DS-174-U.S.DepartmentofState.docVIP

POSITION Position Title Grades Vacancy Announcement Number (if known) Date Available for Work (mm-dd-yyyy) PERSONAL INFORMATION Last Name(s)/Surnames First Name Middle Name Other Names Used: Date of Birth (mm-dd-yyyy): Place of Birth Current Address Phone Numbers Day Evening Cell E-mail Address Are you a U.S. Citizen? Do you have permanent U.S. Resident status? If Yes, provide number 14a. U.S. Social Security Number (for U.S. Citizens/Permanent U.S. Residents) and/or 14b. Country Identification Number Are you legally eligible to work in this coun