CONFIDENTIAL

Republic of the Philippines

NATIONAL POLICE COMMISSION
Philippine National Police Special Action Force
Camp Bagong Diwa, Bicutan, Taguig City

BADGE NO: 299848

PNP PERSONAL DATA SHEET
GSIS NO:
PHILHEALTH NO:
PAG-IBIG NO: 121048543448
WARNING !
The correctness of all statements or entries made herein is subjected to verification and any deliberate omission or distortion of information may give
sufficient cause for Investigation.

I. GENERAL INFORMATION
1. NAME (Last Name, First Name, Middle Name, Qualifier)
JURBINA ROELDEN ARAZA
2. RANK 3. DESIGNATION 4. DATE DESIGNATED
Pat

5. UNIT : SAF 6. TEL # :

SUBUNIT : Rapid Deployment Battalion
STATION : 82nd SAC
ADDRESS : Camp Bagong Diwa, Bicutan, Taguig City

7. DATE OF BIRTH 8. PLACE OF BIRTH: 9. E-MAIL ADDRESS

11/23/1987 W/SAMAR roeljurbina2016@gmail.com

10. HOME ADDRESS (House No. / Street / Mun. / City / Province) 11. PHONE #
BONIFACIO ST CORAZON CATMON CEBU 09958942995
12. SEX: 13. CIVIL STATUS: 14. RELIGION
Male Single Roman Catholic
15. COLOR OF EYES 16. HEIGHT (cm.) 17. WEIGHT (kgs.)
BROWN 168 68
18. BLOOD TYPE : 19. BUILD: 20. COMPLEXION
O MEDIUM FAIR
21. COLOR OF HAIR: 22. IDENTIFYING MARKS
BLACK MOLE LEFT SIDE CHEEK
23. LANGUAGES/DIALECT (Read/Write/Speak) 24. ETHNIC GROUP
English, Tagalog
25. HOUSING DATA:

25. DEPENDENTS

NAME RELATIONSHIP BIRTHDATE ADDRESS

RODOLFO L JURBINA Father BONIFACIO ST CORAZON CATMON CEBU

ANECITA A JURBINA Mother

Signature page: 1
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II. APPOINTMENT DATA
26. AUTHORITY FOR PRESENT RANK 27. EFFECTIVITY DATE (mm/dd/yy) 28. IF TEMP, STATE REASON
MODE/STATUS OF PROMOTION
GO 1353-J SAF dtd 12/16/2017
12/16/2017(Temporary)

29. AUTHORITY FOR PREVIOUS RANK 30. EFFECTIVITY DATE (mm/dd/yy) 31. ABSORPTION ORDER
MODE/STATUS OF PROMOTION

32. AUTHORITY FOR APPOINTMENT/CAD 33. EFFECTIVITY DATE / SOURCE OF 34. ORIGINAL RANK/UNIT
AS OFFICER/PCO COMMISSION
PO1

35. AUTH FOR APPT AS PNCO/ 36. DATE ENTERED MIL/ 37. CSC ACCREDITED SVC
CADET/EP/PATROLMAN POLICE SERVICE (RANK) (DATE ENTERED/POSITION/OFFICE)

GO 1353-J SAF dtd 12/16/2017 12/16/2017(PO1)

III. EDUCATIONAL BACKGROUND

LEVEL COURSE NAME OF SCHOOL INCLUSIVE DATE

COLLEGE BS INFORMATION STO TOMAS COLLEGE 22008-2012

TECHNOLOGY

IV. TRAINING

COURSE TITLE CLASS NUMBER LOCATION AUTHORITY NO. OF HOURS INCLUSIVE DATE

A. Mandatory Course

PS BASIC RECRUIT 2017-04 CAMP BAGONG DIWA GO#2018-106 dtd 960 12/17/2017 -
COURSE 06/20/2018 06/20/2018
B. Specialized Course
SAF COMMANDO COURSE 85-2018 SAFTB SO#725-E dtd 10/10/2018 -
12/04/2019 12/06/2019
C. Seminars

V. ELIGIBILITIES
DATE TAKEN TITLE TEST CENTER RATING
04/23/2017 NAP PO1 ENT / PNP ENTRANCE EXAM CEBU 80.66%
(NAPOLCOM)

VI. ASSIGNMENT RECORD

UNIT SUB UNIT / STATION DESIGNATION / DETAILED AUTHORITY SOURCE EFFECTIVITY
DATE
SAF RDB, 82nd SAC SO 2021-07 dtd 02/26/2021 SAF 02/26/2021

SAF RDB SO SAF-SO-RA-2019-1611 SAF 12/06/2019

dtd 12/05/2019
SAF SAF Training School SO 1341-F dtd 12/16/2017 SAF 12/16/2017

SAF GO 1353-J dtd 12/16/2017 SAF 12/16/2017

VII. PROMOTION RECORD

RANK STATUS AUTHORITY EFFECTIVITY DATE REMARKS

Pat (P) GO#26 dtd 03/24/2020, SAF 01/31/2020

Signature page: 2
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PO1 (T) GO#1353-J dtd 12/16/2017, SAF 12/16/2017

VIII. MEDALS / AWARDS / COMMENDATION

NATURE OF AWARD SSC# BAL# AUTHORITY AWARDED BY REMARKS

Medalya ng Kasanayan GO#SAF-GO-AW-2021-4554 dtd 08/23/2021, PBGEN NATIVIDAD

SAF
Medalya ng Kasanayan GO#SAF-GO-AW-2021-3544 dtd 06/22/2021, PBGEN NATIVIDAD
SAF
Medalya ng Kasanayan GO#SAF-GO-AW-2021-2154 dtd 04/22/2021, PMGEN BALBA
SAF
Medalya ng Papuri GO#SAF-GO-AW-2021-1932 dtd 04/15/2021, PMGEN BALBA
SAF
Medalya ng Ugnayang Pampulisya GO#SAF-GO-AW-2021-1361 dtd 03/15/2021, PMGEN BALBA
SAF
Medalya ng Pagtulong sa Nasalanta GO#SAF-GO-AW-2021-696 dtd 01/26/2021, PMGEN BALBA
SAF
Medalya ng Kasanayan GO#SAF-GO-AW-2021-551 dtd 01/18/2021, PMGEN EMPISO
SAF
Medalya ng Kasanayan GO#SAF-GO-AW-2020-4116 dtd 12/04/2020, PMGEN BALBA
SAF
Medalya ng Papuri GO#SAF-GO-AW-2020-3324 dtd 10/08/2020, PBGEN BALBA
SAF
Medalya ng Papuri GO#SAF-GO-AW-2020-3308 dtd 10/07/2020, PBGEN BALBA
SAF
Medalya ng Papuri GO#SAF-GO-AW-2020-2975 dtd 09/01/2020, PMGEN EMPISO
SAF
Medalya ng Kasanayan GO#SAF-GO-AW-2020-1961 dtd 07/08/2020, PMGEN EMPISO
SAF
Medalya ng Kasanayan GO#SAF-GO-AW-2020-1375 dtd 05/20/2020, PMGEN EMPISO
SAF
Medalya ng Papuri GO#SAF-GO-AW-2020-919 dtd 04/02/2020, PMGEN EMPISO
SAF
Medalya ng Pagtulong sa Nasalanta GO#SAF-GO-AW-2020-307 dtd 02/17/2020, PMGEN EMPISO
SAF
AUTHORITY TO WEAR THE BLACK GO#592-E dtd 12/04/2019, SAF PMGEN EMPISO
BERET AND SAF OPERATIONAL BADGE
Authority to Wear BISOC Badge GO#593-E dtd 12/04/2019, SAF PMGEN EMPISO

Medalya ng Kasanayan GO#SAF-GO-AW-2019-1164 dtd 07/15/2019, PMGEN EMPISO

SAF
Medalya ng Kasanayan GO#68-F dtd 01/18/2019, SAF PMGEN TALIÑO

Medalya ng Papuri GO#903-J dtd 08/03/2018, SAF PMGEN TALIÑO

IX. INDIVIDUAL OPERATION ACCOMPLISHMENT

PARTICULARS ROLE/DESIGNATION DATE AWARDED BY

X. PHYSICAL FITNESS TEST

DATE TAKEN RATING CONDUCTED BY REMARKS

XI. OFFENSE DATA

Signature page: 3
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CASE STATUS/
NATURE OF IMPLEMENTING
CASE NATURE SPECIFIC OFFENSE PENALTY REMARKS
OFFENSE ORDERS
IMPOSED

XII. PERFORMANCE EVALUATION RATING

RATING PERIOD NUMERICAL RATING ADJECTIVAL RATING

XIIi. FIRE ARMS RECORD

LICENCE NO. KIND MAKE CALIBER AMMO ISSUING UNIT

MASADA PISTOL 9MM

XVIII. CERTIFICATION

"I CERTIFY to the truthfulness, correctness and accuracy of the foregoing data. I hold myself for perjury and shall
be dealt with in accordance to the provisions of NAPOLCOM MC 2016-002, (The Uniform Rules of Procedures before the
Disciplinary Authorities and the Internal Affairs Service of the PNP), and/or 2017 RACCS (The Rules on Administrative
Cases in the Civil Service) for any misrepresentation."

Pat ROELDEN ARAZA JURBINA

SIGNATURE OVER PRINTED NAME

LEFT RIGHT

THUMBMARK

SUBSCRIBED AND SWORN TO before me this __________day of _____________20_________at___________________

Signature page: 4