SF-171 - continuation sheet.pdf

PDF 78 KB Posted Dec 6, 2024

Attached to: Anticorruption Program Advisor
Solicitation number: PSC-25-009-INL
Issued by: Department of State Office of Acquisition Management

About this file

Written by GovTribe AI · Dec 6, 2024

This is Standard Form 171-A, which is a continuation sheet used with Standard Form 171 for documenting additional work experience when applying for federal positions. The form provides space to record detailed work history including employer information, dates of employment, salary, supervisors, job titles, duties and responsibilities. This continuation sheet is specifically referenced as a required document for applying to the Anticorruption Program Advisor position (Solicitation PSC-25-009-INL) with the Department of State's Bureau of International Narcotics and Law Enforcement Affairs.

The form contains fields for listing employer organization names/addresses, position details, salary information, supervisor contact information, and description of work duties. It includes sections for documenting start/end dates, hours worked per week, number of employees supervised, and reasons for leaving positions. The form must be attached to the main SF-171 application at the top of page 3. This is a standard government template that does not contain any completed information - it shows only the blank form fields to be filled out by applicants.

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SF-171 Fillable.pdf	PDF	Dec 6, 2024

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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 Dec 6, 2024.