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VETERAN CREDIT APPLICATION Before completing this form, please read the INSTRUCTIONS TO VETERANS on the following page. This form is NOT valid unless accompanied by discharge documents or other proof of active military service. EXAMINATION TITLE: EXAM NUMBER: APPLICANT'S NAME: SOC. SEC. NO.: - - Last Name First Name M.I. MAILING ADDRESS: Post Office Box or Street Address City State Zip Code LEGAL RESIDENCE: Street Address City State Zip Code 1. Dates of Active Military Service: / / TO / / 2. Service Serial Number(s): 3. Branch of Service: Army Navy Air Force Marine Corps Coast Guard 4. County & State of Residence upon Date of Entry into Military Service: COUNTY: STATE: 5. Were you discharged (or released to inactive duty) under honorable conditions? YES NO 6. CITIZENSHIP: Are you a United States Citizen? YES NO 7. Type of Veteran Credits you would like to claim: Non-Disabled Disabled* * IMPORTANT: If claiming Disabled Credits, you must send a Veteran’s Authorization for Disability Record form to the Veterans Benefits Administration Regional Office where your disability claim is on file. This form is on our website at: cayugacounty.us/Portals/0/civilservice/Jobs/Veteran%20Authorization%20for%20Disability%20Record.pdf. 8. List all of your PUBLIC SERVICE EMPLOYMENTS since January 1, 1951. Attach additional sheets if necessary. Dates of Employment Employer Name & Address Title of Your Position Veteran Credits Used? / to / YES NO / to / YES NO / to / YES NO I declare, subject to the penalties of perjury, that the statements made on this form and any attachments are, to the best of my knowledge, true and correct. X Signature of Applicant Date Signed (DO NOT WRITE BELOW – CIVIL SERVICE USE ONLY) Reviewed by: (Initials) (Date) NON-DISABLED VETERAN’S CREDITS: DISABLED VETERAN’S CREDITS: Approved Disapproved Approved Disapproved Reason (if disapproved): Reason (if disapproved): Department of Human Resources and Civil Service Commission County Office Building, 2nd Floor, 160 Genesee Street, Auburn, NY 13021 Website: www.cayugacounty.us/civilservice Telephone: (315) 253-1284 ---PAGE BREAK--- INSTRUCTIONS TO VETERANS ALL VETERANS: Answer all questions on the Veteran Credit Application. Attach documentary proof of your eligibility, and return to the Cayuga County Civil Service Commission, 160 Genesee Street, 2nd Floor, Auburn, NY 13021, on or before the date of the exam. DISABLED VETERANS: In addition, you must complete the Veteran’s Authorization for Disability Record and immediately forward it to your Veterans Benefits Administration Regional Office. You may request this form by calling (315) 253-1284, or download at: cayugacounty.us/Portals/0/civilservice/Jobs/Veteran%20Authorization%20for%20Disability%20Record.pdf. According to Civil Service Law, additional credits in examinations may be granted to successful candidates who have claimed and established status as a non-disabled or disabled veteran. These additional credits are granted on the following basis: Open-Competitive Promotional Examinations Examinations Non-Disabled Veterans: 5 2.5 Disabled Veterans: 10 5 These additional credits, which are added to the final passing score on the examination, may only be granted at the time of the establishment of the eligible list. Candidates who claim credit, but who fail to submit adequate proof of eligibility for such credit by the time the eligible list is established, cannot later be granted credit on such eligible list. ELIGIBILITY REQUIREMENTS: 1. You must be a Citizen of the United States. 2. You must have been honorably discharged, or released under honorable circumstances, from such service. 3. You must have served in the United States Armed Forces during any of the following periods: World War II: December 7, 1941 – December 31, 1946 Korea: June 27, 1950 – January 31, 1955 Vietnam: February 28, 1961 – May 7, 1975 Persian Gulf: August 2, 1990 – the date upon which such hostilities end Service for which a veteran received the Armed Forces Expeditionary Medal, the Navy Expeditionary Medal, or the Marine Corps Expeditionary Medal for: Hostilities in Lebanon: June 1, 1983 – December 1, 1987 Hostilities in Grenada: October 23, 1983 – November 21, 1983 Hostilities in Panama: December 20, 1989 – January 31, 1990 Service in the commissioned corps of the United States Public Health Service during the following dates: July 29, 1945 – December 31, 1946 June 27, 1950 – July 3, 1952 ACCEPTABLE DOCUMENTARY PROOF (originals or copies): DD 214; NAVPERS-553; NAVMC-78 PD; WDAGO-53, 55; WDAGO-53, 98. The NYS Constitution allows members of the US Armed Forces who are on active duty (other than for training purposes) the right to request extra War Time Veteran credits on civil service examinations prior to discharge. The mere application for Veteran credits does not obligate applicant to the use of such credits. Candidates who pass the examination will be notified of their standing on the eligible list with or without these additional credits. At the time of appointment eligible candidates will be asked to sign forms using or relinquishing these additional credits. AMENDMENT TO NEW YORK STATE CONSTITUTION REGARDING VETERAN CREDITS UPDATE: Effective January 1, 2014, an amendment to Section 6, Article 5 of the New York State Constitution allows certain disabled veterans to use additional credits on civil service exams to obtain a second appointment or promotion. Previously, the New York State Constitution had provided a strict one-time-only use of veteran credits on a civil service examination. A non-disabled war-time veteran was entitled to a one-time use of either 5 points on an open-competitive examination or 2.5 points on a promotional examination. A disabled war-time veteran was entitled to a one-time use of either 10 points on an open-competitive examination or 5 points on a promotional examination. IMPACT OF THE NEW AMENDMENT: The amendment creates an exception to the one-time-only use of veteran credits. It permits veterans who are certified as disabled after having already received credits at either an original appointment or a promotion because of their status as non-disabled veterans to receive additional credits after the certification of their disability. After being certified disabled, such a veteran would be entitled to an additional grant of credits equal to the difference between 10 credits and the number of credits received at the initial appointment or promotion. This would bring the total additional points of Civil Service credits such a veteran can receive to 10 for either an appointment or a promotion. If a veteran previously received 5 (non-disabled) points on an open-competitive examination and subsequently became certified as disabled, he or she would be entitled to receive another 5 (disabled) points on a subsequent examination whether an open-competitive or a promotional examination. If a veteran previously received 2.5 (non-disabled) points on a promotional examination and subsequently became certified as disabled, he or she would be entitled to receive another 7.5 (disabled) points on a subsequent examination whether an open-competitive or a promotional examination. There is no change for a veteran who has already received non-disabled veteran credits and remains non-disabled. A disabled veteran who received disabled veteran credits without previously having received non-disabled veteran credits is not entitled to any additional credits. z:civil\APPLICATION SUPPLEMENTAL FORMS\Veteran Credit Application