SF-171 - continuation sheet.pdf

PDF 78 KB Posted

Attached to
Senior Law Enforcement Advisor
Solicitation number
PSC-25-016-INL
Issued by

About this file

This is Standard Form 171-A, which is a continuation sheet attachment for the SF-171 Application for Federal Employment. The form provides additional space for documenting work experience beyond what fits on the main SF-171 form. It contains sections for capturing employer information, dates of employment, salary details, supervisor information, job titles, and detailed descriptions of work duties and responsibilities. The form includes fields for listing multiple previous positions, with space to describe specific duties, accomplishments, and number of employees supervised for each role.

This particular form is associated with Department of State solicitation PSC-25-016-INL for a Senior Law Enforcement Advisor position in Washington, DC. The form must be completed and submitted as part of the application package along with a resume, evaluation factor responses, and professional references by January 31, 2025 at 3:00 PM ET. The form is identified by OMB No. 3206-0012 and includes instructions to attach all SF 171-A sheets to page 3 of the main application.

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SF-171 Fillable.pdf PDF

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Text version

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

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 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

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

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

b:
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:
Next Page:
POSFROMDATE2:
BLOCK2:
g:
POSSKILLCODES1:
POSSKILLCODES2:
SPVRTELNO1:
SPVRTELNO2:
LASTNAME:
APPPOSTITLE:
COMPLETEDDATE:
SPVRTELNO3:
POSDESCRIP1:
POSDESCRIP8:
LASTPROMODATE2:
FIRSTNAME:
MINAME:
POSSKILLCODES3:
Previous Page:
POSDESCRIP2:
POSDESCRIP9:
POSDESCRIP10:
POSDESCRIP11:

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