Form Ds-174 - Application For Employment As A Locally Employed Staff Or Family Member - U.s. Department Of State Page 15

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REFERENCES
List three personal references. Ideally they are individuals who know you professionally and can
Block 26.
comment on your suitability for employment at the Mission. Personal references may not be
relatives, members of your household, or your former supervisors. You may wish to inform
personal references that you are including their names and contact information in your application
since Mission HR may contact personal references.
SIGNATURE AND CERTIFICATION
Block 27.
It is your responsibility to sign and date your application in ink. If you do not sign and date the
application, or if you sign and date the application in pencil, then you lose consideration for the
position. Your signature in ink certifies that the information on and attached to your application is
true, correct, complete, and made in good faith. Including false information on and attached to
your application is fraud. It is grounds for not hiring you, or for terminating you after you begin to
work. Signing the application also confirms that you understand that the Mission may investigate
any information you voluntarily submit.
DS-174 CONTINUATION SHEET
Use the DS-174 Continuation Sheet to list your complete work experience. Use as many of the DS-174
Continuation Sheets as you need. Start at the top of the DS-174 Continuation Sheet with 25E and proceed
through the alphabet until you provide your complete work history. Use the instructions for completing Block
25 to complete the DS-174 Continuation Sheet.
EQUAL OPPORTUNITY EMPLOYER
The U.S. Mission provides equal opportunity and fair and equitable treatment in employment to all people
without regard to race, color, religion, sex, national origin, age, disability, political affiliation, marital status,
protected genetic information, or sexual orientation.
The EEO complaint procedure is not available to individuals who believe they have been denied equal
opportunity based upon marital status or political affiliation. Individuals with such complaints should avail
themselves of the appropriate grievance procedures, remedies for prohibited personnel practices, and/or
courts for relief."
DS-174
Instruction Page 8 of 8

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