INSTRUCTIONS FOR USERRA CLAIMS
VETS/USERRA/VP FORM 1010
You may submit Form 1010 in either of two ways:
- Submitting a signed hard copy of
Form 1010.
You may download
Form 1010 to your computer, complete the
items on the form that are relevant to your claim, print the
form, sign and date the form, and mail to the
VETS
office nearest the location of the employer. The Form 1010
information you enter after download is not being saved or
collected from this Internet site; instead, you must print
out the completed form and mail it to VETS.
- Submitting Form 1010 electronically via the Internet. If
you prefer to file Form 1010 electronically via the Internet
instead of mailing a printed form, you can complete and submit
the “On-line” version of Form 1010 at VETS 1010 Form On-line
Submission website:
https://vets1010.dol.gov/ .
Please read the Privacy Act statement and certification on page
two of Form 1010 before signing and submitting the form.
Below are some brief instructions on filling out Form 1010.
However, if questions arise that are not addressed here, please
contact the
nearest
VETS office for assistance.
SPECIFIC INSTRUCTIONS
NOTE: These instructions are for persons filing USERRA claims
only. If you are filing a Veterans' Preference complaint, please
refer to the instructions in the
Veterans' Preference
Advisor.
Section I
- Self-explanatory. Social Security number is optional, but
desired.
Section II
- Complete item 8 only if you are currently a member
of the Reserve or National Guard.
- For item 9, enter only the dates of service that are
directly related to this USERRA complaint. If the complaint
is not related to a specific period of service, enter "not
applicable" or "N/A."
Section III
- Self-explanatory. If an item is not applicable, enter
"not applicable" or "N/A."
Section IV
- Leave item 18 blank. Item 18 is for Veterans' Preference
complaints only.
- Items 20 through 28 will not all be applicable in every
case. For example, if your claim involves reemployment
following a period of military service, you may skip items
20 through 22. Similarly, if your complaint involves hiring
discrimination, you may skip items 23 through 28.
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