USERRA Advisor

You may submit Form 1010 in either of two ways:

1. 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 send it by mail, email, fax, or in-person delivery, to the following VETS office only:

Veterans’ Employment and Training Service (VETS)
Attention: VETS1010
200 Constitution Ave NW
Room S-1325
Washington, DC 20210
Email: VETS1010@dol.gov
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.

2. 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 Online 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 -
  1. 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.)
  2. 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.
  1. If yes, fill in your position and pay rate.
  2. If no, fill in the date that your reemployment was denied and state the reason that was given.
  3. 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.

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