INSTRUCTIONS FOR VETERANS’ PREFERENCE CLAIMS
VETS/USERRA/VP FORM 1010
PLEASE NOTE:
The Electronic 1010 Claim filing system might be inaccessible at times. If that website is unavailable for any reason, you may submit a hard copy Form
1010 instead. To do so, please send a hard copy 1010 form (by mail or fax) to:
Veterans' Employment and Training Service
U.S. Department of Labor
ATTENTION: Form 1010
61 Forsyth Street, S.W., Room 6T85
Atlanta, Georgia 30303
FAX: (404) 562-2313
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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 then either mail it, or fax it, or deliver it in person, to the
following VETS office only:
Veterans' Employment and Training Service
U.S. Department of Labor ATTENTION: Form 1010 61 Forsyth Street, S.W., Room 6T85
Atlanta, Georgia 30303
FAX: (404) 562-2313
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 either mail it, or fax it, or deliver it
in person, to the VETS address shown above.
- 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/ .
By law, Veterans' Preference complaints must be received by VETS,
in writing or via the VETS 1010 Form On-line Submission website,
within 60 days of the date of the alleged veterans' preference
violation or the complaint will be determined as "not timely", and
closed without action.
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 Veterans'
Preference claims only. If you are filing a USERRA complaint, please
refer to the instructions in the
USERRA Advisor.
Section I
Self-explanatory. Social Security number is optional, but
desired.
Section II
For this section please use the branch of service that you
were, are or will be in when the allegations that lead you to
file this complaint occurred. For each question, answer to the
best of your ability only the questions that apply to you. This
information must eventually be supported with documentation in
order for VETS to establish your eligibility under the law.
- Question 8 - Fill in the branch of service
you that you are, have been or will be a member of. May leave
this question blank if filing a VP claim.
- Question 9 - Fill in the specific
information you have of your unit including name, address and
phone number.
- Question 10 - Fill in the dates that you
served in, the date that you began your service, or the date
that you will begin your service.
- Question 11 - Fill in the appropriate
bubble that best describes how you were discharged.
Section III
Please report the information of the employer(s) that your
complaint involves. Do so accurately because this information
will be used to establish a point of contact within the agency
or company.
- Question 12 - Fill in the name of your
employer or the employer you are applying for.
- Question 13 - Fill in the address.
- Question 14 -
- Fill in the name and, if
possible, title of whoever you are or have been in contact with
regarding your position.
(Often a HR specialist or supervisor)
- Fill in their phone number
- Question 15 - Fill in the dates that you
have been employed with this employer, the date that you started
working for this employer, or the date you will start working
for this employer.
- Question 16 - Fill in no if you have not
exceeded five cumulative years of uniformed service with this
employer. Answer yes, and explain in the comment section below,
if you have.
- Question 17 - Fill in the name of any
Union(s) that may represent you.
- Question 18 - Fill in the title of the
position you have, had or are applying to.
Section IV
Please use this section to detail some specifics of your
complaint. Answer each question that applies to you as
completely and accurately as you can.
- Leave Question 19 blank. - Question 19 is
for USERRA complaints only.
If Claim Concerns Veterans’ Preference in Federal Hiring
- Question 20 - If you feel that your
Veterans’ Preference rights were violated regarding a position
within a Federal Agency, please fill in the issue that
best describes your complaint.
- Leave Question 21 blank. Question 21 is for
USERRA complaints only.
If Claim Concerns Hiring, RIF, Promotion or Termination
- Question 22 - Fill in the title of the
position that relates to this complaint.
- Leave Questions 23 through 24 blank.
Questions 23 through 24 are for USERRA complaints only.
If Claim Concerns Reemployment Following Service
- Leave Questions 25 through 28 blank.
Questions 25 through 28 are for USERRA complaints only.
- Question 29 - Fill in the name and title of
the person who you applied for reemployment with.
- Question 30 - Fill in yes and the date if
you are reemployed or have been reinstated with your employer.
- If yes, fill in your position and pay rate.
- If no, fill in the date that your reemployment was denied and state the reason that was given.
- Fill in the name of who within your employer denied your reemployment.
Comments
Please write clearly and coherently why you are filing this
claim. Detail what remedies (e.g., employment, reemployment
rights, lost wages, seniority benefits) you seek by filing this
claim.
Please return to the Previous Page.
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