Standard Form 86A at a glance
What it is: Standard Form 86A is the continuation sheet for questionnaires SF 85, SF 85P, and SF 86.
Who signs: Sign on the Signature line and enter the Date (mm/dd/yyyy).
Use this form with the SF 85, Questionnaire for Non-Sensitive Positions; SF 85P, Questionnaire for Public Trust Positions; and SF 86, Questionnaire for National Security Positions.
A filled-in Standard Form 86A example: continuing a residence entry
How to fill out Standard Form 86A, box by box
Your Name and Your Social Security Number
Enter Your Name and Your Social Security Number. Enter your Social Security Number before going to the next page.
11 WHERE YOU HAVE LIVED (Continued)
Under 11 WHERE YOU HAVE LIVED (Continued), enter the Month/Year To Month/Year and the Status: Own, Rent, Military housing or Other (Explain).
Enter the Street address, the Apt.#, the APO/FPO address, and the City (Country), State and ZIP Code.
Enter the Name of person who knows you, with the Current address, Apt.#, APO/FPO address (if currently applicable), City (Country), State and ZIP Code.
Enter the Telephone number and Alternate contact number, and mark the Relationship: Neighbor, Landlord, Friend, Business associate or Other (Explain).
12 WHERE YOU WENT TO SCHOOL (Continued)
Under 12 WHERE YOU WENT TO SCHOOL (Continued), for #6 enter the Code, Name of school and Month/Year To Month/Year, and mark YES or NO for Degree/diploma received?
If "Yes," identify type of degree/diploma received and date awarded.
Enter the Street address and City (Country) of school, State and ZIP Code.
Enter the Name of person who knows you, with the Current address, Apt. #, City (Country), State, ZIP Code and Telephone number.
13 EMPLOYMENT/UNEMPLOYMENT INFORMATION (Continued)
Under 13 EMPLOYMENT/UNEMPLOYMENT INFORMATION (Continued), enter the Dates of Employment Month/Year To Month/Year, Type of Employment, Work hours (Full-Time or Part-Time), Position title/Military rank and Employment code.
Enter the Employer/Verifier Name of employer/verifier and Telephone number, and the Address of employer/verifier, City (Country), State and ZIP Code.
Under Physical Location, enter Your actual work address (if different from employer address), Telephone number, City (Country), State and ZIP Code.
Enter the Supervisor (if different from employer) Name and title, Telephone number, Work address of supervisor, City (Country), State and ZIP Code.
Under Additional Periods of Activity with this Employer, enter Month/Year To Month/Year, Position title and Supervisor, and the Explanation/Reason for leaving.
Certification and signature
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 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.
More rules for Standard Form 86A
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.
Common questions about Standard Form 86A
Where do I file it?
Do not send your completed form to the OPM Forms Officer, U.S. Office of Personnel Management, 1900 E Street NW, Washington, DC 20415, send it to the office that provided you the form.
Sources
[1] Standard Form 86A (Revised July 2008), Continuation Sheet for Questionnaires SF 85, SF 85P, and SF 86 (the served file; no issuer file found) (the Official source link on this page).