SAUSA Pre-Employment Security Checklist

Checklist Of Required Forms:

• SF-86 - Security Questionnaire
  • Security investigation data for sensitive positions. The following questions must be answered covering the previous 10 years: 9, 10, 11, 12, 21, 22, 23, 29.
  • You have been registered in the on-line security system called E-Qip. You have been sent an e-mail from the Human Resources Office with the E-Qip web site address and answers to 3 "Golden Questions". You should retain that e-mail and refer to it when accessing the E-Qip web site. Initially, please review the "Quick Reference Guide for the Applicant" and the "Frequently Asked Questions about E-Qip". 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 on-line.
  • Carefully follow the on-screen instructions and remember the information you provide will be used by investigators to conduct your background investigation. All blocks must be completely filled out with accurate and up-to-date names/dates/addresses/telephone numbers. Please follow instructions to print out signature pages, sign, and date the form.
  • Hint: It will be helpful to print out a copy of the SF-86 and complete it in hard copy before sitting down at the computer and completing it online.
    Quick Reference Guide for the Applicant
    Frequently Asked Questions about E-Qip

• Copy of Birth Certificate and/or Passport

• DOJ-555 - Disclosure and Authorization Pertaining to Consumer Reports Pursuant to the Fair Credit Reporting Act
  • Review, sign and date the form.

• Dual Citizenship/Loyalty Statement - Applicant certifies s/he is a dual citizen of the United States and another country. Submit the above and submit one copy of the following, if applicable:
  • Letter of explanation stating why the applicant feels s/he is a dual citizen of the U.S. and another country

• Foreign Born Relatives or Associates Statement
  • Complete this form if you have any foreign-born relatives, foreign-born spouse that you listed on your security questionnaire.

• OFI-36 Additional Data
  • Complete this form, regardless of citizenship status, for (1) cohabitants; and (2) any foreign-born relatives, foreign-born spouse.

• DOJ-488 - Tax Check Waiver - Please sign but do not date the form. If you answered on this form that you have had late tax filing(s), did not file tax return(s), have numerous tax filing extensions, or 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 - Bar Affidavit

• SF-87A - Fingerprint Cards
  • Fingerprint cards will be mailed to you. You can be fingerprinted at any local law enforcement agency.
  • Cards should be signed in the presence of the person fingerprinting you.

• Derogatory Information - i.e., bankruptcy, indebtedness, arrests, income tax issues, drug use, etc. If you answered Yes to questions #23, 24, 25, 27, 28 or 29 on the SF86, you must:
  • Provide a letter of explanation addressing each derogatory issue
  • Provide supporting documents, e.g., canceled payment checks, letter from creditor, court disposition, etc.

• OARM-9
  - Reminder of Government Attorney Ethical Obligations to Client

• Statement of Appointment Conditions

• Attachment 1 - Acknowledgment of Duty to Preserve Federal Records

• US Attorney's Information System Rules of Behavior

Please Federal Express or hand deliver forms to the following address:

For additional information, please contact Human Resources at 515-473-9300