SF-171 - continuation sheet.pdf

PDF 78 KB Posted Apr 16, 2026

Attached to: Contracting Officer’s Representative (COR)
Solicitation number: PSC-26-026-INL
Issued by: Department of State Office of Acquisition Management

About this file

Written by GovTribe AI · Apr 16, 2026

This is a continuation sheet form (Standard Form 171-A) used for federal employment applications. The form serves as an attachment to the primary SF 171 application and is designed to provide additional work experience blocks when the main form's space is insufficient. Applicants must attach all SF 171-A continuation sheets to the top of page 3 of their SF 171 application.

The form contains multiple identical work experience blocks, each requiring the applicant to provide comprehensive employment history including: employer organization name and address with ZIP code, exact job title, supervisor name and telephone number, employment dates (month, day, and year), average hours per week, number of employees supervised, salary or earnings information (starting and ending amounts), detailed description of specific duties and responsibilities, accomplishments, and job titles of any supervised employees. For federal employment, applicants must list the series, grade or rank, and promotion date if applicable. Each block also requests the applicant's reason for leaving or wanting to leave the position and includes a section for agency use regarding skill codes. The form is OMB approved under number 3206-0012, was revised in June 1988, and indicates that the previous edition remained usable until December 31, 1990. The form includes equal opportunity employer language and provides options to save data, print, email, or navigate to the next page.

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SF-171 Fillable.pdf	PDF	Apr 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 Apr 16, 2026.