Veteran's Preference Points Application Form - City of Marshall, Minnesota

This Minnesota-specific "Veteran's Preference Points Application Form" is a document released by the Minnesota Department of Veteran Affairs.

Download the fillable PDF by clicking the link below and use it according to the applicable legal guidelines.

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VETERAN’S PREFERENCE
POINTS APPLICATION
Please return completed form to:
FOR OFFICE USE ONLY
City of Marshall Human Resources Office • 344 West Main Street • Marshall, MN 56258
Phone: 507/537-6790 • Fax: 507/537-6830 • E-mail:
Jobinformation@ci.marshall.mn.us
Date Received:
Website address:
www.ci.marshall.mn.us
You must submit a copy of your DD214—Member Copy 4 or other military documents to substantiate the service information requested on this
form. Claims not accompanied by proper documentation will not be processed. For assistance in obtaining military documents, contact the local
County Veterans’ Service Office at (507) 537-6729.
The City of Marshall operates under a point preference system, which awards points to qualified veterans to supplement their application. Points are awarded subject to the
provisions of MN Statute 43A.11. Ten (10) points are granted to non-disabled veterans on open competitive examinations; fifteen (15) points are awarded on open competitive
examinations if the veteran has a 10% or greater service connected compensable disability as certified by the U.S. Department of Veterans Affairs (USDVA).
Veteran’s Preference claims must be made on the form below and submitted with your application by the application deadline of the position for which you are applying. If the
DD214—Member Copy 4 or other supporting documentation is submitted to our office separate from this form, please attach a note with it indicating the position for which you are
applying and your present address.
Position you are applying for:
Name (Last)
(First)
(MI)
Are you a U.S. Citizen or Resident Alien?
Phone Number
 Yes
(
)
 No
Address (Street)
(City)
(State)
(Zip)
FOR OFFICE USE ONLY
5 points
10 points
15 points
Not approved
VETERAN—10 points
Member Copy 4 of DD214 or DD215 must be submitted to receive points
Honorably discharged veteran ………………………………………………  Yes
 No
DISABLED VETERAN—15 points on the passing score of an open competitive exam; 5 points on a promotional examination
rating for a first promotion only
Member Copy 4 of DD214 and USDVA letter of disability rating must be submitted to receive points
Honorably discharged veteran ………………………………………………  Yes
 No
Percent of Disability: _____%
 Yes
 No (entitled to 5 pts for first promotion only)
Have you ever been promoted in City of Marshall employment? ………
SPOUSE OF DECEASED VETERAN—10 points; 15 if the veteran was disabled at time of death
Member Copy 4 of DD214 or DD215, photocopy of marriage certificate, spouse’s death certificate and proof veteran died on or as a result
of active duty must be submitted to receive points. You are ineligible to receive points if you have remarried or were divorced from the
veteran.
 Yes
 No
Date of Death: _________
Have you remarried? ……………..
SPOUSE OF DISABLED VETERAN—15 points
Member Copy 4 of DD214 or DD215 and USDVA letter of disability rating decision must be submitted to receive points.
How does Veteran’s disability prevent performance of a stated job “requirement?” Due to the veteran’s service-connected disability the
veteran is unable to qualify for this position because (be specific):
AFFIDAVIT: I hereby claim Veterans’ Preference points for this examination and swear/affirm that the information given is true, complete
and correct to the best of my knowledge. I hereby acknowledge that I am responsible to obtain the required Veterans’ Preference
verification documents and submit them to the City of Marshall within 7 days of the application deadline.
Date:_______________________Signed:____________________________________________________________________________
Form 2014-10
VETERAN’S PREFERENCE
POINTS APPLICATION
Please return completed form to:
FOR OFFICE USE ONLY
City of Marshall Human Resources Office • 344 West Main Street • Marshall, MN 56258
Phone: 507/537-6790 • Fax: 507/537-6830 • E-mail:
Jobinformation@ci.marshall.mn.us
Date Received:
Website address:
www.ci.marshall.mn.us
You must submit a copy of your DD214—Member Copy 4 or other military documents to substantiate the service information requested on this
form. Claims not accompanied by proper documentation will not be processed. For assistance in obtaining military documents, contact the local
County Veterans’ Service Office at (507) 537-6729.
The City of Marshall operates under a point preference system, which awards points to qualified veterans to supplement their application. Points are awarded subject to the
provisions of MN Statute 43A.11. Ten (10) points are granted to non-disabled veterans on open competitive examinations; fifteen (15) points are awarded on open competitive
examinations if the veteran has a 10% or greater service connected compensable disability as certified by the U.S. Department of Veterans Affairs (USDVA).
Veteran’s Preference claims must be made on the form below and submitted with your application by the application deadline of the position for which you are applying. If the
DD214—Member Copy 4 or other supporting documentation is submitted to our office separate from this form, please attach a note with it indicating the position for which you are
applying and your present address.
Position you are applying for:
Name (Last)
(First)
(MI)
Are you a U.S. Citizen or Resident Alien?
Phone Number
 Yes
(
)
 No
Address (Street)
(City)
(State)
(Zip)
FOR OFFICE USE ONLY
5 points
10 points
15 points
Not approved
VETERAN—10 points
Member Copy 4 of DD214 or DD215 must be submitted to receive points
Honorably discharged veteran ………………………………………………  Yes
 No
DISABLED VETERAN—15 points on the passing score of an open competitive exam; 5 points on a promotional examination
rating for a first promotion only
Member Copy 4 of DD214 and USDVA letter of disability rating must be submitted to receive points
Honorably discharged veteran ………………………………………………  Yes
 No
Percent of Disability: _____%
 Yes
 No (entitled to 5 pts for first promotion only)
Have you ever been promoted in City of Marshall employment? ………
SPOUSE OF DECEASED VETERAN—10 points; 15 if the veteran was disabled at time of death
Member Copy 4 of DD214 or DD215, photocopy of marriage certificate, spouse’s death certificate and proof veteran died on or as a result
of active duty must be submitted to receive points. You are ineligible to receive points if you have remarried or were divorced from the
veteran.
 Yes
 No
Date of Death: _________
Have you remarried? ……………..
SPOUSE OF DISABLED VETERAN—15 points
Member Copy 4 of DD214 or DD215 and USDVA letter of disability rating decision must be submitted to receive points.
How does Veteran’s disability prevent performance of a stated job “requirement?” Due to the veteran’s service-connected disability the
veteran is unable to qualify for this position because (be specific):
AFFIDAVIT: I hereby claim Veterans’ Preference points for this examination and swear/affirm that the information given is true, complete
and correct to the best of my knowledge. I hereby acknowledge that I am responsible to obtain the required Veterans’ Preference
verification documents and submit them to the City of Marshall within 7 days of the application deadline.
Date:_______________________Signed:____________________________________________________________________________
Form 2014-10
INFORMATION REGARDING CLAIMING VETERANS’ PREFERENCE
The City of Marshall operates under a point preference system, which awards points to qualified veterans to supplement their
application. Completion of the Veterans Preference Points Application is optional; however, in the event you are claiming Veteran’s
Preference your DD214 and other military documents are required. Preference points are awarded to qualified veterans as defined by
Minn. Stat. § 43A.11, Minn. Stat. § 197.477, and to certain spouses of deceased or disabled veterans subject to the provision of Minn.
Stat. §§ 197.447 and 197.455.
The veteran must:
a) be a U.S. citizen or resident alien;
b) have received a discharge under honorable conditions from any branch of the U.S. Armed Forces; AND have either:
i.
served on active duty for at least 181 consecutive days, or
ii.
have been discharged by reason of service connected disability, or
iii.
have completed the minimum active duty requirement of federal law, as defined by CFR title 38, section 3.12a, i.e.,
having fulfilled the full period for which a person was called or ordered to active duty by the United States President,
or
iv.
certified service and verification of “veteran status” granted under U.S. PL 95-202.
The information provided will be used to determine your eligibility for veterans’ preference points. You are required to supply the
following information:
1)
Attach a copy of the “Member Copy 4” of your DD214 or DD215. This copy must state the nature of discharge; i.e., honorable,
general, medical, under honorable conditions. A “DD214 “Member-1” copy will not be accepted.
2)
Disabled veterans must also supply a Military/United States Department of Veterans’ Affairs Rating Decision that
supports/verifies the fact that the injury was incurred while on, or as a result of, active duty service. Disability incurred while on, or as a
result of, active duty for training purposes does not quality for disabled veteran preference per Minn. Stat. §§ 197.455 and 197.447.
3)
A spouse of a deceased veteran, applying for preference points must supply their marriage certificate, the veteran’s “Member
Copy 4” DD214 or DD215, USDVA verification that veteran died on or as a result of active duty, a death certificate, verification of their
marriage at the time of veteran’s death, and that the spouse has not remarried.
Open, Competitive Exams:
To qualify for preference for (non-promotional) open competitive exam, you must have earned a passing score and been separated
under honorable conditions from any branch of the armed forces of the United States after having served on active duty for 181
consecutive days, or by reason of disability incurred while serving on active duty, or after having served the full period called or ordered
for federal active duty and be a United States citizen or resident alien. Veteran’s preference may be used by the surviving spouse of a
deceased veteran, who died on active duty or as a result of active duty, and by the spouse of a disabled veteran who is unable to qualify
because of the disability.
Promotional Exams:
To qualify for five points preference on a promotional exam, a veteran must have earned a passing exam score and received a USDVA
active duty service connected disability rating of 50% or more. Disabled veterans eligible for such preference may use the five points
preference only for the first promotion after securing employment with the City of Marshall. (Minn. Stat. 197.455)
Thank you for your military service and for your interest in employment with the City of Marshall. Please contact our office at (507)
537-6790 or your local County Veterans’ Service Office at (507) 537-6729, if you have any questions regarding veterans’ preference in
public employment.
Form 2014-10

Download Veteran's Preference Points Application Form - City of Marshall, Minnesota

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