Standard Form 85P S PDF Details

Diving into the realm of federal employment and security clearances introduces us to various standardized forms, among which the Standard Form 85P-S (SF 85P-S) plays a pivotal role. Revised in September 1995, this form has been crafted by the U.S. Office of Personnel Management under the guidance of several federal regulations. Acting as a supplemental questionnaire for selected positions, it is designed to be filled out post-offer of employment, ensuring that all inquiries are both job-related and justified by the necessity of the business at hand. Mirroring the purposes and authorities of its primary counterpart, the SF 85P, which is for public trust positions, the SF 85P-S delves deeper into personal backgrounds. It requires full and truthful responses to sensitive questions regarding illegal drug use, alcohol consumption, and mental health consultations within the last seven years, emphasizing that honest disclosure will not be used against the respondent in criminal proceedings. The importance of accuracy and honesty is underscored by the certification at the document's conclusion, where signatories attest to the truthfulness of their responses under the penalty of law. This detailed approach not only aids in maintaining national security but also upholds the integrity of the public trust through a meticulous vetting process.

QuestionAnswer
Form NameStandard Form 85P S
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesGSA, 85P, PCP, 1900

Form Preview Example

Standard Form 85P-S (EG)

Form approved:

Revised September 1995

OMB No. 3206-0191

U.S. Office of Personnel Management

NSN 7540-01-368-7778

5 CFR Parts 731, 732, and 736

85-1700

Supplemental Questionnaire for Selected Positions

 

 

 

INSTRUCTIONS

 

 

 

This form is supplemental to SF 85P, Questionnaire for Public Trust Positions, but is used only after an offer of employment has been made and when the information it requests is job-related and justified by business necessity. Other than this restriction to its use, this form has the same purposes and authorities described on SF 85P. The agency which gave you this form will tell you which questions to answer.

Instructions for completing this form are the same as SF 85P: you must type or legibly print your answers in black ink, use State codes, etc. Be sure to sign and date the certification statement at the bottom of this page.

PUBLIC BURDEN INFORMATION: Public burden reporting for this collection of information is estimated to average 10 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Reports and Forms Management Officer, U.S. Office of Personnel Management, 1900 E Street, N.W., Room CHP-500, Washington DC 20415. Do not send your completed form to this address.

IDENTIFICATION INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

1

FULL NAME

Enter your name exactly as it appears on your SF 85P, Questionnaire for Public Trust Positions.

 

 

2

SOCIAL SECURITY NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

Last Name

 

First Name

Middle Name

Jr., II, etc.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SUPPLEMENTAL QUESTIONS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YOUR USE OF ILLEGAL DRUGS AND DRUG ACTIVITY

 

 

 

 

 

 

 

 

3

 

 

 

 

 

Yes

No

 

 

The following questions pertain to the illegal use of drugs or drug activity. You are required to answer the questions fully and truthfully, and your

 

 

 

 

 

 

failure to do so could be grounds for an adverse employment decision or action against you, but neither your truthful response nor information derived

 

 

 

 

 

 

from your response will be used as evidence against you in any subsequent criminal proceeding.

 

 

 

 

 

 

aSince the age of 16 or in the last 7 years, whichever is shorter, have you illegally used any controlled substance, for example, marijuana, cocaine, crack cocaine, hashish, narcotics (opium, morphine, codeine, heroin, etc.), amphetamines, depressants (barbiturates, methaqualone, tranquilizers, etc.), hallucinogenics (LSD, PCP, etc.), or prescription drugs?

bHave you ever illegally used a controlled substance while employed as a law enforcement officer, prosecutor, or courtroom official; while possessing a security clearance; or while in a position directly and immediately affecting the public safety?

If you answered "Yes" to any question above, provide the date(s), identify the controlled substance(s) and/or prescription drugs used, and the number of times each was used.

 

 

 

Month/Year

Month/Year

Controlled Substance/Prescription Drug Used

Number of Times Used

 

 

 

 

 

 

 

 

To

 

 

 

 

 

 

 

 

 

 

 

 

To

 

 

 

 

 

 

 

 

 

4

 

YOUR USE OF ALCOHOL

 

 

 

 

 

Yes

 

No

 

 

 

In the last 7 years, has your use of alcoholic beverages (such as liquor, beer, wine) resulted in any alcohol-related treatment or counseling (such

 

 

 

 

 

 

 

as for alcohol abuse or alcoholism)?

 

 

 

 

 

 

 

 

 

 

If you answered "Yes," provide the dates of treatment and the name and address of the counselor below. Do not repeat information reported in

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Month/Year

Month/Year

Name/Address of Counselor or Doctor

 

State

 

ZIP Code

 

 

 

 

 

To

 

 

 

 

 

 

 

 

 

 

 

 

To

 

 

 

 

 

 

 

 

 

 

YOUR MEDICAL RECORD

 

 

 

 

 

Yes

No

 

5

 

 

 

 

 

In the last 7 years, have you consulted with a mental health professional (psychiatrist, psychologist, counselor, etc.) or have you consulted with another health care provider about a mental health related condition? You do not have to answer "Yes" if you were only involved in marital, grief, or family counseling not related to violence by you.

If you answered "Yes," provide the dates of treatment and the name and address of the therapist or doctor below.

Month/Year Month/Year

Name/Address of Therapist or Doctor

State

ZIP Code

To

To

CERTIFICATION

Certification That My Answers Are True

My statements on this form, and any attachments to it, are true, complete, and correct to the best of my knowledge and belief and are made in good faith. I understand that a knowing and willful false statement on this form can be punished by fine or imprisonment or both. (See section 1001 of title 18, United States Code).

Signature (Sign in ink)

Date

Exception to SF85, SF85P, SF85P-S, SF86, and SF86A approved by GSA September, 1995. Designed using Perform Pro, WHS/DIOR, Sep 95

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