Form Vets-100 - Federal Contractor Report On Veterans' Employment
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2VETS-100 FEDERAL CONTRACTOR REPORT ON VETERANS' EMPLOYMENT
OMB NO:1293-0005
RETURN COMPLETED REPORT TO:
Expires: 04/30/2011
U.S. DEPARTMENT OF LABOR
VETERANS' EMPLOYMENT AND TRAINING SERVICE
VETS-100 Reporting Office
P.O. Box 726
Persons are not required to respond to this collection of
Lanham, Maryland 20703-0726
information unless it displays a valid OMB number
TYPE OF FORM (Check only one)
TYPE OF
REPORTING
Single Establishment
ORGANIZATION
(Check one or both, as
Multiple Establishment-
applicable)
Headquarters
Multiple Establishment-Hiring
Prime Contractor
Location
Subcontractor
Multiple Establishment-State
Consolidated (specify number of
ATTN: Human Resource/EEO Department
locations)
(MSC)
COMPANY IDENTIFICATION INFORMATION
(Omit items preprinted above-ADD Company Contact Information Below)
COMPANY No:
TWELVE MONTH PERIOD ENDING
2
0
1
0
M
M
D
D
Y
Y
Y
Y
NAME OF PARENT COMPANY:
ADDRESS (NUMBER AND STREET):
CITY:
COUNTY:
STATE:
ZIP CODE:
NAME OF COMPANY CONTACT:
TELEPHONE AND EMAIL FOR CONTACT:
NAME OF HIRING LOCATION:
ADDRESS (NUMBER AND STREET):
CITY:
COUNTY:
STATE:
ZIP CODE:
EMPLOYER ID
NAICS:
DUNS:
_
_
_
(IRS TAX No.)
EMPLOYEE DATA AND VETERAN REPORTING REQUIREMENTS
REPORT ALL PERMANENT FULL-TIME OR PART-TIME EMPLOYEES AND NEW HIRES WHO ARE TARGETED VETERANS, DATA ON NUMBER OF EMPLOYEES
ARE TO BE ENTERED IN COLUMNS L, M, AND N, LINES 1-9. DATA ON NEW HIRES ARE TO BE ENTERED IN COLUMNS O, P, Q, R, AND S. INSTRUCTIONS ARE
FURTHER DETAILED ON THE REVERSE OF THIS FORM.
NUMBER OF EMPLOYEES
NEW HIRES (PREVIOUS 12 MONTHS)
JOB
RECENTLY
TOTAL NEW HIRES,
SPECIAL DISABLED
VIETNAM ERA
OTHER PROTECTED
SPECIAL DISABLED
VIETNAM ERA
SEPARATED
OTHER PROTECTED
BOTH VETERANS
CATEGORIES
VETERANS
VETERANS
VETERANS
VETERANS
VETERANS
VETERANS
VETERANS
AND NON-VETERANS
(L)
(M)
(N)
(O)
(P)
(Q)
(R)
(S)
OFFICIALS AND MANAGERS
1
PROFESSIONALS
2
TECHNICIANS
3
SALES WORKERS
4
OFFICE AND CLERICAL
5
CRAFT WORKERS (SKILLED) 6
OPERATIVE (SEMI-SKILLED)
7
LABORERS (UNSKILLED)
8
SERVICE WORKERS
9
TOTAL
10
Report the total maximum and minimum number of permanent employees during the period covered by this report.
Maximum Number
Minimum Number
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