Form 1293-0005 FEDERAL CONTRACTOR VETERANS’ EMPLOYMENT REPORT VETS-4212

FEDERAL CONTRACTOR VETERANS’ EMPLOYMENT REPORT VETS-4212
RETURN COMPLETED REPORT TO:
VETS-4212 Submission
VETERANS’ EMPLOYMENT AND TRAINING SERVICE (VETS)
Service Center
In care of: Department of Labor National Contact Center (DOL-NCC)
7425 Boston Blvd
Springfield, VA 22153

OMB NO: 1293-0005
Expires: 11/30/2017
Persons are not required to respond to this collection of information unless it displays a valid OMB
number. It is mandatory for a covered Federal contractor respond to this information collection. See
38 U.S.C. § 4212(d) and “Who Must File” section of instructions.

TYPE OF REPORTING ORGANIZATION
(Check one or both, as applicable)
Prime Contractor
Subcontractor

ATTN: Human Resource/EEO Department

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

NAME OF PARENT COMPANY:
COUNTY:

NAME OF COMPANY CONTACT:

1

5

Y

Y

Y

Y

ZIP CODE:

STATE:

TELEPHONE FOR CONTACT:

NAME OF HIRING LOCATION:

EMAIL:

ADDRESS (NUMBER AND STREET):

CITY:

DUNS:

D

0

ADDRESS (NUMBER AND STREET):

CITY:

NAICS:

D

2

COUNTY:

_

EMPLOYER ID
(IRS TAX No.)

_

STATE:

ZIP CODE:

_

INFORMATION ON EMPLOYEES
REPORT THE TOTAL NUMBER OF EMPLOYEES AND NEW HIRES WHO ARE PROTECTED VETERANS, AS DEFINED IN THE INSTRUCTIONS. DATA ON NUMBER OF EMPLOYEES ARE TO
BE ENTERED IN COLUMN A AND B, LINES 1.1 THROUGH 9. DATA FOR NEW HIRES ARE ENTERED IN COLUMNS C AND D. LINE 10 IS TOTAL OF EACH COLUMN. ENTRIES IN
COLUMNS C AND D, LINES 1.1 THROUGH 9 (GRAY SHADED AREAS) ARE OPTIONAL. ENTER THE MAXIMUM AND MINIMUM NUMBER OF EMPLOYEES.
NUMBER OF EMPLOYEES
PROTECTED VETERANS
TOTAL EMPLOYEES
(A)
(B)

JOB
CATEGORIES

NEW HIRES (PREVIOUS 12 MONTHS)
PROTECTED VETERANS
TOTAL NEW HIRES
(C)
(D)

EXECUTIVE/SENIOR LEVEL
OFFICIALS AND MANAGERS
1.1
FIRST/MID LEVEL
OFFICIALS AND
MANAGERS
1.2
PROFESSIONALS

2

TECHNICIANS

3

SALES WORKERS

4

ADMINISTRATIVE
SUPPORT WORKERS

5

CRAFT WORKERS

6

OPERATIVES

7

LABORERS/HELPERS

8

SERVICE WORKERS

9

TOTAL EMPLOYEES

10

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

Minimum Number

Form VETS-4212 11/2014

Federal Contractor Veterans’ Employment Report (VETS-4212)
WHO MUST FILE: This VETS-4212 Report is to be completed by all nonexempt Federal contractors and
subcontractors with a contract or subcontract in the amount of $150,000 or more with any department or
agency of the United States for the procurement of personal property or 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-4212 Report during the following calendar year.
WHEN TO FILE: This annual report must be filed no later than September 30.
LEGAL BASIS FOR REPORTING REQUIREMENTS: Title 38, United States Code, Section 4212(d) mandates that
Federal contractors and subcontractors subject to the statute’s affirmative action provisions in 38 U.S.C.
4212(a) report, at least annually, the number of employees in their workforces by job category and hiring
location, and the number of such employees, by job category and hiring location, who are qualified protected
veterans. In addition, Federal contractors and subcontractors must report the total number of new hires
during the period covered by the report and the number of such new hires who are qualified protected
veterans. Further, Federal contractors and subcontractors must report on the maximum and minimum
number of employees during the period covered by the report. The Department of Labor’s Veterans’
Employment and Training Service (VETS) has promulgated regulations found at 41 CFR part 61-300 to
implement the reporting requirements of 38 U.S.C. 4212(d). The regulations require contractors and
subcontractors to file the VETS-4212 Report to comply with the requirements of 38 U.S.C. 4212(d). The
regulations in 41 CFR part 61-300 can be found at http://www.dol.gov/dol/cfr/Title_41/Chapter_61.htm.
HOW TO FILE THE VETS-4212 REPORT: The preferred method for filing VETS-4212 Reports is electronically
through the VETS web-based filing system. Instructions for electronically filing the VETS-4212 Report are
found on the VETS website at http://www.dol.gov/vets/vets4212.htm. Alternative filing methods are
described below in these instructions.
Single Establishment Employers: Employers doing business at one hiring location may complete and submit a
single VETS-4212 Report using the web-based filing system, or submit a single paper version of the VETS-4212
Report, as described below under Alternative Filing Methods.
Multi-Establishment Employers: Employers doing business at more than one hiring location, must file: (A) a
VETS-4212 Report covering the principal or headquarters office; (B) a separate VETS-4212 Report for each
hiring location employing 50 or more persons; and (C) EITHER, (i) a separate VETS-4212 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. Multi-establishment employers doing business at more than 10
locations must submit their VETS-4212 Reports in the form of an electronic data file that complies with current
Department of Labor specifications for the format of these records, and any other specifications established
by the Department for the applicable reporting year. Multi-establishment employers with fewer than 10
hiring locations are strongly encouraged to submit their VETS-4212 Reports in the form of an electronic data
file, but are not required to do so. In these cases, state consolidated reports count as one location each.
VETS-4212 Reports in the form of electronic data files may be submitted through the web-based filing system.
Electronic data files also may be transmitted electronically as an e-mail attachment (if they do not exceed the
size stated in the specifications), or submitted on compact discs or other electronic storage media.

ALTERNATIVE FILING METHODS: The VETS-4212 Report may also be filed in paper format. Reporting
organizations may download a paper version of the VETS-4212 Report from the VETS website at
http://www.dol.gov/vets/vets4212.htm or send a written request for the paper version of the VETS-4212
Report to: Office of the Assistant Secretary for Veterans’ Employment and Training, U.S. Department of Labor,
200 Constitution Avenue, NW, Room S-1325, Washington, DC 20210, Attn: VETS-4212 Report Form Request.
WHERE TO FILE: VETS-4212 Reports in paper format or electronic data files on compact discs or other
electronic storage media may be delivered by U.S. mail or courier delivery service to: Veterans’ Employment
and Training Service, c/o Department of Labor National Contact Center, 15000 Conference Center Drive,
Suite B0132, Chantilly, VA 20194. Paper copies of the VETS-4212 Reports and electronic data files (if they do
not exceed the size stated in the specifications) also may be sent as e-mail attachments to: [email protected]
HOW TO PREPARE THE VETS-4212 REPORT: All fields and answers to questions in all areas of the VETS-4212
Report are mandatory unless otherwise specified below. If the multi-establishment employer has hiring
locations employing fewer than 50 persons, the employer may file separate reports for each hiring location or
consolidated reports that cover multiple hiring locations within one state.
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. If a reporting
organization submits only one VETS-4212 Report for a single location, check the Single Establishment box. If
the reporting organization submits more than one VETS-4212 Report, one report should be checked as
Multiple Establishment-Headquarters. The remaining VETS-4212 Reports should be checked as either Multiple
Establishment-Hiring Location or Multiple Establishment-State Consolidated. For state consolidated reports,
the number of hiring locations included in that report should be entered in the space provided. For each
report, only one box should be checked within this block.
Company Identification Information: Leave it Blank only if your company has not previously filed. If
there are any questions regarding a Company Number, please call the VETS-4212 Customer Support
Center at (866) 237-0275 or e-mail [email protected].
Twelve Month Period Ending: Enter the end date for the twelve month reporting period used as the basis for
filing the VETS-4212 Report. To determine this period, select a date in the current year between July 1 and
August 31 that represents the end of a payroll period. The selected date will be the basis for reporting the
Number of Employees, as described below. The twelve-month period preceding that date is your twelvemonth covered period. This period is the basis for reporting New Hires, as described below. Any Federal
contractor or subcontractor that 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-4212 Report.
Name and Address for Single Establishment Employers: Complete the identifying information under the
Parent Company name and address section.
Name and Address for Multi-Establishment Employers: For parent company headquarters location, complete
the name and address for the parent company headquarters and leave blank the name and address of the
Hiring Location. For hiring locations of a parent company, complete the 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 North American Industry Classification System (NAICS) Code, Dun and
Bradstreet I.D. Number (DUNS), and Employer Identification Number (EIN) 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.
• DUNS Number: If there is a specific Dun and Bradstreet Identification applicable to the hiring location for
which the report is filed, please enter the nine (9) digit in the space provided. If the hiring location does
not have a DUNS Number, enter the DUNS number for the Parent Company. If an appropriate DUNS
Number cannot be identified, leave this field blank.
• 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.
Number of Employees: Report the total number of employees who are protected veterans for each of the 10
occupational categories (Lines 1.1 through 9) in column A. Report the total number of employees, including
protected veterans, for each of the 10 occupational categories (Lines 1.1 through 9) in column B. Blank spaces
will be considered zeros.
New Hires (Previous 12 Months): Report the total number of employees who were hired and included in the
payroll for the first time during the 12-month period preceding the ending date of the selected payroll period.
Report the total number of new hires who are protected veterans in column C. Report the total number of
new hires, including protected veterans, in column D. Providing new hire data for each of the occupational
categories (columns C and D, lines 1.1 through 9) is optional. Blank spaces will be considered zeros.
Maximum/Minimum Employees: Report the maximum and minimum number of employees on board during
the twelve-month period covered by this report, as indicated by 41 CFR 61-300.10(a)(3).
DEFINITIONS:
‘Employee’ – means any individual on the payroll of an employer who is an employee for purposes of the employer’s

withholding of Social Security taxes except insurance sales agents who are considered to be employees for such
purposes solely because of the provisions of 26 U.S.C. 3121 (d)(3)(B) (the Internal Revenue Code). Part-time employees
and leased employees are included in the definition of ‘employee.’ The definition does not include persons hired on a
casual basis for a specific job ( e.g., persons at a construction site whose employment relationship is expected to
terminate with the end of the employee’s work at the site); persons employed temporarily in an industry other than
construction who are hired through a hiring hall or some other referral arrangement; or persons on the payroll of an
employment agency who are referred by such agency for work to be performed on the premises of another employer
under that employer’s direction and control, as provided in 41 CFR 61-300.2(b)(5).

‘Hiring location’ – means an establishment as defined at 41 CFR 61-300.2(b)(6).
‘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)(7).
‘Protected Veteran’ – means a veteran who is protected under the nondiscrimination and affirmative action
provisions of the Vietnam Veterans’ Readjustment Assistance Act, 38 U.S.C. 4212; specifically a veteran who
may be classified as an active duty wartime or campaign badge veteran, disabled veteran, Armed Forces
service medal veteran, or recently separated veteran,

•
•

•

•

’Active duty wartime or campaign badge 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 under the laws administered by the Department of Defense.
‘Armed Forces Service Medal Veteran’ – means any 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 FR 1209, 3 CFR, 1996 Comp., p.
159).
‘Disabled Veteran’ – means (1) 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 (2) A person who was discharged or released
from active duty because of a service-connected disability.
‘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.

RECORD KEEPING: Employers must keep a copy of the completed annual VETS-4212 Report(s) submitted to
DOL for a period of three years.
Public Burden Statement: Public reporting burden for this collection is estimated to average 20 minutes per
location to make an electronic filing and 40 minutes per location to make a paper filing, 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, Veterans’ Employment and Training Service, Office of Information Management,
Room N-1316, 200 Constitution Avenue, NW, Washington D.C. 20210 or electronically transmitted to
[email protected] All completed VETS-4212 Reports should be sent to the address
indicated on the front of the form. See actual VETS-4212 Report for additional disclosures.