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Assistant U.S. Attorney - Security Forms

 

SF-86 / 86A Security Questionnaire

Security investigation data for sensitive positions.  The SF86 form is provided here for your completion, but you will be transferring this data on it electronically via e-QIP.  You will be provided further information on e-QIP later.

eQIP Applicant Brochure eQIP system reference guide. The eQIP system is used to electronically file the SF-86 form. The electronic filing of the SF-86 form is now mandatory.
OF-306 Declaration of Federal Employment.
Please sign and date form in 17 a  only,   not 17 b.
OF-612 Optional Application for Federal Employment and/or Resume
DOJ-555 Disclosure and Authorization Pertaining to Consumer Reports Pursuant to the Fair Credit Reporting Act
I-9 Employment Eligibility Verification
SF-181 Ethnicity and Race Identification
SF-144 Statement of Prior Federal Service
SF-256 Self-Identification of Handicap

Dual Citizenship - Applicant certifies s/he is a dual citizen with the U.S. and another country

Submit the above and submit one copy of the following, if applicable:

 
DOJ-488

Tax Check Waiver - Use the same ink for the candidate's signature and date with no white out or erasures. Otherwise, IRS will not accept the form. Revised form was issued 4/00. If you answered on this form that you had or have had late tax filing(s), did not file tax return(s), have numerous tax filing
extensions, was or currently on a payment plan, the following will be required:

  • A detailed explanation(s), copies of all documents pertaining to the years involved, and all correspondence with IRS.
DOJ -54 Attorney's Entry-On-Duty Bar Certification
Residence Information  

OFI-36 - Single Scope, Additional Data for Single Scope Background Investigations and Other Background Investigations.

If applicable please call for form.

This form is only applicable under the following conditions:
Immediate family members are resident aliens or U.S. citizens other than by birth;
Current spouse is foreign born
Co-inhabitant(s) and any other persons to whom applicant is bound by affection or obligation who may be subject to duress by a foreign power
If the OFI-36 is applicable, also complete the Foreign National Relatives or Associates form Describe the nature, frequency, and degree of your contact.
The form can be found in the above listed Dual Citizenship information bullet.
OARM-9 Reminder of Government Attorney Ethical Obligations to Client.
OARM-1 Memorandum of Agreement for Experienced Attorneys
Letter of Good Standing Provide a letter of good standing from the bar in which you are an active member.
SF-87A - Fingerprint Cards

Fingerprint cards will be mailed to you upon request and you can be fingerprinted at any local police station. Fingerprint cards need to be completely filled out and in BLACK ink ONLY.

Email Address Must provide email address on either resume or on a separate piece of paper.
Derogatory Information - i.e., bankruptcy, indebtedness, arrests, income tax issues, drug use, etc. Provide a letter of explanation addressing each derogatory issue
Provide supporting documents, e.g., canceled payment checks.

 

Please mail forms directly to the following address or make an appointment to have hand delivered to:

United States Attorney's Office
District of Connecticut
157 Church Street
Floor 25
New Haven, CT 06510
Attn: Human Resources Office

For additional information, please contact:
John Carsten at (203) 821 -3700

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