SF-171 - continuation sheet.pdf

PDF 78 KB Posted Oct 16, 2026

Attached to: Deputy Law Enforcement Coordinator
Solicitation number: PSC-27-005-INL
Issued by: Department of State Office of Acquisition Management

About this file

Written by GovTribe AI · Oct 16, 2026

This document is the Standard Form 171-A (Continuation Sheet for SF 171), a federal employment application form used by the U.S. Office of Personnel Management. The form serves as a continuation sheet for applicants to provide additional work experience beyond what can be accommodated on the primary SF 171 application. The form is organized into multiple "Additional Work Experience Blocks," each requiring applicants to document employment history including employer name and address with ZIP code, exact job title, dates of employment (month, day, and year), average hours per week, number of employees supervised, and immediate supervisor information with telephone number.

For each position listed, applicants must provide a detailed description of specific duties, responsibilities, and accomplishments, including job titles of any supervised employees and approximate percentages of time spent on different types of work. The form also requires salary or earnings information (starting and ending amounts per designated period) and the applicant's reason for leaving each position. Federal employment positions require applicants to list the series, grade or rank, and promotion date if applicable. The form includes header fields for applicant name, Social Security number, job title or announcement number being applied for, and date completed. All SF 171-A continuation sheets must be attached at the top of page 3 of the primary application. The form was last revised June 1988 and is OMB-approved under number 3206-0012.

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SF-171 Fillable.pdf	PDF	Oct 16, 2026

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Your immediate supervisor N a me Te l eph phone No.

N am e and ad dr ess of employer's organization(include ZIP Code, if known)

Exact title of your job If Federal employment (civilian or military) list series, grade or rank, and, if promoted in this job, the date of your last promotion

Description of work: Describe your specific duties, responsibilities and accomplishments in this job, including the job title(s) of any employees you supervise. If you describe more than one type of work (for example, carpentry and painting, or personnel and budget), write the approximate percentage of time you spent doing each.

Dates employed (give month, day and year)

From: To:

Average number of hours per week

Number of employees you supervise

Your reason for wanting to leave

ADDITIONAL WORK EXPERIENCE BLOCKS

For Agency Use (skill codes, etc.)

Salary or earnings

Starting $ per

Ending $ per

Your immediate supervisor N a me Te l eph on e N o .

Name and address of employer's organization (include ZIP Code, if known)

Exact title of your job If Federal employment (civilian or military) list series, grade or rank, and, if promoted in this job, the date of your last promotion

Dates employed (give month, day and year)

From: To:

Average number of hours per week

Number of employees you supervise

Your reason for leaving

For Agency Use (skill codes, etc.)

Salary or earnings

Starting $ per

Ending $ per

Attach all SF 171-A's to your application at the top of page 3.

Form Approved:

OMB No. 3206-0012

Standard Form 171-A Continuation Sheet for SF 171

1. Name (Last, First, Middle Initial)

3. Job Title or Announcement Number You Are Applying For

2. Social Security Number

4. Date Completed

THE FEDERAL GOVERNMENT IS AN EQUAL OPPORTUNITY EMPLOYER

PREVIOUS EDITION USABLE UNTIL 12-31-90 NSN 7540-00-935-7157 171-206

Standard F orm 171-A ( Rev. 6-88) U.S. Office of Personnel Management

FPM Chapter 295

Your immediate supervisor N a me Te l eph on e N o .

Name and address of employer's organization (include ZIP Code, if known)

Exact title of your job If Federal employment (civilian or military) list series, grade or rank, and, if promoted in this job, the date of your last promotion

Dates employed (give month, day and year)

From: To:

Average number of hours per week

Number of employees you supervise

Your reason for wanting to leave

ADDITIONAL WORK EXPERIENCE BLOCKS

Salary or earnings

Starting $ per

Ending $ per

For Agency Use (skill codes, etc.)

Attach all SF 171-A's to your application at the top of page 3.

Form Approved:

OMB No. 3206-0012

Standard Form 171-A Continuation Sheet for SF 171 (Back)

1. Name (Last, First, Middle Initial)

3. Job Title or Announcement Number You Are Applying For

2. Social Security Number

4. Date Completed

Standard F orm 171-A (BA CK) (Rev. 6-88) U.S . Office of Pe rsonnel M an agement

FPM Chapter 295

EMPLYRNAME1:

EMPLYRADDR1:

POSFROMDATE1:

POSTODATE1:

POSHRS1:

EMPSUPV1:

POSSTARTSALARY1:

POSSTARTSALARYPER1:

POSENDSALARY1:

POSENDSALARYPER1:

POSLEAVEREASON1:

SPVRNAME1:

POSTITLE1:

POSGRADE1:

POSSERIES1:

LASTPROMODATE1:

SSN:

EMPLYRNAME2:

EMPLYRADDR2:

POSTODATE2:

POSHRS2:

EMPSUPV2:

POSSTARTSALARY2:

POSSTARTSALARYPER2:

POSENDSALARY2:

POSENDSALARYPER2:

POSLEAVEREASON2:

SPVRNAME2:

POSTITLE2:

POSGRADE2:

POSSERIES2:

EMPLYRNAME3:

EMPLYRADDR3:

POSFROMDATE3:

POSTODATE3:

POSHRS3:

EMPSUPV3:

POSSTARTSALARY3:

POSSTARTSALARYPER3:

POSENDSALARY3:

POSENDSALARYPER3:

POSLEAVEREASON3:

SPVRNAME3:

POSTITLE3:

POSGRADE3:

POSSERIES3:

LASTPROMODATE3:

Save Data:

Print:

Email Form:

Retrieve Data:

Reset Form:

BLOCK3:

BLOCK1:

POSFROMDATE2:

BLOCK2:

POSSKILLCODES1:

POSSKILLCODES2:

SPVRTELNO1:

SPVRTELNO2:

LASTNAME:

APPPOSTITLE:

COMPLETEDDATE:

SPVRTELNO3:

POSDESCRIP1:

POSDESCRIP8:

LASTPROMODATE2:

FIRSTNAME:

MINAME:

POSSKILLCODES3:

POSDESCRIP2:

POSDESCRIP9:

POSDESCRIP10:

POSDESCRIP11:

File details come from the government source that posted it. Updated Oct 16, 2026.