Standard Form 86a - Continuation Sheet For Questionnaires Sf 86, Sf 85p, And Sf 85
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1
2Standard Form 86A (EG)
Form approved:
CONTINUATION SHEET FOR QUESTIONNAIRES
Revised September 1995
OMB No. 3206-0007
U.S. Office of Personnel Management
SF 86, SF 85P, AND SF 85
NSN 7540-01-268-4828
5 CFR Parts 731, 732, and 736
86-203
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
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)
Month/Year
Month/Year
Street Address
Apt. #
City (Country)
State
ZIP Code
#1
To
Name of Person Who Knew You
Street Address
Apt. #
City (Country)
State
ZIP Code
Telephone Number
(
)
Month/Year
Month/Year
Street Address
Apt. #
City (Country)
State
ZIP Code
#2
To
Name of Person Who Knew You
Street Address
Apt. #
City (Country)
State
ZIP Code
Telephone Number
(
)
Month/Year
Month/Year
Street Address
Apt. #
City (Country)
State
ZIP Code
#3
To
Name of Person Who Knew You
Street Address
Apt. #
City (Country)
State
ZIP Code
Telephone Number
(
)
Month/Year
Month/Year
Street Address
Apt. #
City (Country)
State
ZIP Code
#4
To
Name of Person Who Knew You
Street Address
Apt. #
City (Country)
State
ZIP Code
Telephone Number
(
)
Month/Year
Month/Year
Street Address
Apt. #
City (Country)
State
ZIP Code
#5
To
Name of Person Who Knew You
Street Address
Apt. #
City (Country)
State
ZIP Code
Telephone Number
(
)
WHERE YOU WENT TO SCHOOL (Continued)
Month/Year
Month/Year
Code
Name of School
Degree/Diploma/Other
Month/Year Awarded
#1
To
Street Address and City (Country) of School
State
ZIP Code
Name of Person Who Knew You
Street Address
Apt. #
City (Country)
State
ZIP Code
Telephone Number
(
)
Code
Month/Year
Month/Year
Name of School
Degree/Diploma/Other
Month/Year Awarded
#2
To
Street Address and City (Country) of School
State
ZIP Code
Name of Person Who Knew You
Street Address
Apt. #
City (Country)
State
ZIP Code
Telephone Number
(
)
Month/Year
Month/Year
Code
Name of School
Degree/Diploma/Other
Month/Year Awarded
#3
To
Street Address and City (Country) of School
State
ZIP Code
Name of Person Who Knew You
Street Address
Apt. #
City (Country)
State
ZIP Code
Telephone Number
(
)
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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