Voluntary Pre-Offer Self-Identification of Protected Veteran Status

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1 Vluntary Pre-Offer Self-Identificatin f Prtected Veteran Status This emplyer is a Gvernment cntractr subject t the Vietnam Era Veterans' Readjustment Assistance Act f 1974, as amended by the Jbs fr Veterans Act f 2002, 38 U.S.C (VEVRAA), which requires Gvernment cntractrs t take affirmative actin t emply and advance in emplyment: (1) disabled veterans; (2) recently separated veterans; (3) active duty wartime r campaign badge veterans; and (4) Armed Frces service medal veterans. These classificatins are defined as fllws: A disabled veteran is ne f the fllwing: Why are yu being asked t cmplete this frm? Hw d yu knw if yu are a prtected veteran? a veteran f the U.S. military, grund, naval r air service wh is entitled t cmpensatin (r wh but fr the receipt f military retired pay wuld be entitled t cmpensatin) under laws administered by the Secretary f Veterans Affairs; r a persn wh was discharged r released frm active duty because f a service-cnnected disability. A recently separated veteran means any veteran during the three-year perid beginning n the date f such veteran's discharge r release frm active duty in the U.S. military, grund, naval, r air service. An active duty wartime r campaign badge veteran means a veteran wh served n active duty in the U.S. military, grund, naval r air service during a war, r in a campaign r expeditin fr which a campaign badge has been authrized under the laws administered by the Department f Defense. An Armed frces service medal veteran means a veteran wh, while serving n active duty in the U.S. military, grund, naval r air service, participated in a United States military peratin fr which an Armed Frces service medal was awarded pursuant t Executive Order Prtected veterans may have additinal rights under USERRA the Unifrmed Services Emplyment and Reemplyment Rights Act. In particular, if yu were absent frm emplyment in rder t perfrm service in the unifrmed service, yu may be entitled t be reemplyed by yur emplyer in the psitin yu wuld have btained with reasnable certainty if nt fr the absence due t service. Fr mre infrmatin, call the U.S. Department f Labr's Veterans Emplyment and Training Service (VETS), tllfree, at USA-DOL.

2 If yu believe yu belng t any f the categries f prtected veterans listed abve, please indicate by checking the apprpriate bx belw. As a Gvernment cntractr subject t VEVRAA, we request this infrmatin in rder t measure the effectiveness f the utreach and psitive recruitment effrts we undertake pursuant t VEVRAA. I identify as ne r mre f the classificatins f Prtected Veteran listed abve. I am nt a prtected veteran. Vluntary Self-Identificatin Submissin f this infrmatin is vluntary and refusal t prvide it will nt subject yu t any adverse treatment. The infrmatin prvided will be used nly in ways that are nt incnsistent with the Vietnam Era Veterans' Readjustment Assistance Act f 1974, as amended. Cnfidentiality The infrmatin yu submit will be kept cnfidential, except that (i) supervisrs and managers may be infrmed regarding restrictins n the wrk r duties f disabled veterans, and regarding necessary accmmdatins; (ii) first aid and safety persnnel may be infrmed, when and t the extent apprpriate, if yu have a cnditin that might require emergency treatment; and (iii) Gvernment fficials engaged in enfrcing laws administered by the Office f Federal Cntract Cmpliance Prgrams, r enfrcing the Americans with Disabilities Act, may be infrmed. The Cmpany s Cmmitment It is the plicy at the Cmpany t prvide equal emplyment and advancement pprtunities t all qualified individuals. T achieve this gal, the Cmpany is dedicated t taking affirmative actin t emply and advance in emplyment cvered veterans in cmpliance with Sectin 402 f the Vietnam Era Veterans Readjustment Assistance Act f

3 Vluntary Pst-Offer Self-Identificatin f Prtected Veteran Status This emplyer is a Gvernment cntractr subject t the Vietnam Era Veterans' Readjustment Assistance Act f 1974, as amended by the Jbs fr Veterans Act f 2002, 38 U.S.C (VEVRAA), which requires Gvernment cntractrs t take affirmative actin t emply and advance in emplyment: (1) disabled veterans; (2) recently separated veterans; (3) active duty wartime r campaign badge veterans; and (4) Armed Frces service medal veterans. These classificatins are defined as fllws: A disabled veteran is ne f the fllwing: Why are yu being asked t cmplete this frm? Hw d yu knw if yu are a prtected veteran? a veteran f the U.S. military, grund, naval r air service wh is entitled t cmpensatin (r wh but fr the receipt f military retired pay wuld be entitled t cmpensatin) under laws administered by the Secretary f Veterans Affairs; r a persn wh was discharged r released frm active duty because f a service-cnnected disability. A recently separated veteran means any veteran during the three-year perid beginning n the date f such veteran's discharge r release frm active duty in the U.S. military, grund, naval, r air service. An active duty wartime r campaign badge veteran means a veteran wh served n active duty in the U.S. military, grund, naval r air service during a war, r in a campaign r expeditin fr which a campaign badge has been authrized under the laws administered by the Department f Defense. An Armed frces service medal veteran means a veteran wh, while serving n active duty in the U.S. military, grund, naval r air service, participated in a United States military peratin fr which an Armed Frces service medal was awarded pursuant t Executive Order Prtected veterans may have additinal rights under USERRA the Unifrmed Services Emplyment and Reemplyment Rights Act. In particular, if yu were absent frm emplyment in rder t perfrm service in the unifrmed service, yu may be entitled t be reemplyed by yur emplyer in the psitin yu wuld have btained with reasnable certainty if nt fr the absence due t service. Fr mre infrmatin, call the U.S. Department f Labr's Veterans Emplyment and Training Service (VETS), tllfree, at USA-DOL.

4 As a Gvernment cntractr subject t VEVRAA, we are required t submit a reprt t the United States Department f Labr each year identifying the number f ur emplyees belnging t each specified prtected veteran categry. If yu believe yu belng t any f the categries f prtected veterans listed abve, please indicate by checking the apprpriate bx belw. I belng t the fllwing classificatins f Prtected Veterans (chse all that apply): Disabled Veteran Recently Separated Veteran Active Wartime r Campaign Badge Veteran Armed Frces Service Medal Veteran I am a Prtected Veteran, but I chse nt t self-identify the classificatin(s) t which I belng. I am NOT a prtected veteran. Vluntary Self-Identificatin If yu are a disabled veteran it wuld assist us if yu tell us whether there are accmmdatins we culd make that wuld enable yu t perfrm the essential functins f the jb, including special equipment, changes in the physical layut f the jb, changes in the way the jb is custmarily perfrmed, prvisin f persnal assistance services r ther accmmdatins. This infrmatin will assist us in making reasnable accmmdatins fr yur disability. Submissin f this infrmatin is vluntary and refusal t prvide it will nt subject yu t any adverse treatment. The infrmatin prvided will be used nly in ways that are nt incnsistent with the Vietnam Era Veterans' Readjustment Assistance Act f 1974, as amended. Cnfidentiality The infrmatin yu submit will be kept cnfidential, except that (i) supervisrs and managers may be infrmed regarding restrictins n the wrk r duties f disabled veterans, and regarding necessary accmmdatins; (ii) first aid and safety persnnel may be infrmed, when and t the extent apprpriate, if yu have a cnditin that might require emergency treatment; and (iii) Gvernment fficials engaged in enfrcing laws administered by the Office f Federal Cntract Cmpliance Prgrams, r enfrcing the Americans with Disabilities Act, may be infrmed. 2

5 The Cmpany s Cmmitment It is the plicy at the Cmpany t prvide equal emplyment and advancement pprtunities t all qualified individuals. T achieve this gal, the Cmpany is dedicated t taking affirmative actin t emply and advance in emplyment cvered veterans in cmpliance with Sectin 402 f the Vietnam Era Veterans Readjustment Assistance Act f

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