Fillable Personal Information Form (PIF) The University of Toledo (University of Toledo)

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Personal Information Form (PIF) The University of Toledo (University of Toledo)

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Country of origin: US
File type: PDF

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Personal Information Form (PIF)
(Last)
(First) (Middle)
SSN
(Number and Street)
Date of Birth (mm-dd-yy)
Female Male
Are you a Citizen of the United States?
Yes
No
Complete The Following Section If You Are Not A Citizen Of The United States
Yes NoAre you a Lawful Permanent Resident Alien? (Holder of a Green Card)
VISA Status
(Complete the following only if a NON-RESIDENT ALIEN)
Student
Faculty, Staff
H1B
J1
Other:
Country of Legal Residence
Date of Original Entry To U.S.
Race/Ethnicity
This information is required for Ohio and United States governmental Affirmative Action statistical purposes. Check all that apply.
African American:
Caucasian or White:
Hispanic::
American Indian or
Alaskan Native
:
Asian American or
Pacific Islander:
(not of Hispanic origin) All persons having origins in any of the Black racial groups of Africa.
(not of Hispanic origin) All persons having origins in any of the original peoples of Europe, North Africa, or
the Middle East.
All persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race.
All persons having origins in any of the original peoples of North America, and who maintain cultural identifications through tribal affiliation
or community recognition.
All persons having origins in any of the original peoples of Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands.
Veteran Status: Complete If Applicable
Dates of Service (mm-dd-yy) (From) (To) Highest Rank
Campaign Ribbon(s) (see page 2/3) :
Veteran Vietnam Veteran
Disabled Veteran
(Type of Disability) (Percent)
Phone Number
Marital Status
Zip
StateCity
Q1M1J1F1
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The University of Toledo
Name
Divorced Separated Married
Single Widowed
Domestic
Partner
Address
OPT
Gender
Reset
Personal Information Form (PIF)
Page 2
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Identification of a Disability
(Percent)(Type of Disability)
As a new employee, you are given the opportunity to advise the University whether or not you consider yourself to be disabled
according to the definition given below. Your response is purely voluntary and you will not be subjected to disciplinary action for
failing to respond. Should you decide to change your decision at a later date, please notify the Human Resources Office in writing.
According to Section 504 of the Rehabilitation Act of 1973, a disabled person is any person who: (1) has a physical or mental
impairment that substantially limits one or more major life activities (functions such as caring for one's self, performing manual tasks,
walking, seeing, hearing, speaking, breathing, learning, and working); (2) has a record of such an impairment that substantially limits
one or more major life activities; or (3) is regarded as having such an impairment.
No YesNo
Accommodation Requested(Religion)
As a new employee, you are given the opportunity to advise the University whether or not you will require any religious
accommodations. Your response is purely voluntary and you will not be subjected to disciplinary action for failing to respond. Should
you decide to change your decision at a later date, please notify your supervisor and the Human Resources Office in writing.
Religious Accomodation (optional)
Relationship
Cell Phone NumberHome Phone Number
Address
Name
Emergency Contact Information
Date (mm-dd-yy)Signature of Employee
I understand and agree that providing the information requested on this form is based on the fact that I have accepted employment with the University of Toledo and that the
information is required in order to establish my employment record and to place me on the University's payroll system
.
Reset
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signature
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War Service Creditable for Veterans Preference. In the absence of statutory definition for "war" and "campaign
or expedition," OPM considers to be "wars" only those armed conflicts for which a declaration of war was issued by
Congress. The title 38, U.S.C., definition of "period of war," which is used in determining benefits administered by
the Department of Veterans Affairs, includes the Vietnam Era and other armed conflicts. That title 38 definition is
NOT applicable for civil service purposes. Thus the last "war" for which active duty is qualifying for Veterans
preference is World War II. The inclusive dates for World War II service are December 7, 1941, through April 28,
1952.
Non-combat operations that are not qualifying for Veterans preference. Many medals are awarded for non-
combat operations. These medals are not a basis for preference and include the following: Global War on Terrorism
Service Medal for service from September 11, 2001, to date to be determined, The Medal of Merit for meritorious service
in World War II, The Medal of Freedom for meritorious achievements or meritorious service to the United States on or
after December 7, 1941, in the war against an enemy outside the continental limits of the United States, The Antarctica
Service Medal for participating in a scientific, direct support, or exploratory operation on the Antarctic Continent, The
National Defense Service Medal for honorable service between June 27, 1950 and July 27, 1954 or January 1, 1961 and
August 14, 1974; or for the period between August 2, 1990, and November 30, 1995, The Armed Forces Service Medal for
participation in a United States military operation deemed to be a significant activity for which there was no threat of
encounter of foreign armed opposition or imminent threat of hostile action, The Armed Forces Reserve Medal for 10
years of honorable service in a Reserve component; or active duty service in a Reserve component on or after August 1,
1990; or volunteer service for active duty on or after August 1, 1990.
Military Operations Since 1937 for Which a Campaign or Expeditionary Medal Has Been Awarded, Except
for Operations Occurring During a Declared War
Military personnel receive many awards and decorations. To help agencies make decisions concerning entitlement
to Veterans preference and other benefits, the following list identifies those awards that are campaign and
expeditionary medals. Any Armed Forces expeditionary Medal, whether listed here or not, is qualifying for
Veterans preference. The Department of Defense, not OPM, determines who is entitled to receive a medal, and
under what circumstances. The list below is derived from DoD 1348.33-M, Manual of Military Decorations and
Awards. DD 214, Certificate of Discharge or Separation from Active Duty, or other official documents issued by the
branch of service are required as verification of eligibility for Veterans preference.
Note: Section 572 of Subtitle G of the Defense Authorization Act of Fiscal Year 1998 (Public Law 105-85),
signed into law on November 18, 1997, allows the Secretary of the military department concerned to
determine whether individual members who participated in Operation Joint Endeavor or Operation Joint
Guard in the Republic of Bosnia and Herzegovina and in such other areas in the region as the Secretary of
Defense considers appropriate, meet the individual service requirements for award of the Armed Forces
Expeditionary Medal (AFEM). Generally, service members will be considered eligible if they: deployed to
Bosnia and Herzegovina (or other area that the Secretary of Defense considers appropriate) in direct support of
one or both of the operations; served on board a ship in the Adriatic in direct support of one or both of the
operations; or operated in airspace above Bosnia, Herzegovina (or other area that the Secretary of Defense
considers appropriate) while the operations were in effect.
U.S. Office of Personnel Management VetGuide Appendix A:
Wars, Campaigns and Expeditions of the Armed Forces
Since WWII Quality for Veterans' Preference
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Personal Information Form (PIF) The University of Toledo (University of Toledo)

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Completed 31 August 2020

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