Security Forms

Student Volunteer Internship Security Form

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.


Please let us know as soon as possible if any of the following items apply to you as your security package will require additional documentation: 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.

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 out of the last 5 years. The 5 years is counted going back from the month/date that you submit your online security application.

If any of the following apply to you, please contact our office to obtain additional forms:

  • If you have dual citizenship,
  • Were born outside of the United States,
  • Have parents and/or siblings born outside of the United States,
  • Studied abroad within the past 5 years.

All Applicants must submit the following documents for their clearance through email (PDF or Microsoft Word):

1) E-QIP Application- This is the online security application that needs to be completed. Please read the instructions attached here. Once completed, the two signature pages will need to be printed, signed and emailed.

2) Color copy of valid US Passport- You only need the 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. If you want to have your fingerprints taken free of charge, contact Elizabeth Ferraro at (718) 254-6214 or Romel Hill at (718) 254-6191 to set up an appointment in the Brooklyn office.

-If coming to the 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.

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.

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 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) 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:

2- Father
3- Stepmother
4- Stepfather
5- Foster Parent
6- Child (adopted also)
7- Stepchild
8- Brother
9- Sister

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

10) Foreign Born Relatives or Associates Statement– You must include your immediate relatives (mother, father, spouse and siblings) listed on the OFI-36 form who were born in a foreign country even if they currently hold U.S. citizenship.

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.

12) Network Account Records Management and IT Rules of Behavior forms.

13) Parent Information – If your internship program will be more than 1 semester please provide complete names of your father and mother, including mother’s maiden name, date of births, place of births and their social security numbers.


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