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USERRA Inquiry

Employer Support of the Guard and Reserve (ESGR) can assist in answering questions related to the Uniformed Services Employment and Reemployment Rights Act (USERRA). ESGR also has ombudsmen available to conduct neutral, informal mediation for conflicts between Service members and their civilian employers.

If you have questions you can call ESGR's toll-free number, 1-800-336-4590 (select option 1), between 8 AM and 6 PM EST (M-F); e-mail osd.USERRA@mail.mil or complete the form below.

If you are a Uniformed Service (National Guard, Reserve, the National Disaster Medical System (NDMS)) member desiring to have an Ombudsman assist you and your employer resolve a conflict, call ESGR's toll-free number, 1-800-336-4590 (select option 1), between 8 AM and 6 PM EST (M-F) or submit a USERRA Support Request.

UNIFORMED SERVICES EMPLOYMENT AND REEMPLOYMENT RIGHTS ACT (USERRA) INQUIRY


INSTRUCTIONS

Employer Support of the Guard and Reserve (ESGR) can assist in answering questions related to the Uniformed Services Employment and Reemployment Rights Act (USERRA). ESGR also has ombudsmen available to conduct neutral, informal mediation for conflicts between Service members and their civilian employers.

If you have questions you can call ESGR's toll-free number, 1-800-336-4590 (select option 1), between 8 AM and 6 PM EST (M-F); e-mail osd.USERRA@mail.mil or complete the form below.

If you are a Uniformed Service (National Guard, Reserve, the National Disaster Medical System (NDMS)) member desiring to have an Ombudsman assist you and your employer resolve a conflict, call ESGR's toll-free number, 1-800-336-4590 (select option 1), between 8 AM and 6 PM EST (M-F) or submit a USERRA Support Request.

REQUESTOR INFORMATION

(Items marked with an asterisk(*) are required.)

DATE SUBMITTED:
* I AM:
 
Name
   
 
   
IF A CURRENT UNIFORMED SERVICE MEMBER:
* EMAIL ADDRESS:
   
* TELEPHONE NUMBER:
 
ALTERNATE TELEPHONE NUMBER:
* STATE
 
* ZIP CODE

 
HOW DID YOU HEAR ABOUT ESGR?
* USERRA QUESTION
 
You have 250 characters

Please note: This form takes 20-30 seconds to submit. Please only click the Submit button once. Once submitted, you will be directed to a completion page and receive a confirmation email.

DD FORM 3021

OMB CONTROL NUMBER: 0704-0678
OMB EXPIRATION DATE: 2/28/2027

AGENCY DISCLOSURE NOTICE

The public reporting burden for this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering, and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of theis collection of information including suggestions for reducing the burden, to the Department of Defense, Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE ABOVE ORGANIZATION.

PRIVACY ACT STATEMENT

AUTHORITY: 38 U.S.C. 43, Employment and Reemployment Rights of Members of the Uniformed Services; 5 U.S.C. 574, Confidentiality; 5 U.S.C. Part I, Chapter 5, Subchapter IV, Alternative Means of Dispute Resolution in the Administrative Process; 42 U.S.C. 300hh-11,National Disaster Medical System, ((d)(3) Employment and reemployment rights); 20 CFR 1002, Regulations Under the Uniformed Services Employment and Reemployment Rights Act of 1994; 5 CFR 353, Restoration to Duty from Uniformed Service or Compensable Injury; DoD Instruction 1205.22, Employer Support of the Guard and Reserve; and DoD Instruction 1205.12, Civilian Employment and Reemployment Rights of Applicants for, and Service Members and Former Service Members of the Uniformed Services.

PRINCIPLE PURPOSE(S): To record information related to the mediation of disputes and answering of inquiries related to the USERRA; by tracking case assignments and mediation results of potential conflicts between employers and the National Guard, Reserves, or National Disaster Medical Service (NDMS) members they employ; and by reporting statistics related to the Ombudsman Program in aggregate and at the state committee-level. These records are also used as a management tool for statistical analysis, tracking, reporting, evaluating program effectiveness and conducting research.

ROUTINE USE(S): Disclosure of records are generally permitted under 5 U.S.C. 522a(b) of the Privacy Act of 1974, as amended.

To Department of Labor for Congressionally-mandated USERRA reporting (38 U.S.C. Employment and Reemployment Rights of Members of the Uniformed Services § 4432, Reports) with consideration of 5 U.S.C. § 574, Confidentiality requirements.

Additional routine uses are listed in the applicable System of Records Notice, DHRA 16 DoD, Inquiry and Case Management System (ICMS), and is located at: http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570696/dhra-16/

DISCLOSURE: Voluntary; however, failure to provide accurate contact information and other solicited information may delay or prevent ESGR from processing the request.