIPS, AND FELLOWSHIP GRANTS (in inverse chronological order)
Inclusive
Course Title Place Conducted by
Period

(continue on separate sheet if necessary)

PROFESSIONAL EXPERIENCE
21. SERVICE RECORD (include services in both private & government sectors in inverse chronological order)
Inclusive Period Nature of
No. Department/Agency Supervisor
Salary Work (include current
Position From To of (include current address & (e.g. judicial, legal,
Grade phone no.)
address & phone
(mm/dd/yy) (mm/dd/yy) Years administrative, no.)
corporate)

22. BRIEF JOB DESCRIPTION OF EACH OF THE POSITIONS HELD

(continue on separate sheet if necessary)

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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 b. Nature of Current c. If private practitioner, latest MCLE Compliance Certificate No.
Practice of Law: Practice: with Compliance Period:

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

e. Number and Nature of Cases Lost in the Past 5 f. Number of Cases Handled in the Appellate Courts in
Years: the Past 5 Years:

g. Significant Cases Handled in the Past 5 Years:

Date Date Names, Current Addresses & Tel. Nos. of

Case Title/Docket No. Type of Case Court Counsel for the other Parties
Filed Decided

25. 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 d. Number of Decisions Appealed or Pending Appeal:
Past 5 Years:

e. Percentage of Affirmances in the Past 5 Years: 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?
 
No 
Yes If Yes, give particulars.
Date Submitted Date Extension of
Case Title Docket No. Type of Case Date Filed for Decision or Time was Requested
Resolution & Granted

(continue on separate sheet if necessary)

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26. TEACHING EXPERIENCE
School Inclusive Period Nature of Appointment Courses Taught

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

RECORD OF CASES FILED AGAINST YOU

28. FORMAL OR INFORMAL COMPLAINTS FILED AGAINST YOU (Civil, Criminal, or Administrative including
disbarment and contempt of court)
Have you ever been charged with violation of any law, decree, ordinance, administrative issuance, or regulation by any
court, prosecution office, tribunal, or any other government office, agency or instrumentality in the Philippines or in any
foreign country?
 
No 
Yes If Yes, give particulars:
Complainant’s Name, Address Type of
Case Title/Docket No. Date Filed Court Disposition
& Tel. No. Complaint

29. 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 law, decree, ordinance, administrative issuance, or regulation before any court,
prosecution office, any other office, agency or instrumentality of the government, or the Integrated Bar of the Philippines
or in any foreign country?
 
No 
Yes If Yes, give particulars:
Complainant’s Name, Address Type of
Case Title/Docket No. Date Filed Court Status
& Tel. No. Complaint

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30. 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 regulation by any court, tribunal, bar association, disciplinary committee, or any other
government office, agency or instrumentality in the Philippines or any foreign country?
 
No 
Yes If Yes, give particulars:
Complainant’s Name, Address Type of Date Decided /
Case Title/Docket No. Date Filed Court Disposition
& Tel. No. Complaint

OTHER MATTERS
31. TERMINATION OF EMPLOYMENT
Have you been retired, dismissed, or forced to resign from employment? 
Yes 
No If yes, state particulars.

32. CANDIDACY FOR ELECTIVE OFFICE

Have you been a candidate for any elective office in any election?
Yes
No If yes, when and for what position?

33. RELATIVES in Government Service in the Region where you seek to be appointed
Name Position Place of Assignment Nature of Employment Relationship

REFERENCES
34. Persons not related to you by consanguinity or affinity who have knowledge of your personal or professional background.
Name Address Tel. No.

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 AGREEMENT
I declare under oath that the answers given above are true and correct to the best of my knowledge and belief. I
bind myself to inform the Judicial and Bar Council (JBC) of any material changes that may arise in the future affecting the
information contained herein.
Likewise, I authorize the JBC and its agents or representatives to verify the truth of any of the above information
or to conduct investigation on my background and qualifications from any and all available sources. In this regard, I
authorize any government or law enforcement agency and its representatives or agents, as well as private individuals or
entities, to release any document, record or information they may have about me that the JBC may request. I agree that
the information contained herein and public documents submitted by me or gathered by the JBC, except personal
information such as those under numbers 11 to 16, the addresses and telephone numbers of other persons, shall be open to
the public.
Furthermore, I am willing to be nominated for appointment to any of the vacancies which I applied for. If I am
not nominated at all, the JBC is not obliged to disclose the reason. In the event that I decide to withdraw my application
or decline my nomination, I shall immediately notify the JBC in writing. Should I be appointed to the position I am
applying for, I am committed to assume the duties and functions of the said office.

__________________________
Signature

__________________________
Date

JURAT

SUBSCRIBED AND SWORN to before me in the City/Municipality of _______________________, this

_____ day of ________________________ 20___, affiant exhibiting to me his/her Community Tax Certificate No.
__________________________ issued at _____________________________ on _________________________.

__________________________
Notary Public
Doc. No. _______;
Page No. _______;
Book No. _______;
Series of 20 _____.

PDS-Form-December 2012

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