Standart Form 85 - Questionnaire For Non-Sensitive Positions
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8Standard Form 85
Form approved:
Revised September 1995
OMB No. 3206-0005
U.S. Office of Personnel Management
NSN 7540-00-634-4035
5 CFR Parts 731 and 736
85-111
Questionnaire for Non-Sensitive Positions
Follow instructions fully or we cannot process your form. Be sure to sign and date the certification statement on Page 5 and the release on
Page 6. If you have any questions, call the office that gave you the form.
Purpose of this Form
The U.S. Government conducts background investigations to establish
2. Type or legibly print your answers in black ink (if your form is not
that applicants or incumbents either employed by the Government or
legible, it will not be accepted). You may also be asked to submit your
working for the Government under contract, are suitable for the job.
form in an approved electronic format.
Information from this form is used primarily as the basis for this
investigation. Complete this form only after a conditional offer of
employment has been made.
3. All questions on this form must be answered. If no response is
necessary or applicable, indicate this on the form (for example, enter
Giving us the information we ask for is voluntary. However, we may
"None" or "N/A"). If you find that you cannot report an exact date,
not be able to complete your investigation, or complete it in a timely
approximate or estimate the date to the best of your ability and indicate
manner, if you don’t give us each item of information we request. This
this by marking "APPROX." or "EST."
may affect your placement or employment prospects.
4. Any changes that you make to this form after you sign it must be
initialed and dated by you.
Under certain limited circumstances,
Authority to Request this Information
agencies may modify the form consistent with your intent.
The U.S. Government is authorized to ask for this information under
Executive Order 10577, sections 3301 and 3302 of title 5, U.S. Code;
5. You must use the State codes (abbreviations) listed on the back of
and parts 5, 731, and 736 of Title 5, Code of Federal Regulations.
this page when you fill out this form. Do not abbreviate the names of
cities or foreign countries.
Your Social Security Number is needed to keep records accurate,
because other people may have the same name and birth date. Executive
6. The 5-digit postal ZIP codes are needed to speed the processing of
Order 9397 also asks Federal agencies to use this number to help
identify individuals in agency records.
your investigation. The office that provided the form will assist you in
completing the ZIP codes.
The Investigative Process
7. All telephone numbers must include area codes.
Background investigations are conducted using your responses on this
form and on your Declaration for Federal Employment (OF 306) to
8. All dates provided on this form must be in Month/Day/Year or
develop information to show whether you are reliable, trustworthy, and
Month/Year format.
Use numbers (1-12) to indicate months. For
of good conduct and character.
Your current employer must be
example, June 10, 1978, should be shown as 6/10/78.
contacted as part of the investigation, even if you have previously
indicated on applications or other forms that you do not want this.
9. Whenever "City (Country)" is shown in an address block, also
provide in that block the name of the country when the address is
outside the United States.
Instructions for Completing this Form
1. Follow the instructions given to you by the person who gave you the
10.
If you need additional space to list your residences or
form and any other clarifying instructions furnished by that person to
employments/self-employments/unemployment or
education,
you
assist you in completion of the form. Find out how many copies of the
should use a continuation sheet, SF 86A. If additional space is needed
form you are to turn in. You must sign and date, in black ink, the
to answer other items, use a blank piece of paper. Each blank piece of
original and each copy you submit.
paper you use must contain your name and Social Security Number
at the top of the page.
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