Veteran, Disabled Spouse, Blind, and Exempt Volunteer Firefighter Status
Name (PRINT):
Oneida County must maintain veteran, disabled spouse, blind, and exempt volunteer firefighter status on all employees under our Civil Service jurisdiction. This information is very important to ensure employees’ rights and statuses are protected in the event of a reduction in force, disciplinary action, promotion, testing, etc.
Please complete the following and check the appropriate items:
Non Veteran Veteran (Must submit Member Disabled Veteran (Must submit
4 copy of DD-214) proof of disability from the Division
of Veterans’ Affairs)
Date(s) of Service:
Did you serve in the Armed Forces of the United States during any of the following periods?
12/7/41-12/31/46 6/27/50-1/31/55 02/28/61-5/7/75 Persian Gulf: 8/2/90-present
Lebanon: 6/1/83-12/1/87 Grenada: 10/23/83-11/21/83 Panama: 12/20/89-1/31/90
U.S. Public Health Service: 7/29/45-12/31/46, 6/27/50-7/3/52
Lebanon, Grenada and Panama will be limited to those who received the following Expeditionary Medals: Armed Forces, Navy or Marine Corps.
Check if you are a spouse of a 100% Disabled Veteran. You must submit proof of spouse’s disability by the Division of Veterans’ Affairs.
Check if you have been certified as blind by the Commission for the Blind. You must submit proof.
Exempt Volunteer Firefighter Status
Check if you are an Exempt Volunteer Firefighter.
You must provide a notarized certificate signed by two officers that you have been a volunteer member of the company for five years or more. A form for this purpose can be obtained from your volunteer fire company or from Oneida County Civil Service.
Signature Date
Rev. 9/15
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