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Student Volunteer Internship Security Forms

Welcome to the U.S. Attorney’s Office, Eastern District of New York! We look forward to your joining our team. If you have received and accepted an offer to participate in the Student Volunteer Internship Program (Law School and other Student Intern Programs) in our district, your participation will be contingent on a favorable evaluation of your background by the Department of Justice’s Office of Attorney Recruitment and Management, which reviews student intern background materials. You will be required to complete a security clearance application and have this clearance approved prior to your entrance on duty. Below is a checklist describing the items that we require you submit to process your security clearance. It can take 6-8 weeks to obtain your clearance once you submit your application.


Contact our office as soon as possible if any of the following items apply to you as your security package will require additional documentation and may take longer to process: summonses (can include speeding tickets or other moving violations, open container violation), arrests, income tax issues, drug use, etc. With respect to summonses you will need documentation from the local jurisdiction that issued the summons to show that a fine was paid, community service completed or the matter dismissed. The information requested must include a letter of explanation addressing each derogatory issue.


1) E-QIP Application-This online security application must be completed immediately.
SF-85 (2 forms) Please read the instructions attached here. Once completed, the two signature pages will need to be printed, signed, and emailed in PDF form.

2) Color copy of valid US Passport- Only photocopy the two pages which provide the passport number, picture, expiration date and your signature. [Note: You may send us a color copy of your birth certificate in place of your passport]

3) Copy of your current Resume in Microsoft Word format only- Your resume should mirror what was input on your e-QIP application. Include any Legal and other experience within 5 years. All dates on your resume should follow the Month/Year format.

4) Fingerprint Cards – Your security package must include a set of fingerprint cards. You will need to be printed for this internship regardless of the last time you were fingerprinted.If you want to have your fingerprints taken free of charge, contact Romel Hill at (718) 254-6191 to set up an appointment in the Brooklyn office. We will take your photo for your ID card in the office, so please dress accordingly.

-If coming to the Brooklyn office is not convenient, you can also have fingerprints done at a local police precinct for a fee. Please send us your address as soon as possible if you need cards mailed to you. A suitable photo of yourself should be emailed in JPEG form. It should be a clear headshot of you against a plain, white background.

5) Student Volunteer Agreement Form – Your School Registrar or Bursar representative must sign and stamp in the appropriate marked Section II. Completely fill out Section I at the top of the first page, which includes your name, academic discipline, the name of your school, and your school year level, 1, 2, or 3. You must sign and date in Section III.

NYU (2 forms) New York University School of Law requires students to complete a Request Form and a Student Volunteer Agreement form. Please complete Section 1 and 3 of this form immediately and email to Romel Hill. You will not drop the form off at your school; our office will forward the forms to the registrar’s office.

6) OF-306 –Declaration of Federal Employment – If you answer YES to any of the questions from 9 through 13, contact the coordinators immediately to obtain information on additional documentation that may be required. Please sign and date on line 17A: APPLICANT’S SIGNATURE in this form.

7) OARM Form 9A – Intern Ethical Obligations Agreement.

8) Certification for Non-Sensitive Positions –Sign on the “employee” and “date” lines.

9) IT Rules of Behavior forms.

10) Acknowledgement of Duty to Preserve Federal Records.


If any of the following statements apply to you, please include these essential forms:

I was born outside the United States and/or I have dual citizenship with another country (2 forms).

11) Loyalty Statement – Complete this form only if you have dual citizenship or can be considered a citizen of another country. If this is the case, you must sign the enclosed Loyalty Statement and provide a separate, typed “Letter of Explanation” concerning your dual citizenship status. The “Letter of Explanation” must give an explanation regarding the circumstances under which the dual citizenship was acquired and an offer to relinquish citizenship to the non-US country if so requested. If you were born outside of the United States but do not currently hold citizenship in another country, continue to fill out the loyalty statement; for the “Letter of Explanation”, please acknowledge that you were born outside of the United States in [country of birth] but do not have citizenship with such country.

My parents, siblings, spouse, and/or cohabitants were born outside of the United States (2 forms).

12) OFI-36 - Complete this form only if you have immediate family members, spouse, and/or a cohabitant who are foreign born. Put your parents and siblings that are foreign born in Section A (codes listed below). Your spouse will go under Section B if foreign born and only individuals that live with you that are under duress with another country go under Section C.
Codes for Section A:
1-Mother            3- Stepmother          5- Foster Parent      7- Stepchild     9- Sister
2- Father             4- Stepfather            6- Child                     8- Brother          

*If submitting OFI-36, you must also submit the Foreign Born Relatives or Associates Statement form.

13) Foreign Born Relatives or Associates Statement– You must include your immediate relatives (parents, siblings, spouse, and/or cohabitants) listed on the OFI-36 form who were born in a foreign country even if they currently hold U.S. citizenship. Please include a small description of frequency of contact per entry.

My internship will be more than one semester, or I have previously interned for the Department of Justice within the past year (2 forms).

14) Parent Information – If your internship program will be more than six months, or if you will be continuing through another semester, please provide complete names of your father and mother, including mother’s maiden name, and each parent’s date of birth, place of birth and social security number. The letter must be typed and signed.

15) Persons Sharing Living Quarters Please also include the OFI-36 form with Section C filled out for all persons living in your household. If additional space is needed, please use a separate sheet.

I have lived outside of the United States within the past 5 years (1 form).

NOTICE: The U.S. Department of Justice requires that prospective law students meet a residency requirement which means that you must have lived in the United States for a total of 3 years (36 months) out of the last 5 years. The 5 years is counted going back from the month/date that you submit your online security application.

16) Study Abroad - If you have lived, worked, volunteered or studied abroad within the past 5 years, a typed explanation is essential for your security clearance. Please include the month/year that you were living outside of the country, what your purpose was and what month/year you returned to the United States. If it was a study abroad or internship program please include the name of the school program you participated in and if credit was received. If you were employed please include the name of your employer along with your title and clarify if this was a position with the federal government.  Each entry lived outside of the United States should be a separate paragraph. The letter must be typed and signed. An example is attached here.

I have been terminated from a former employment within the past 5 years (1 form).

17) A letter of explanation is necessary if you have been fired from any job for any reason, quit after being told that you would be fired, left any job by mutual agreement because of specific problems, or were debarred from Federal employment by the Office of Personnel Management of any other Federal agency. If this applies to you, please type up a letter and provide the date, an explanation of the problem, reason for leaving, and the employer’s name and address, and upload the signed explanation.

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Updated November 24, 2015