APPLICATION FOR VETERAN’S CREDITS
Monroe County Civil Service Commission
39 West Main Street, Room 210 * Rochester, New York 14614
585-753-1700 * 585-753-1728 FAX
Veterans Status Claimed: (Check one)
Wartime Veteran
Applicants for Wartime Veteran’s Credits must complete this form (VC-1) for each examination and
provide a copy of their DD-214 separation papers within 30 days after exam date. Candidates who
have previously submitted a copy of their DD-214 to the Monroe County Department of Human
Resources on or after January 1, 2013 do not need to resubmit them, but a new VC-1 form must be
filed for each examination. DD-214 separation papers establishes proof the veteran:
•
Served on active duty in wartime, as defined in §85 of the State Civil Service Law (see back),
•
Was honorably discharged or released under honorable circumstances from such services, and
•
Is a resident of New York State at the time of the establishment of the eligible list.
Disabled Wartime Veteran
In addition to the proof above, applicants for Disabled Wartime Veteran’s Credits must also submit a
“Veterans Disability Records Release” form (VC-4), to a Veteran's Affairs office or the Monroe County
Veterans Services Agency to show that they have a war-incurred disability of at least 10% which is
certified to be in existence at the time of application for additional credits. This form should be
forwarded in sufficient time so that the Commission will receive verification of the disability within 30
days after exam date.
Active Duty Military
Wartime Veteran’s Credits will be applied after you are discharged and provide your DD-214.
Full Name:
Social Security Number:
Address:
Number and Title of Examination(s) for which
credit is claimed:
Date of Enlistment or Induction:
Dates of Active Service:
From:
To:
Were you discharged under honorable conditions?
Yes
No
Have you ever been appointed through the use of Veteran's Credits to any position in the State Civil Service or
any City or Civil Division of New York State?
Yes
No
If Yes, where and when?
__________________________________________________________________________
If you used your veteran’s credit for permanent appointment or promotion in New York State or its civil
divisions, you may not claim them again.
I HEREBY CERTIFY THAT THE ABOVE STATEMENTS ARE TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF
Veteran’s Signature:
Date:
VC-1 Rev (12/14)