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DS-4170 (2021) Fillable PDF Form – Download & Complete Online

  1. 语言 英语
  2. 国家 美国
  3. 部门 国务院
DS-4170 (2021) Fillable PDF Form – Download & Complete Online

The DS-4170 (2021) is the official Time and Attendance record used by employees of the U.S. Department of State. It captures daily work hours, overtime, leave types, and employee certifications. This page gives you a direct link to the original fillable PDF and step‑by‑step instructions for completing it online with Formize’s PDF Filler.

What Is the DS-4170 Form?

Issued by the Department of State, the DS-4170 tracks each employee’s scheduled and actual work hours, ensuring accurate payroll and compliance with federal labor regulations. The 2021 version includes updated fields for remote work and flexible scheduling.

Key Sections & Fields Explained

  • Employee Name – Enter last name, first name, and middle initial exactly as they appear on your badge.
  • Day / Date – Fill in the calendar day and date (MM‑DD‑YYYY) for each entry.
  • Start Time & Scheduled Start – Record the actual clock‑in time and the pre‑approved start time.
  • End Time & Scheduled Finish – Record the actual clock‑out time and the scheduled finish time.
  • Hours Type – Check the appropriate boxes: Reg, OT, AL, SL, LWOP, Comp.
  • Total & Grand Total – The form automatically sums daily totals; verify the final grand total.
  • Employee Certification – Sign and date to certify accuracy.
  • Supervisor Certification – Supervisor signs after review.

How to Fill the DS-4170 Form Online

Instead of downloading the PDF and opening a separate editor, simply click the Fill out this form button below. The Formize PDF Filler app loads in your browser, letting you type, select checkboxes, and add a digital signature without leaving the page.

Common Mistakes to Avoid

  • Leaving any mandatory field blank – the filler will highlight missing data.
  • Using the wrong date format – the form requires MM‑DD‑YYYY.
  • Mixing AM/PM designations – be consistent for all time entries.
  • Forgetting the employee or supervisor certification – unsigned forms are rejected.

Where to Submit the Completed Form

After you finish, download the completed PDF or email it directly to your supervisor’s official address. Keep a copy for your records. If your agency requires electronic submission, follow the internal portal instructions provided by the Department of State.

常问问题
  • Is the DS-4170 form available as a fillable PDF?

    Yes. The official 2021 version is a fillable PDF hosted by the U.S. Department of State and can be completed online with Formize.

  • Do I need Adobe Acrobat to fill the DS-4170?

    No. Formize’s web‑based PDF Filler works in any modern browser, so you don’t need any additional software.

  • Can I save my progress and finish later?

    Yes. Use the “Save” button in the filler to download a partially completed PDF, then reopen it later to continue.

  • What format should I use for dates and times?

    Enter dates as MM‑DD‑YYYY and times in 12‑hour format with AM/PM (e.g., 08:30 AM).

  • Who must sign the DS-4170 form?

    Both the employee and the supervising officer must sign and date the certification sections before submission.

  • Where do I submit the completed DS-4170?

    Submit the PDF to your department’s HR or payroll office as instructed, typically via email or the internal document portal.

  • Is there a paper‑only version of the DS-4170?

    A printable version exists, but the fillable PDF is recommended for accuracy and faster processing.

  • What if I make a mistake after signing?

    Contact your supervisor immediately. You may need to void the signed copy and submit a corrected version.

如何

如何通过 5 个简单步骤在线免费填写 DS-4170 2021:

  1. 1
    Click the Fill Button
    Press the “Fill out this form” button on the page to launch Formize’s PDF Filler in your browser.
  2. 2
    Wait for the Filler to Load
    The app loads in a few seconds; you’ll see the DS-4170 PDF with editable fields.
  3. 3
    Complete Each Section
    Enter your name, dates, times, and select the appropriate hour‑type checkboxes. The filler highlights required fields.
  4. 4
    Add Your Signature
    Use your mouse, trackpad, or touch screen to sign in the certification box, then type the date.
  5. 5
    Save or Email the Form
    When finished, click “Download” to save a copy or “Email” to send it directly to your supervisor.
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关于

国务院 (DOS) 表格

DS-4170 2021 是美国国务院 (DOS) 用于收集信息和处理与国际旅行、签证、护照和领事服务相关的各种服务的申请表之一。国务院负责管理美国外交政策、国际关系,并为美国公民和外国人提供服务。

以下是国务院表格的一些示例:

护照申请表:这些表格用于申请美国护照,美国护照是政府颁发的允许个人进行国际旅行的官方文件。护照申请表收集个人信息、公民身份详细信息、身份和其他所需信息。

非移民签证申请表:美国国务院负责监督非移民签证的签发,该签证允许外国人出于旅游、商务、学习或工作等各种目的临时访问美国。非移民签证申请表,例如 DS-160、DS-156 或 DS-260,用于收集有关申请人的个人详细信息、旅行历史、旅行目的和其他相关信息。

移民签证申请表:对于寻求移民到美国的个人,可以使用移民签证申请表。这些表格收集有关申请人的个人历史、家庭成员、工作经历和其他相关信息的详细信息。例如,针对家庭移民的 DS-260 表格或针对多元化签证抽签获胜者的 DS-230 表格。

海外出生领事报告(CRBA)表格:使用此表格记录美国公民父母在国外出生的美国公民孩子。它收集有关儿童、父母和支持文件的信息。

支持宣誓书:在担保移民到美国时,美国公民或合法永久居民可能需要提交支持宣誓书。这种表格,例如 I-864 或 I-134,用于证明支持有意移民并防止他们成为公共负担的财务能力。

领事服务表格:国务院向美国公民和外国人提供各种领事服务,例如公证服务、紧急援助请求或放弃美国公民身份。这些服务使用特定表格,包括表格 DS-11、DS-3053 或 DS-4079,具体取决于所请求服务的性质。

值得注意的是,美国国务院使用的具体表格可能会随着时间的推移而变化,并且不同的服务可能需要不同的表格。建议访问美国国务院官方网站或咨询最近的美国大使馆或领事馆,以获取有关各种服务所需的具体表格的最新、准确信息。

特征

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