Standard Form 86A PDF Details

The Standard Form 86A, revised in July 2008 by the U.S. Office of Personnel Management under the regulations of 5 CFR Parts 731, 732, and 736, serves as a crucial instrument for individuals seeking various government positions, including non-sensitive, public trust, and national security roles. This form functions as a continuation sheet for Questionnaires SF 85, SF 85P, and SF 86, enabling applicants to provide comprehensive details regarding their residences, educational background, and employment history that could not be fully covered within the primary forms due to space constraints. Applicants use it to ensure a thorough disclosure of their living situations, schooling, and work experiences by offering additional space to elucidate on "Where You Have Lived," "Where You Went to School," and "Your Employment Activities." The form demands precise information, including dates of residence, educational institutions attended along with degrees or diplomas earned, and a detailed employment history specifying the nature of employment, positions held, and supervisors' details, among others. It underscores the importance of accuracy and completeness, with a reminder of the legal implications of knowingly providing false information, amplifying its role in the integrity and security of federal employment and security clearance processes. Its design reflects the necessity for meticulous vetting in sensitive and trust-required positions by allowing applicants the opportunity to provide a full and transparent account of their background, thereby facilitating a comprehensive evaluation by U.S. personnel management authorities.

QuestionAnswer
Form NameStandard Form 86A
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other namesNSN, CFR, OMB, Verifier

Form Preview Example

Standard Form 86A

Revised July 2008

U.S. Office of Personnel Management

5 CFR Parts 731, 732, and 736

CONTINUATION SHEET FOR QUESTIONNAIRES

SF 85, SF 85P, AND SF 86

For use with the SF 85, Questionnaire for Non-Sensitive Positions;

SF 85P, Questionnaire for Public Trust Positions;

and SF 86, Questionnaire for National Security Positions

Form approved: OMB No. 3206 0005 NSN 7540-01-268-4828 86-111

INSTRUCTIONS: Use this form to continue your answers to "Where You Have Lived," "Where You Went to School," and/or "Your Employment Activities." Follow the instructions on the form for the particular questions you are answering and give information in the same sequence. Use as many continuation sheets as needed.

Your Name

Your Social Security Number

11 WHERE YOU HAVE LIVED (Continued)

#5 Month/Year

To

Month/Year

Status

 

 

Own

 

 

Military housing

Street address

 

 

 

 

 

 

Apt.#

 

 

 

 

 

 

 

 

 

Rent

 

 

Other (Explain)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

APO/FPO address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City (Country)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State

 

ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of person who knows you at this address

 

Current address

 

 

 

 

 

 

 

 

 

Apt.#

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

APO/FPO address (if currently applicable)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City (Country)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State

 

ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Telephone number

 

Alternate contact number

 

 

 

Relationship

 

 

Neighbor

 

Landlord

 

Other (Explain)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Friend

 

Business associate

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

#6 Month/Year

To

Month/Year

Status

 

Own

 

 

Military housing

Street address

 

 

 

 

 

 

Apt.#

 

 

 

 

 

 

 

 

Rent

 

 

Other (Explain)

 

 

 

 

 

 

 

 

 

 

APO/FPO address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City (Country)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State

 

ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of person who knows you at this address

 

Current address

 

 

 

 

 

 

 

 

 

Apt.#

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

APO/FPO address (if currently applicable)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City (Country)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State

 

ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Telephone number

 

Alternate contact number

 

 

 

Relationship

 

 

Neighbor

 

Landlord

 

Other (Explain)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Friend

 

Business associate

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

#7 Month/Year

To

Month/Year

Status

 

Own

 

 

Military housing

Street address

 

 

 

 

 

 

Apt.#

 

 

 

 

 

 

 

 

Rent

 

 

Other (Explain)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

APO/FPO address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City (Country)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State

 

ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of person who knows you at this address

 

Current address

 

 

 

 

 

 

 

 

 

Apt.#

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

APO/FPO address (if currently applicable)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City (Country)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State

 

ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Telephone number

 

Alternate contact number

 

 

 

Relationship

 

 

Neighbor

 

Landlord

 

Other (Explain)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Friend

 

Business associate

 

 

 

 

 

Enter your Social Security Number before going to the next page

Standard Form 86A

Revised July 2008

U.S. Office of Personnel Management

5 CFR Parts 731, 732, and 736

CONTINUATION SHEET FOR QUESTIONNAIRES

SF 85, SF 85P, AND SF 86

Form approved: OMB No. 3206 0005 NSN 7540-01-268-4828 86-111

12 WHERE YOU WENT TO SCHOOL (Continued)

#6 Month/Year To Month/Year Code

Name of school

Degree/diploma received? If "Yes," identify type

 

 

 

 

 

 

 

 

 

of degree/diploma received and date awarded.

 

 

 

YES

 

 

 

 

 

 

 

 

 

NO

 

 

 

 

 

 

 

 

 

 

 

Street address and City (Country) of school

State

ZIP Code

Name of person who knows you

Current address

 

 

Apt. #

 

 

 

 

 

City (Country)

 

State

ZIP Code

Telephone number

#7 Month/Year To Month/Year Code

Name of school

Degree/diploma received? If "Yes," identify type

 

 

of degree/diploma received and date awarded.

YES

NO

Street address and City (Country) of school

 

 

 

 

State

ZIP Code

 

 

 

 

 

 

 

Name of person who knows you

Current address

 

 

 

 

Apt. #

 

 

 

 

 

 

City (Country)

 

State

ZIP Code

Telephone number

 

#8 Month/Year To Month/Year Code

Name of school

Degree/diploma received? If "Yes," identify type

 

 

of degree/diploma received and date awarded.

YES

NO

Street address and City (Country) of school

 

 

 

 

State

ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of person who knows you

Current address

 

 

 

 

Apt. #

 

 

 

 

 

 

City (Country)

 

State

ZIP Code

Telephone number

 

#9 Month/Year To Month/Year Code

Name of school

Degree/diploma received? If "Yes," identify type

 

 

of degree/diploma received and date awarded.

YES

NO

Street address and City (Country) of school

 

 

 

 

State

ZIP Code

 

 

 

 

 

 

 

Name of person who knows you

Current address

 

 

 

 

Apt. #

 

 

 

 

 

 

City (Country)

 

State

ZIP Code

Telephone number

 

#10 Month/Year To Month/Year Code

Name of school

Degree/diploma received? If "Yes," identify type

 

 

of degree/diploma received and date awarded.

YES

NO

Street address and City (Country) of school

 

 

 

 

State

ZIP Code

 

 

 

 

 

 

 

Name of person who knows you

Current address

 

 

 

 

Apt. #

 

 

 

 

 

 

City (Country)

 

State

ZIP Code

Telephone number

 

Enter your Social Security Number before going to the next page

Standard Form 86A

Revised July 2008

U.S. Office of Personnel Management

5 CFR Parts 731, 732, and 736

CONTINUATION SHEET FOR QUESTIONNAIRES

SF 85, SF 85P, AND SF 86

Form approved: OMB No. 3206 0005 NSN 7540-01-268-4828 86-111

13 EMPLOYMENT/UNEMPLOYMENT INFORMATION (Continued)

#5 Dates of Employment

 

Type of Employment

 

 

 

 

 

 

 

Month/Year

To

Month/Year

Employment code

 

Position title/Military rank

 

Work hours

Full-Time

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Part-Time

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer/Verifier

 

 

 

 

 

 

 

 

 

 

 

Name of employer/verifier

 

 

 

 

 

Telephone number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address of employer/verifier

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City (Country)

 

 

 

 

 

 

 

 

State

ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Physical Location

 

 

 

 

 

 

 

 

 

 

 

Your actual work address (if different from employer address)

 

Telephone number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City (Country)

 

 

 

 

 

 

 

 

 

 

State

ZIP Code

 

 

 

 

 

 

 

 

 

 

 

Supervisor (if different from employer)

 

 

 

 

 

 

 

Name and title

 

 

 

 

 

 

 

 

Telephone number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Work address of supervisor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City (Country)

 

 

 

 

 

 

 

 

 

 

State

ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Additional Periods of Activity with this Employer

 

 

 

 

 

 

 

Month/Year

To

 

Month/Year

Position title

 

Supervisor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Month/Year

To

 

Month/Year

Position title

 

Supervisor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Month/Year

To

 

Month/Year

Position title

 

Supervisor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Explanation/Reason for leaving

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

#6 Dates of Employment

 

Type of Employment

 

 

 

 

 

 

 

Month/Year

To

Month/Year

Employment code

Position title/Military rank

 

Work hours

Full-Time

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Part-Time

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer/Verifier

 

 

 

 

 

 

 

 

 

 

 

Name of employer/verifier

 

 

 

 

 

Telephone number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address of employer/verifier

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City (Country)

 

 

 

 

 

 

 

 

State

ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Physical Location

 

 

 

 

 

 

 

 

 

 

 

Your actual work address (if different from employer address)

 

 

Telephone number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City (Country)

 

 

 

 

 

 

 

 

 

 

State

ZIP Code

 

 

 

 

 

 

 

 

Supervisor (if different from employer)

 

 

 

 

 

 

 

Name and title

 

 

 

 

 

 

 

 

Telephone number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Work address of supervisor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City (Country)

 

 

 

 

 

 

 

 

 

 

State

ZIP Code

Enter your Social Security Number before going to the next page

Standard Form 86A

Revised July 2008

U.S. Office of Personnel Management

5 CFR Parts 731, 732, and 736

CONTINUATION SHEET FOR QUESTIONNAIRES

SF 85, SF 85P, AND SF 86

Form approved: OMB No. 3206 0005 NSN 7540-01-268-4828 86-111

13EMPLOYMENT/UNEMPLOYMENT INFORMATION (Continued) Additional Periods of Activity with this Employer

Month/Year

To

Month/Year

Position title

Supervisor

 

 

 

 

 

 

Month/Year

To

Month/Year

Position title

Supervisor

 

 

 

 

 

 

Month/Year

To

Month/Year

Position title

Supervisor

 

 

 

 

 

 

Explanation/Reason for leaving

#7 Dates of Employment

 

Type of Employment

 

 

 

 

 

 

Month/Year

To Month/Year

Employment code

 

Position title/Military rank

 

Work hours Full-Time

 

 

 

 

 

 

 

 

 

 

 

 

 

Part-Time

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer/Verifier

 

 

 

 

 

 

 

 

 

Name of employer/verifier

 

 

 

 

 

Telephone number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address of employer/verifier

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City (Country)

 

 

 

 

 

 

 

State

ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Physical Location

 

 

 

 

 

 

 

 

 

Your actual work address (if different from employer address)

 

 

Telephone number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City (Country)

 

 

 

 

 

 

 

 

 

State

ZIP Code

 

 

 

 

 

 

 

Supervisor (if different from employer)

 

 

 

 

 

 

Name and title

 

 

 

 

 

 

 

Telephone number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Work address of supervisor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City (Country)

 

 

 

 

 

 

 

 

 

State

ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Additional Periods of Activity with this Employer

 

 

 

 

 

 

Month/Year

To

 

Month/Year

Position title

 

Supervisor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Month/Year

To

 

Month/Year

Position title

 

Supervisor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Month/Year

To

 

Month/Year

Position title

 

Supervisor

 

 

 

Explanation/Reason for leaving

PUBLIC BURDEN INFORMATION

Public burden reporting for this collection of information averages 20 minutes, 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 OPM Forms Officer, U.S. Office of Personnel Management, 1900 E Street NW, Washington, DC 20415. Do not send your completed form to this address, send it to the office that provided you the form. The OMB clearance number, 3206-0005, is currently valid. OPM may not collect this information, and you are not required to respond, unless this number is displayed.

After completing this form and any attachments, you should review your answers to all questions to make sure the form is complete and accurate, and then sign and date the following certification and the attached release(s).

Certification

My statements on this form, and on any attachments to it, are true, complete, and correct to the best of my knowledge and belief and are made in good faith. I have carefully read the foregoing instructions to complete this form. I understand that a knowing and willful false statement on this form can be punished by fine or imprisonment or both (18 U.S.C. 1001). I understand that intentionally withholding, misrepresenting, or falsifying information may have a negative effect on my security clearance, employment prospects, or job status, up to and including denial or revocation of my security clearance, or my removal and debarment from Federal service.

Signature

Date (mm/dd/yyyy)

Enter your Social Security Number before going to the next page

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Completing this PDF will require thoroughness. Ensure that every single blank is filled in properly.

1. While filling in the Verifier, make sure to incorporate all of the essential blanks within the relevant form section. It will help expedite the process, which allows your details to be processed promptly and correctly.

Step # 1 of filling out Washington

2. Just after completing the previous section, head on to the subsequent part and enter all required particulars in all these blank fields - City Country, Name of person who knows you at, Current address, APOFPO address if currently, City Country, State, ZIP Code, Apt, State, ZIP Code, Telephone number, Alternate contact number, Relationship, Neighbor, and Landlord.

Step no. 2 in completing Washington

Concerning ZIP Code and Relationship, be sure that you double-check them in this current part. Those two are the most important fields in this form.

3. The following portion is all about City Country, State, ZIP Code, Telephone number, Alternate contact number, Relationship, Neighbor, Landlord, Other Explain, Friend, Business associate, and Enter your Social Security Number - complete each of these blank fields.

Find out how to fill in Washington stage 3

4. You're ready to proceed to the next segment! Here you'll get all these WHERE YOU WENT TO SCHOOL Continued, MonthYear, MonthYear, Code, Name of school, Street address and City Country of, Name of person who knows you, Current address, Degreediploma received If Yes, State, ZIP Code, Apt, City Country, State, and ZIP Code blanks to fill in.

ZIP Code, ZIP Code, and Street address and City Country of inside Washington

5. Now, this final part is what you need to finish before submitting the form. The blanks at issue are the following: City Country, State, ZIP Code, Telephone number, MonthYear, MonthYear, Code, Name of school, Degreediploma received If Yes, Street address and City Country of, Name of person who knows you, Current address, State, ZIP Code, and Apt.

Completing part 5 in Washington

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