VETS-100A-Form.pdf

APPENDIX A TO PART 61-300 – FEDERAL CONTRACTOR VETERANS' EMPLOYMENT

REPORT VETS-100A

FEDERAL CONTRACTOR VETERANS’ EMPLOYMENT REPORT VETS-100A

(For covered contracts entered into or modified on or after December 1, 2003.)

OMB NO: 1293-0005

Expires: 04/30/2014

RETURN COMPLETED REPORT TO:

VETS-100 Submission

VETERANS’ EMPLOYMENT AND TRAINING SERVICE (VETS)

Service Center In care of: Department of Labor National Contact Center (DOL-NCC) (Suite 200) 14120 Newbrook Drive Chantilly, VA 20151

Persons are not required to respond to this collection of information unless it displays a valid OMB number

ATTN: Human Resource/EEO Department

TYPE OF REPORTING

ORGANIZATION (Check one or both, as applicable)

Prime Contractor Subcontractor

TYPE OF FORM (Check only one)

Single Establishment Multiple Establishment-Headquarters Multiple Establishment-Hiring Location Multiple Establishment-State Consolidated

(specify number of locations) (MSC)

COMPANY IDENTIFICATION INFORMATION (Omit items preprinted above-ADD Company Contact Information Below) COMPANY No:

TWELVE MONTH PERIOD ENDING

M

M

D

D

Y

NAME OF PARENT COMPANY:

ADDRESS (NUMBER AND STREET):

CITY:

COUNTY:

STATE:

ZIP CODE:

NAME OF COMPANY CONTACT:

TELEPHONE FOR CONTACT: EMAIL:

NAME OF HIRING LOCATION:

ADDRESS (NUMBER AND STREET):

CITY:

COUNTY:

STATE:

ZIP CODE:

NAICS: DUNS: _ _ EMPLOYER ID

(IRS TAX No.) _

INFORMATION ON EMPLOYEES

REPORT ALL PERMANENT FULL-TIME OR PART-TIME EMPLOYEES AND NEW HIRES WHO ARE VETERANS, AS DEFINED ON REVERSE. DATA ON NUMBER OF EMPLOYEES IS TO BE ENTERED IN COLUMN L, M, N, O, AND P, LINES 1-10. DATA ON NEW HIRES IS TO BE ENTERED IN COLUMNS Q, R, S, T, AND U. ENTRIES IN COLUMNS Q THROUGH U, LINES 1-10, AND COLUMNS L, M, N, O, AND P. ENTER THE MAXIMUM AND

MINIMUM NUMBER OF EMPLOYEES. INSTRUCTIONS ARE FOUND ON THE REVERSE OF THIS FORM.

JOB

CATEGORIES

NUMBER OF EMPLOYEES NEW HIRES (PREVIOUS 12 MONTHS)

DISABLED

VETERANS

(L)

OTHER

PROTECTED

VETERANS

(M)

ARMED FORCES

SERVICE MEDAL

VETERANS

(N)

RECENTLY

SEPARATED

VETERANS

(O)

TOTAL EMPLOYEES,

BOTH VETERANS AND

NON-VETERANS

(P)

DISABLED

VETERANS

(Q)

OTHER

PROTECED

VETERANS

(R)

ARMED FORCES

SERVICE MEDAL

VETERANS

(S)

RECENTLY

SEPARATED

VETERANS

(T)

TOTAL NEW HIRES,

BOTH VETERANS AND

NON-VETERANS

(U)

EXECUTIVE/SENIOR

LEVEL OFFICIALS AND

MANAGERS

FIRST/MID LEVEL

OFFICIALS AND

MANAGERS 2

PROFESSIONALS 3

TECHNICIANS 4

SALES WORKERS 5

ADMINISTRATIVE

SUPPORT WORKERS 6

CRAFT WORKERS 7

OPERATIVES 8

LABORERS/HELPERS 9

SERVICE WORKERS 10

TOTAL 11

Report the total maximum and minimum number of permanent employees during the period covered by this report.

Maximum Number Minimum Number

Federal Contractor Veterans’ Employment Report (VETS-100-A)

WHO MUST FILE

This VETS-100A Report is to be completed by all nonexempt federal contractors and subcontractors with a contract or subcontract entered into or modified on or after December 1, 2003, in the amount of $100,000 or more with any department or agency of the United States for the procurement of personal property and non-personal services. Services include but are not limited to the following services: utility, construction, transportation, research, insurance, and fund depository, irrespective of whether the government is the purchaser or seller. Entering into a covered federal contract or subcontract during a given calendar year establishes the requirement to file a VETS-100A Report during the following calendar year. The VETS-100A Report is to be completed by all nonexempt federal contractors and subcontractors whose only contract or subcontract with any department or agency of the United States for the procurement of personal property and non-personal services (including construction) was entered into after December 1, 2003 (and did not become subject to 41 CFR part 61-300 through contract modification).

WHEN/WHERE TO FILE

This annual report must be filed no later than September 30. Mail to the address pre-printed on the front of the form.

LEGAL BASIS FOR REPORTING REQUIREMENTS

Title 38, United States Code, Section 4212(d) requires that federal contractors report at least annually the numbers of employees in the workforce by job category and hiring location, and the number of such employees, by job category and hiring location, who are qualified covered veterans. Federal contractors must report the total number of new hires during the period covered by the report and the number of such employees who are qualified covered veterans. Additionally, federal contractors must report on the maximum and minimum number of employees during the period covered by the report.

HOW TO SUBMIT THE VETS-100A REPORT

Single-establishment employers must file one completed VETS-100A Report. All multi-establishment employers, i.e., those doing business at more than one hiring location, must file (A) one VETS-100A Report covering the principal or headquarters office: (B) a separate VETS-100A Report for each hiring location employing 50 or more persons: and (C) EITHER, (i) a separate VETS-100A Report for each hiring location employing fewer than 50 persons, OR (ii) consolidated reports that cover hiring locations within one State that have fewer than 50 employees. Each state consolidated report must also list the name and address of the hiring locations covered by the report. Company consolidated reports such as those required by EEO-1 reporting procedures are NOT required for the VETS-100A Report. Completed reports for the headquarters location and all other hiring locations for each company should be mailed in one package to the address indicated on the front of the form. Employers may submit their reports via the Internet at http://www.dol.gov/vets/programs/fcp/main.htm . A company number is not required in order to use this method of submission. Employers that submit computer-generated output for more than 10 hiring locations to satisfy their VETS-100A reporting obligations must submit the output in the form of an electronic file. This file must comply with current DOL specifications for the layout of these records, along with any other specifications established by the Department for the applicable reporting year. Employers that submit VETS-100A Reports for ten locations or less are exempt from this requirement, but are strongly encouraged to submit an electronic file. In these cases, state consolidated reports count as one location each.

RECORD KEEPING

Employers must keep copies of the completed annual VETS-100A Report submitted to DOL for a period of one year.

HOW TO PREPARE THE FORMS

Answers to questions in all areas of the form are mandatory.

Multi-establishment employers submitting hard copy reports should produce facsimile copies of the headquarters form for reporting data on each location.

Type of Reporting Organization Indicate the type of contractual relationship (prime contractor or subcontractor) that the organization has with the Federal Government. If the organization serves as both a prime contractor and a subcontractor on various federal contracts, check both boxes.

Type of Form If a reporting organization only has a covered contract that was entered into or modified on or after December 1, 2003, it then must use a VETS-100A Report. If a reporting organization only has a covered contract that was entered before December 1, 2003, (and did not become subject to 41 CFR part 61-300 through contract modification) it must use a VETS-100 Report. If a reporting organization has a covered contract entered both before and on or after December 1, 2003, it then must use both a VETS-100 and a VETS-100A Report.

If a reporting organization submits only one VETS-100A Report for a single location, check the Single Establishment box. If the reporting organization submits more than one form, only one form should be checked as Multiple Establishment-Headquarters. The remaining forms should be checked as either Multiple Establishment-Hiring Location or Multiple Establishment-State Consolidated. For state consolidated forms, the number of hiring locations included in that report should be entered in the space provided. For each form, only one box should be checked within this block.

COMPANY IDENTIFICATION INFORMATION:

Company Number Leave Blank. If there are any questions regarding a Company Number, please call the VETS-100 staff at (866) 237-0275 or e-mail VETS100-customersupport@dol.gov .

Twelve Month Period Ending Enter the end date for the twelve month reporting period used as the basis for filing the VETS-100A Report. To determine this period, select a date in the current year between August 1 and September 30 that represents the end of a payroll period. The selected date will be the basis for reporting Number of Employees, as described below. The twelve-month period preceding that date will be your twelve-month period covered. This period is the basis for reporting New Hires, as described below. Any federal contractor or subcontractor who has written approval from the Equal Employment Opportunity Commission to use December 31 as the ending date for the EEO-1 Report may also use that date as the ending date for the payroll period selected for the VETS-100A Report.

Name and Address for Single Establishment Employers COMPLETE the identifying information under the Parent Company name and address section. LEAVE BLANK all of the identifying information for the Hiring Location.

Name and Address for Multi Establishment Employers For parent company headquarters location, COMPLETE the name and address for the parent company headquarters, LEAVE BLANK the name and address of the Hiring Location. For hiring locations of a parent company, COMPLETE the name and address for the Parent Company location, COMPLETE the name and address for the Hiring Location.

NAICS Code, DUNS Number, and Employer ID Number Single Establishment and Multi Establishment Employers must COMPLETE the Employer ID Number, NAICS Code, DUNS Number, as described below.

NAICS Code Enter the six (6) digit NAICS Code applicable to the hiring location for which the report is filed. If there is not a separate NAICS Code for the hiring location, enter the NAICS Code for the parent company.

Dun and Bradstreet I.D. Number (DUNS) If the company or any of its establishments has a Dun and Bradstreet Identification Number, please enter the nine (9) digit number in the space provided. If there is a specific DUNS Number applicable to the hiring location for which the report is filed, enter that DUNS Number. Otherwise, enter the DUNS number for the parent company.

Employer I.D. Number (EIN) Enter the nine (9) digit number assigned by the I.R.S. to the contractor. If there is a specific EIN applicable to the hiring location for which the report is filed, enter that EIN. Otherwise, enter the EIN for the parent company.

INFORMATION ON EMPLOYEES

Counting Veterans. Some veterans will fall into more than one of the qualified covered veteran categories. For example, a veteran may be both a disabled veteran and an other protected veteran. In such cases the veteran must be counted in each category.

Number of Employees. Provide all data for regular full-time and part-time employees who were disabled veterans, other protected veterans, Armed Forces service medal veterans, or recently separated veterans employed as of the ending date of the selected payroll period. Do not include employees specifically excluded as indicated in 41 CFR 61-300.2(b)(2). Employees must be counted by qualified covered veteran status for each of the 10 occupational categories (Lines 1-10) in columns L, M, N, and O. Column P must count all employees, including qualified covered veterans, in each of the 10 occupational categories (Lines 1-10) Blank spaces will be considered zeros.

New Hires. Report the number of regular full-time and part-time employees who were hired, both veterans and non-veterans, as well as those who were hired by veteran category, and who were included in the payroll for the first time during the 12-month period preceding the ending date of the selected payroll period. The total line in columns Q, R, S, T, and U (Line 11) is required. Enter all applicable numbers, including zeros.

Maximum/Minimum Employees. Report the maximum and minimum number of regular employees on board during the twelve-month period covered by this report, as indicated by 41 CFR 61-300.10(a)(3).

DEFINITIONS:

'Hiring location' means an establishment as defined at 41 CFR 61-300.2(b)(1).

‘Job Categories’ means any of the following: Officials and Managers (Executive/Senior Level Officials and Managers and First/Mid Level Officials and Managers), Professionals, Technicians, Sales Workers, Administrative Support Workers, Craft Workers, Operatives, Laborers and Helpers, and Service Workers and are defined in 41 CFR 61-300.2(b)(3).

'Disabled Veteran' means (i) 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 (ii) a person who was discharged or released from active duty because of a service-connected disability.

'Other Protected 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. For those with Internet access, the information required to make this determination is available at http://www.opm.gov/staffingportal/vgmedal2.asp . A replica of that list is enclosed with the annual VETS-100A mailing.

‘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 (61 Fed. Reg. 1209) at http://www.opm.gov/staffingportal/vgmedal2.asp

‘Recently Separated Veteran’ means a 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, ‘Covered Veteran’ means a veteran as defined in the four veteran categories above.

A copy of 41 CFR part 61-300 can be found at http://www.dol.gov/dol/cfr/Title_41/Chapter_61.htm

Public reporting burden for this collection is estimated to average 45 minutes per response, including the time for reviewing instructions, searching existing data source, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden to the Department of Labor, Office of Information Management, Room N-1316, 200 Constitution Avenue, NW, Washington D.C. 20210 or electronically transmitted to VETS100-customersupport@dol.gov All completed VETS-100A Reports should be sent to the address indicated on the front of the form.

http://www.dol.gov/vets/programs/fcp/main.htm mailto:VETS100-customersupport@dol.gov http://www.opm.gov/staffingportal/vgmedal2.asp http://www.opm.gov/staffingportal/vgmedal2.asp http://www.dol.gov/dol/cfr/Title_41/Chapter_61.htm mailto:VETS100-customersupport@dol.gov