Federal Security Clearance Continuous Evaluation Questionnaire
Please complete this form to provide up-to-date information for your ongoing federal security clearance evaluation. All questions are relevant to continuous monitoring requirements.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Current Employment Status
*
Employed (same employer as last evaluation)
Employed (new employer)
Unemployed
Self-employed
Other
Have you had any contact with foreign nationals outside of work in the past 12 months?
*
Yes
No
Have you traveled outside the United States in the past 12 months?
*
Yes
No
Have you been arrested, charged, or convicted of any offense since your last evaluation?
*
Yes
No
Have you experienced any significant financial difficulties (such as bankruptcy, foreclosure, or large unpaid debts) in the past 12 months?
*
Yes
No
Have you used illegal drugs or misused prescription drugs in the past 12 months?
*
Yes
No
Are you aware of any incidents or behaviors (your own or others') that may impact your security clearance?
*
Yes
No
If you answered 'Yes' to any questions above, please provide details below. Otherwise, you may leave this blank.
Submit
Should be Empty: