University of Wisconsin Service Center Human Resource System
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This employer is a Government contractor subject to the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended by
the Jobs for Veterans Act of 2002, 38 U.S.C. 4212
(VEVRAA), which requires Government contractors to take affirmative action to
employ and advance in employment: (1) disabled veterans; (2) recently separated veterans; (3) active duty wartime or campaign badge
veterans; and (4) Armed Forces service medal veterans. These classifications are defined as follows:
• A “disabled veteran” is one of the following:
o a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of
military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or
o a person who was discharged or released from active duty because of a service-connected disability.
• A “recently separated veteran” means any veteran during the three-year period beginning on the date of such veteran's
discharge or release from active duty in the U.S. military, ground, naval, or air service.
• An “active duty wartime or campaign badge veteran” means a veteran who served on active duty in the U.S. military, ground,
naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the
laws administered by the Department of Defense.
• An “Armed forces service medal veteran” means a veteran who, while serving on active duty in the U.S. military, ground, naval
or air service, participated in a United States military operation for which an Armed Forces service medal was awarded
pursuant to Executive Order 12985
Protected veterans may have additional rights under USERRA—the Uniformed Services Employment and Reemployment Rights Act. In
particular, if you were absent from employment in order to perform service in the uniformed service, you may be entitled to be
reemployed by your employer in the position you would have obtained with reasonable certainty if not for the absence due to service.
For more information, call the U.S. Department of Labor's Veterans Employment and Training Service (VETS), toll-free, at 1-866-4-
As a Government contractor subject to VEVRAA, we are required to submit a report to the United States Department of Labor each
year identifying the number of our employees belonging to each specified “protected veteran” category. If you believe you belong to any
of the categories of protected veterans listed above, please indicate by checking the appropriate box below.
I belong to the following classifications of protected veterans (choose all that apply):
Recently separated veteran
Active wartime or campaign badge veteran
Armed forces service medal veteran
I am a protected veteran, but I choose not to self-identify the classifications to which I belong.
I am a veteran, but not a protected veteran.
I am not a veteran.
If you are a disabled veteran it would assist us if you tell us whether there are accommodations we could make that would enable you
to perform the essential functions of the job, including special equipment, changes in the physical layout of the job, changes in the way
the job is customarily performed, provision of personal assistance services or other accommodations. This information will assist us in
making reasonable accommodations for your disability.
Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information
provided will be used only in ways that are not inconsistent with the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as
The information you submit will be kept confidential, except that (i) supervisors and managers may be informed regarding restrictions
on the work or duties of disabled veterans, and regarding necessary accommodations; (ii) first aid and safety personnel may be
informed, when and to the extent appropriate, if you have a condition that might require emergency treatment; and (iii) Government
officials engaged in enforcing laws administered by the Office of Federal Contract Compliance Programs, or enforcing the Americans
with Disabilities Act, may be informed.
Routing Instructions: Submit to your local HR/Payroll office. If at UW-Madison, submit to 21 N. Park Street, Suite 5101.
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