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, you will be required to complete a security clearance application, and have this clearance approve 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 several weeks to obtain your clearance once you submit your application.

***IT TAKES 4 TO 6 WEEKS TO CLEAR***
SO YOU NEED TO GET YOUR SECURITY PACKAGES IN AS SOON AS POSSIBLE

PLEASE FOLLOW ALL INSTRUCTIONS CAREFULLY!
REQUIRED FORMS

-SF-85 Questionnaire for Non-Sensitive Positions
Questionnaire for Non-Sensitive Positions (Standard Form 85) also known as “EQIP” **completed online** - We must have your complete name (first, middle, and last), date of birth, place of birth (county, city, state, and country), and social security number to give you access to this system. Send this to Cheryl R. Moore, Human Resources Specialist via email (Cheryl.Moore@usdoj.gov) immediately to start this process. Once we give you access, you will go to http://www.opm.gov/e-qip/. It is important that you complete this entire online form, print it out and sign it. Be sure to read and respond to all questions that apply or check “N/A” for "not applicable." Under employment section of EQIP, all entries must mirror your resume. You will need to be registered in the on-line security system called EQIP. A hardcopy version of the SF 85 can be downloaded from this link, http://www.opm.gov/forms/pdf_fill/SF85.pdf but please note the form must be completed in EQIP only. However, you can familiarize yourself with the questions that you must complete in EQIP by looking at the hard copy of the SF 85. You will receive an email to confirm that you are registered in EQIP and be given answers to 3 “Golden Questions.” You should retain this email and refer to it when accessing the EQIP web site. Initially, please review the “Quick Reference Guide for the Applicant” and the “Frequently Asked Questions about EQIP.” You may need to set up your personal computer as shown in the Web Browser Requirements and Getting Started sections of the “Quick Reference Guide” before completing the form online.

Quick Reference Guide for EQIP: http://www.opm.gov/EQIP/reference.asp
Frequently Asked Questions about EQIP: http://www.opm.gov/EQIP/faq.asp

• If you cannot access the eQIP website or are experiencing other technical problems, please call the OPM Help Desk at 1-866-631-3019. (Hours of operation: 6:30 am to 10:30 pm EST Monday - Friday and 7:30am to 3:00pm EST on Saturday.)

Carefully follow the on-screen instructions and remember the information you provide will be used by investigators to conduct your security clearance.

All blocks must be completely filled out with accurate and up-to-date names, dates, addresses, and telephone numbers. You must not leave any gaps of time in the five year periods required for completing the residence and employment sections of this form. For example, if you sign the form on June 1, 2007, you must provide information not only for the present, but all the way back to June 1, 2002. If you were a full-time student for any period of time and were not employed you are considered to be unemployed for that period and must indicate a verifier. To verify periods of unemployment, you are permitted to have a relative or friend serve as the verifier. Do not use your law school as a verifier.

If question #7d, regarding dual citizenship, does not apply to you, please indicate so with N/A. The following questions must provide current information for the previous 5 years:
For question #8, Where you currently live and have lived for the past 5 years, please provide the name of a person who has known you for at least three years to verify residency. Make sure your dates of where you have lived are in chronological order. Also, you must have lived in the United States for three of the last five years.
For question #9, Where you are currently in law school and school(s) you've attended for the last 5 years. Make sure your current school is listed first and it must be from when you started to present day.
For question # 10, your employment history must go back from your current job to the last 5 years. If you are currently unemployed, or have any other periods of unemployment, please provide name of one of your parents or spouse with a valid address and telephone number to verify this period of unemployment. Be sure there are no gaps in dates, or overlapping between periods of unemployment and employment.

Follow the sample below for the employment section…remember not to overlap employment and unemployment months:

1. 05/2011 – present – Cullen and Dykman LLP
2. 01/2011 – 04/2011 – Unemployed - you cannot put down that you were a student during any unemployment, you also must have a verifier for the time you were unemployed.
3. 09/2010 – 12/2010 – Magistrate Judge, US District Court, SDNY - all unpaid internships, voluntary activities that you have listed under experience on your resume’ must be included in eQIP under this section.
4. 06/2010 – 08/2010 – International Institute for Conflict Prevention & Resolution
5. 02/2010 - 05/2010 – Legal Aid Society-Health Care Unit
6. 09/2009 - 01/2010 – Unemployed
7. 06/2007 – 08/2009 – Cahill Gordon & Reindel LLP
8. Etc….going back chronologically for the last five years.

For question #11, People who know you well, make sure they have a complete and valid address and phone numbers.

For question #12, if you are a male born after 1959 you must put down a Selective Service Number. You can go to the website www.sss.gov or call 847-688-6888 if you do not know your Selective Service number.

Please follow the instructions for the SF 85 carefully, print and sign all signature pages. These should be sent with your completed package with additional documents as listed below.

Certification for Non-Sensitive Positions – Please sign and date this form regarding security and return with your package. The dates you put on this form should mirror the dates on the Student Volunteer Agreement.

Loyalty Statement – If you have dual citizenship, or can be considered a citizen of another country, you must provide a “Letter of Explanation” concerning your dual citizenship status and sign the enclosed “Loyalty Statement.” 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 this does not apply to you, please disregard.

Foreign Born Relatives or Associates Statement– You must include your immediate relatives (mother, father, and siblings) who were born in a foreign country even if they currently hold U.S. citizenship. If this form does not apply to you, please write N/A and sign the bottom.

OARM Form 9A – Intern Ethical Obligations Agreement

OF-306 – Declaration of Federal Employment – If you answer YES to any of the questions from 9 through 13, please provide a letter of explanation. Contact HR immediately to obtain information on additional documentation that may be required. Please sign and date on line 17a.

OFI-36 - Complete this form only if you have immediate family members who are foreign born, a foreign born spouse, and/or a cohabitant (regardless of citizenship). Put your parents and siblings that are foreign born in Section A. 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.

Student Volunteer Agreement Form – Complete these forms and include the name of your law school and the (printed) name of your school’s designated representative (career services office staff; registrar; bursar, or clinical professor, etc.) on the first page. Make sure on the first page you fill out the top section, which includes your name, the name of your school, and your school year level, 1, 2, or 3. Your school Registrar or Bursar representative must sign and stamp in the appropriate marked area. You must sign as well. Submit original with signatures and dates.

SF-87A - Fingerprint Cards – If you want to have your fingerprints taken (free of charge), leave the mailed fingerprint cards blank and contact Ms. Cheryl Moore , Human Resources Specialist at (718) 254-6545 to set up an appointment in this office and to go over your security documents. You can also have fingerprints done at a local police precinct for whatever fee they set. The authorized official rendering the fingerprinting services must sign in the appropriate area as the administering official for all three (3) cards. All boxes on the fingerprint cards accompanied by a red dot must be filled out. You must use black ink.

Copy of Birth Certificate and/or color copy of valid US Passport

Copy of Resume

Parent Information – If your internship program will be up to 1 year, on a separate sheet of paper 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.

Your completed security package which should include the signature pages that you printed from the online SF-85 form in EQIP and completed fingerprint cards (unless you have scheduled to have them done in our office), and all applicable Security Forms must be forwarded to the following address:

Cheryl Moore, Human Resources Specialist
Human Resources Personnel Office
United States Attorney's Office - Eastern District of New York
271 Cadman Plaza East, Brooklyn, NY 11201

Issues Requiring Additional Documentation;

All student intern security clearance applications are reviewed by our office and forwarded to Washington, DC. If you are offered a legal intern position, 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 law student intern background materials.

Items on your application that may require additional documentation include: arrests, income tax issues, drug use, etc. The information requested must include a letter of explanation addressing each derogatory issue as well as supporting documents that a fine or violation was resolved, e.g., canceled payment checks, and court document indicating that the matter is closed, etc.

The common issue that has significantly delayed or prevented participation in our internship program is listed below:

DUAL CITIZENSHIP- If you maintain dual citizenship with another country you will be required to provide the following:

• a written statement as to why you maintain dual citizenship; must give an explanation regarding the circumstances under which the dual citizenship was acquired; within this statement, you must also state that you will be willing to relinquish citizenship to the non-US country if so requested; and
• a completed Dual Citizenship Form;
• a copy of your U.S. Passport (we only need the page which provides the passport number and expiration date).

Return to Eastern District of New York Internships

Return to the Eastern District of New York Home Page