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Includes sections for employment/administrative history such as military court-martial convictions, current legal charges, past job terminations or departures, and potential federal debt delinquencies. Also captures details related to retirement pay and prior federal service life insurance elections, with references to supplemental item 16 for dates, explanations, locations, and responsible authorities when answers are YES.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":16,"@type":70,"position":76},"https://docshare.wps.com/template/resumes/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/social-security-number-personal-information-eligibility-questions/195041/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/social-security-number-personal-information-eligibility-questions/195041.png","ImageObject",442,249,{"name":88,"@type":89},"Oliver Hayes","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-07","2026-09-03",true,{"@type":98,"interactionType":99,"userInteractionCount":79},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"Which personal details are requested in these sections?","Question",{"text":108,"@type":109},"The form requests social security number, place of birth, U.S. citizenship status, date of birth, other names ever used, and phone numbers.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What kinds of past events trigger the form to require additional explanation?",{"text":113,"@type":109},"If the applicant answers YES to conviction, imprisonment, probation/parole, military court-martial convictions, current legal charges, job termination or related departures, or federal debt delinquency, the form directs the applicant to provide dates, explanations, locations, and responsible authorities.",{"name":115,"@type":106,"acceptedAnswer":116},"How does prior federal employment affect life insurance questions?",{"text":117,"@type":109},"For the appointee section, prior federal employment life insurance elections may affect eligibility during a new appointment, and the form asks when the last federal job ended and whether basic or optional life insurance was waived.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},195041,1788444982,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":15,"category_name":16,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":47,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":76,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":125,"read_time":9},687207020761,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","| 2. SOCIAL SECURITY NUMBER ♦ | 3a. PLACE OF BIRTH (Include city and state or country)\u003Cbr>♦ |  |\n| --- | --- | --- |\n| 3b. ARE YOU A U.S. CITIZEN?\u003Cbr> YES  NO (If \"NO\", provide country of citizenship) ♦ |  | 4. DATE OF BIRTH (MM / DD / YYYY)♦ |\n| 5. OTHER NAMES EVER USED (For example, maiden name, nickname, etc. )\u003Cbr>♦\u003Cbr>♦ |  | 6. PHONE NUMBERS (Include area codes) Day ♦ |\n|  |  | Night ♦ |\n\n| Branch | From (MM/DD/YYYY) | To (MM/DD/YYYY) | Type of Discharge |\n| --- | --- | --- | --- |\n|  |  |  |  |\n|  |  |  |  |\n|  |  |  |  |\n\n\n| 9. During the last 7 years, have you been convicted, been imprisoned, been on probation, or been on parole?(Includes felonies, firearms or explosives violations, misdemeanors, and all other offenses. ) If \"YES,\" use item 16 to provide the date, explanation of the violation, place of occurrence, and the name and address of the police department or court involved. |  YES |  |  |  NO |  |\n| --- | --- | --- | --- | --- | --- |\n| 10. Have you been convicted by a military court-martial in the past 7 years? (If no military service, answer \"NO.\") If\"YES,\" use item 16 to provide the date, explanation of the violation, place of occurrence, and the name and address of the military authority or court involved. | |  | YES | | NO |\n| 11. Are you currently under charges for any violation of law? If \"YES,\" use item 16 to provide the date, explanation of the charges, place of occurrence, and the name and address of the police department or court involved. | |  | YES | | NO |\n| 12. During the last 5 years, have you been fired from any job for any reason, did you quit after being told that you would be fired, did you leave any job by mutual agreement because of specific problems, or were you debarred from Federal employment by the Office of Personnel Management or any other Federal agency? If \"YES,\" use item 16 to provide the date, an explanation of the problem, reason for leaving, and the employer's name and address. |  | | YES | | NO |\n| 13. Are you delinquent on any Federal debt? (Includes delinquencies arising from Federal taxes, loans, overpayment of benefits, and other debts to the U.S. Government, plus defaults of Federally guaranteed or insured loans such as student and home mortgage loans. ) If \"YES,\" use item 16 to provide the type, length, and amount of the delinquency or default, and steps that you are taking to correct the error or repay the debt. | |  | YES | | NO |\n\n\n| 15. Do you receive, or have you ever applied for, retirement pay, pension, or other retired pay based on military, Federal civilian, or District of Columbia Government service? |  YES |  NO |\n| --- | --- | --- |\n\n\n| 18. Appointee (Only respond if you have been employed by the Federal Government before): Your elections of life insurance during previous Federal employment may affect your eligibility for life insurance during your new appointment. These questions are asked to help your personnel office make a correct determination. |  |  |  |  |\n| --- | --- | --- | --- | --- |\n| 18a. When did you leave your last Federal job? | Date:\u003Cbr>(MM / DD / YYYY) |  |  |  |\n| 18b. When you worked for the Federal Government the last time, did you waive Basic Life Insurance or any type of optional life insurance? |  |  YES |  NO |  DO NOT KNOW |","cbCaifmNp9JLImiD","https://ap.wps.com/l/cbCaifmNp9JLImiD","pdf",171239,"English","# Applicant Eligibility Questions\n## Identity and Contact Information\n## Legal, Employment, and Debt History\n## Retirement Pay and Insurance Election","[{\"question\":\"Which personal details are requested in these sections?\",\"answer\":\"The form requests social security number, place of birth, U.S. citizenship status, date of birth, other names ever used, and phone numbers.\"},{\"question\":\"What kinds of past events trigger the form to require additional explanation?\",\"answer\":\"If the applicant answers YES to conviction, imprisonment, probation/parole, military court-martial convictions, current legal charges, job termination or related departures, or federal debt delinquency, the form directs the applicant to provide dates, explanations, locations, and responsible authorities.\"},{\"question\":\"How does prior federal employment affect life insurance questions?\",\"answer\":\"For the appointee section, prior federal employment life insurance elections may affect eligibility during a new appointment, and the form asks when the last federal job ended and whether basic or optional life insurance was waived.\"}]","Social Security Number - Personal Information & Eligibility Questions | PDF"]