Skip to Main Content
Loading
Loading
Government
Departments
Community
Business
How Do I...
Home
Form Center
Form Center
Search Forms:
Search Forms
Select a Category
All Categories
City Clerk
Fire Department
Holiday Home Decorating Contest
Human Resources
P&Z
Photo Contest Entry Form
Police Department
Recreation
Small Business Relief Fund- Grant Application
Speakers Bureau
By
signing in or creating an account
, some fields will auto-populate with your information.
City's Veterans' Preference Certification Form
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
Date:
*
Date:
Name:
*
Section 295.07(1), Florida Statutes, provides for Veterans’ Preference in employment appointment and retention, if qualified under one of the following categories, and not exempt under Section 295.07(4), Florida Statutes. Section 295.09, Florida Statutes, also provides Veterans’ Preference for reinstatement, reemployment, and promotion. If you seek Veterans’ Preference, please “check” the appropriate box, and provide this form and documentation of your status with your employment application, no later than the position advertisement closing date.
I certify that I am qualified to claim Veterans’ Preference under the category checked below:
(a) A disabled veteran: 1. Who has served on active duty in any branch of the United States Armed Forces, has received an honorable discharge, and has established the present existence of a service-connected disability that is compensable under public laws administered by the United States Department of Veterans Affairs; or 2. Who is receiving compensation, disability retirement benefits, or pension by reason of public laws administered by the United States Department of Veterans Affairs and the United States Department of Defense.
This option applies
(b) The spouse of a person who has a total disability, permanent in nature, resulting from a service-connected disability and who, because of this disability, cannot qualify for employment, and the spouse of a person missing in action, captured in line of duty by a hostile force, or forcibly detained or interned in line of duty by a foreign government or power.
This option applies
(c) A wartime veteran as defined in s. 1.01(14), who has served at least 1 day during a wartime period. I acknowledge that active duty for training may not be allowed for eligibility under this paragraph.
This option applies
(d) The unremarried widow or widower of a veteran who died of a service-connected disability.
This option applies
(e) The mother, father, legal guardian, or unremarried widow or widower of a member of the United States Armed Forces who died in the line of duty under combat-related conditions, as verified by the United States Department of Defense.
This option applies
(f) A veteran as defined in s. 1.01(14), F.S. I acknowledge that active duty for training may not be allowed for eligibility under this paragraph.
This option applies
(g) A current member of any reserve component of the United States Armed Forces or the Florida National Guard. If so, please attach FDVA form VP2, signed by your immediate military supervisor, to document your status.
This option applies
Please submit this certification with your application, or as soon as possible, prior to the date that the position advertisement closes. In order to receive Veterans’ Preference and to complete your application, this form and documentation to prove your status must be returned to the Human Resources (“HR”) office in accordance with Rule 55A-7.013, Florida Administrative Code. Please contact HR at pbgcareers@pbgfl.com or call 561-799-4223, if you have any questions.
This statement is true to the best of my knowledge and belief.
Printed Name
Veterans’ Preference Certification, FDVA form VP-1, effective date: June/2016, incorporated in rule 55A-7.013, FAC
Leave This Blank:
Receive an email copy of this form.
Email address
This field is not part of the form submission.
Submit
Submit and Print
* indicates a required field
About PBG
Bid Opportunities
City Budget
City Code
City Council
Fee Schedule (PDF)
GreenMarket
Arrow Left
Arrow Right
[]
Slideshow Left Arrow
Slideshow Right Arrow