SF-171 - continuation sheet.pdf

PDF 78 KB Posted Jul 9, 2026

Attached to: Maritime Interdiction Advisor
Solicitation number: PSC-26-035-INL
Issued by: Department of State Office of Acquisition Management

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Written by GovTribe AI · Jul 9, 2026

Standard Form 171-A (SF 171-A)

This is a federal employment application continuation sheet template used to document additional work experience for applicants seeking positions with the U.S. government. The form serves as a supplementary document to the primary SF 171 application and must be attached at the top of page 3 of the main application.

The SF 171-A provides standardized fields for applicants to record multiple work history entries, with each block capturing: employer name and address (including ZIP code), exact job title, employment dates (month, day, and year), average hours worked per week, number of employees supervised, salary information (starting and ending amounts), supervisor name and telephone number, detailed description of specific duties and responsibilities, and reason for leaving each position. For federal employment positions, applicants must list the civil service series, grade or rank, and promotion dates if applicable. The form includes space for agencies to record skill codes and other administrative information. The template is approved under OMB No. 3206-0012 and is usable until December 31, 1990. It emphasizes that the federal government is an equal opportunity employer and provides options to save data, print, email, or navigate to additional pages.

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SF-171 Fillable.pdf	PDF	Jul 9, 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 Jul 9, 2026.