U.S. Department
of Justice
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.
PLEASE FOLLOW ALL INSTRUCTIONS CAREFULLY!
Contact our office IMMEDIATELY if any of the following items apply to you as your security package will require additional documentation and may take longer to process: dual citizenship, foreign associates, summonses (can include speeding tickets or other moving violations, open container violation), arrests, income tax issues, drug use, medical treatment from a doctor or psychiatrist, 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.
REQUIRED DOCUMENTS
1) 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]
2) Copy of your Social Security Card.
3) Copy of your current Resume. Include any Legal and other experience within 7 years. All dates on your resume should follow the Month/Year format.
Page 1-3: You, the student, will sign and date in your section. Please be sure to completely fill out the top of the first page- the Educational Institution is your full school name and your name goes on the Student Volunteer line.
Page 4: You must bring the form to your Educational Institution Representative (Registrar or Bursar) and s/he must sign and date in the appropriate marked section. Leave the Designated Agency Representative section blank. You, the student, will sign and date in your section.
5) 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.
6) 
OARM Form 9A
7) Federal Grand Jury Information- Non-Disclosure Agreement
8) Sensitive but Unclassified Information Non-Disclosure Agreement
9) IT Rules of Behavior forms.
10) Acknowledgement of Duty to Preserve Federal Records.
12) Standard of Conduct – Financial form
13) 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.
14) Foreign Born Relatives or Associates Statement– You must include your relatives listed on the OFI-36 form even if they currently hold U.S. citizenship.
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.