SF-171 - continuation sheet.pdf

PDF 78 KB Posted

Attached to
Training Coordinator
Solicitation number
PSC-25-024-INL
Issued by

About this file

This document is a Standard Form 171-A Continuation Sheet for SF 171, which is a federal job application form used to provide detailed work experience information. The form includes multiple sections for recording employment history, such as employer name and address, job title, dates of employment, salary, supervisor information, and a description of specific duties and responsibilities. The form is designed for applicants to expand on their work experience beyond the main application, with space to list multiple previous jobs. It is issued by the U.S. Office of Personnel Management and is marked as an equal opportunity employer document, with form approval from the Office of Management and Budget (OMB No. 3206-0012). The form allows applicants to attach additional pages to provide comprehensive employment background details for federal job applications.

View the file

Other files

File Type Posted
SF-171 Fillable.pdf PDF

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

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:

File details come from the government source that posted it. Updated .