Get the free public trust clearance form

Please be fully prepared and complete and include all relevant information so that our personnel and investigators may evaluate your background without delay and if such evaluation will be of value. The information you provide on this form must include your name, Social Security Number, date of birth, country of citizenship, address and telephone number. All names and other personal information on this form should not be used for any purpose other than to protect the confidentiality of private employment information. No further identifying information will be included on this form. Please carefully make sure all boxes are checked, and that each box or question has an answer. Questionnaire Form Attachments are available upon request. The completed form and any additional supporting documentation must be submitted to a member of the Employment Security Division, EEO/EEOC Division, Washington, DC 20508. All supporting material will be reviewed before a decision is reached. Questions? Please call the office that gave you the form at.