Free VA Form SF86A - Continuation Sheet for Questionnaires SF 86, SF 85P, and SF 85 - Federal

Standard Form 86A (EG) Revised September 1995 U.S. Office of Personnel Management 5 CFR Parts 731, 732, and 736

CONTINUATION SHEET FOR QUESTIONNAIRES SF 86, SF 85P, AND SF 85
For use with the SF 86, Questionnaire for National Security Positions; SF 85P, Questionnaire for Public Trust Positions; and SF 85, Questionnaire for Non-Sensitive Positions

Form approved: OMB No. 3206-0007 NSN 7540-01-268-4828 86-203

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

WHERE YOU HAVE LIVED (Continued)

#1

Month/Year

Month/Year

Street Address Street Address Street Address Street Address Street Address Street Address Street Address Street Address Street Address Street Address Apt # Apt # Apt # Apt # Apt #

Apt. #

City (Country) State City (Country) State ZIP Code ZIP Code

State

ZIP Code

To Name of Person Who Knows You Month/Year Month/Year

City (Country) Apt. #

Telephone Number State ZIP Code

#2

To Name of Person Who Knows You Month/Year Month/Year

City (Country) Apt. # City (Country)

Telephone Number State ZIP Code

#3

To Name of Person Who Knows You Month/Year Month/Year

City (Country) Apt. # City (Country)

State

ZIP Code

Telephone Number State ZIP Code

#4

To Name of Person Who Knows You Month/Year Month/Year

City (Country) Apt. # City (Country)

State

ZIP Code

Telephone Number State ZIP Code

#5

To Name of Person Who Knows You

City (Country)

State

ZIP Code

Telephone Number

WHERE YOU WENT TO SCHOOL (Continued)
To Street Address and City (Country) of School Name of Person Who Knew You Month/Year Month/Year Street Address Code Name of School Apt # City (Country) State

#1

Month/Year

Month/Year

Code

Name of School

Degree/Diploma/Other State ZIP Code

Month/Year Awarded ZIP Code Telephone Number Month/Year Awarded State ZIP Code Telephone Number Month/Year Awarded State ZIP Code Telephone Number

#2

Degree/Diploma/Other

To Street Address and City (Country) of School Name of Person Who Knew You Month/Year Month/Year Street Address Code Name of School Apt # City (Country) State

ZIP Code

To Street Address and City (Country) of School Name of Person Who Knew You Street Address Apt # City (Country) State

#3

Degree/Diploma/Other

ZIP Code

Exception to SF 85, SF 85P, SF 85P-S, SF 86, and SF 86A approved by GSA September 1995. Designed using Adobe LiveCycle Designer 7.1

YOUR EMPLOYMENT ACTIVITIES (Continued)
Month/Year Month/Year Code Present Employer/verifier Name/Military Duty Location City (Country) City (Country) City (Country) Your Position Title/Military Rank State State State Supervisor Supervisor Supervisor Your Position Title/Military Rank State State State Supervisor Supervisor Supervisor Your Position Title/Military Rank State State State Supervisor Supervisor Supervisor Your Position Title/Military Rank State State State Supervisor Supervisor Supervisor ZIP Code ZIP Code ZIP Code Telephone Number Telephone Number Telephone Number ZIP Code ZIP Code ZIP Code Telephone Number Telephone Number Telephone Number ZIP Code ZIP Code ZIP Code Telephone Number Telephone Number Telephone Number ZIP Code ZIP Code ZIP Code Telephone Number Telephone Number Telephone Number To Employer's/Verifier's Street Address Street Address of Job Location (if different than Employer's Address) Supervisor's Name & Street Address (if different than Job Location) Month/Year PREVIOUS PERIODS OF ACTIVITY Month/Year Month/Year To To Month/Year Month/Year Month/Year Code Position Title Position Title Position Title Employer/verifier Name/Military Duty Location City (Country) City (Country) City (Country)

Month/Year

To Month/Year

To Employer's/Verifier's Street Address Street Address of Job Location (if different than Employer's Address) Supervisor's Name & Street Address (if different than Job Location) Month/Year PREVIOUS PERIODS OF ACTIVITY Month/Year Month/Year To To Month/Year Month/Year Month/Year Code Position Title Position Title Position Title

Month/Year

To Month/Year

Employer/verifier Name/Military Duty Location City (Country) City (Country) City (Country)

To Employer's/Verifier's Street Address Street Address of Job Location (if different than Employer's Address) Supervisor's Name & Street Address (if different than Job Location) Month/Year PREVIOUS PERIODS OF ACTIVITY Month/Year Month/Year To To Month/Year Month/Year Month/Year Code Position Title Position Title Position Title

Month/Year

To Month/Year

Employer/verifier Name/Military Duty Location City (Country) City (Country) City (Country)

To Employer's/Verifier's Street Address Street Address of Job Location (if different than Employer's Address) Supervisor's Name & Street Address (if different than Job Location) Month/Year PREVIOUS PERIODS OF ACTIVITY Month/Year Month/Year To To To Month/Year Month/Year Month/Year Position Title Position Title Position Title

Enter your Social Security Number before going to the next page
Standard Form 86A (Back)