Form AID XXX AID XXX Employment Verification Questionnaire

OMB 0412-NEW

EXPIRATION DATE: xx/xx/xxxx

EMPLOYMENT VERIFICATION QUESTIONNAIRE

Name of Organization      		Date      
Name of Person Filling out This Form      	Contact Information      
1. Have you employed Iraqi citizens or nationals for 1 year or more to perform work in Iraq funded through a USAID grant, contract, or cooperative agreement worth $25,000 or more since March 20, 2003? Yes No
If you answered yes to the first question, please answer the following: Did you create personnel records for the Iraqi citizens or nationals you hired in response to question 1? Yes No If yes, how long do you keep those records? Please indicate length of time in months or years:       What personally identifiable information is contained in the personnel records (e.g. – passport number, government ID number, first/last name, family name, tribal name, name of spouse/children/father/mother/grandfather/other family members, four part Arabic name, date of birth etc.)? Please list personally identifiable information you collect:       What employment information is contained in those records (e.g. – location of job, badge or company ID number, dates of employment, supervisor’s name/HR office point of contact, etc.)?       Is biometric data contained in those records? (e.g. – height, weight, hair color, eye color, finger prints, photograph, gender, iris scan, etc)? Yes No If you answered yes to the above question, what biometric data do you collect?       Is the personnel information referenced in question 1 located in an automated searchable and retrievable database or records system? Yes No If yes, how do you retrieve those records? (e.g. – name, contract number, date, etc.)       If this information is not retained in an automated database, how is the information stored?       Please estimate how long it would take you to verify the employment of an Iraqi citizen or national you employed as referenced in question 1.      
2. Would you be willing to share employment information with the U.S. Government to verify an individual’s employment history for visa purposes? Yes No
3. What costs, if any, would be incurred should the U.S. Government ask you to produce employment verification information for Iraqi citizens/nationals as referenced in question 1 (please specify the measurement of cost, e.g. – per person, hours, etc.)?      

4. What challenges do you foresee should the U.S. Government ask you to produce employment verification information for Iraqi citizens/nationals as referenced in question 1?

     

5. Are there any other points that you think the U.S. Government should consider when creating a system to verify employment history of Iraqi citizens/nationals for visa purposes?

     

6. Should the U.S. Government ask you to produce employment verification information for Iraqi citizens/nationals as referenced in question 1, would you have access to employment verification information from your sub-contractors or sub-grantees?

     

7. Do you have any additional information that may be relevant to USAID’s ability to assist the Department of State in verifying the employment status of an Iraqi citizen or national for visa purposes?

     

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