SF-171 - continuation sheet.pdf

PDF 78 KB Posted Dec 10, 2024

Attached to: Foreign Assistance EUM Advisor
Solicitation number: PSC-25-010-INL
Issued by: Department of State Office of Acquisition Management

About this file

Written by GovTribe AI · Dec 10, 2024

This is Standard Form 171-A, a continuation sheet used for documenting additional work experience as part of federal job applications. The form contains fields for capturing detailed employment history including employer information, dates of employment, salary, supervisor details, job titles, and descriptions of work duties and responsibilities. The form is approved under OMB No. 3206-0012 and is issued by the U.S. Office of Personnel Management.

The document is a blank template form that provides space for two additional work experience entries beyond the main SF-171 application. Each entry section includes fields for employer name/address, employment dates, hours worked, number of employees supervised, salary information, supervisor contact details, and a large text area for describing specific duties and accomplishments. The form instructs applicants to include the percentage breakdown of time spent on different types of work if describing multiple duties.

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SF-171 Fillable.pdf	PDF	Dec 10, 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 10, 2024.