Get Va Form 0860 - Va

The VA Form 0860, commonly known as the Breach of Settlement Agreement Allegation form, is used to report instances where a settlement agreement with the Department of Veterans Affairs has not been honored. This guide provides step-by-step instructions on how to complete this form online to ensure that your concerns are submitted accurately and efficiently.

Follow the steps to complete the VA Form 0860 - Va online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the name of the employee involved in the settlement agreement in the corresponding field.
3. Provide the name of the VA facility where the employee is associated.
4. Enter the home mailing address for the employee in the specified section.
5. Input the mailing address of the VA facility.
6. List the home telephone number of the employee.
7. Enter the business telephone number of the relevant VA facility.
8. Clearly state the claims and basis that the agreement settled within the designated area.
9. Indicate whether you contacted the EEO program manager after learning of the breach, marking 'Yes' or 'No'.
10. If 'Yes' is selected, provide the approximate date of contact and the case number assigned.
11. Detail the specific provisions of the settlement agreement that you believe were breached in the appropriate field.
12. Explain how the settlement agreement was breached, referencing any actions that led you to this conclusion and including the names of the individuals involved.
13. Provide the approximate dates when you believe the breach occurred. This is important to comply with the 30-day submission requirement.
14. If applicable, elaborate on any reasons for delays in reporting the breach if you are beyond the 30-day timeframe.
15. Conclude by signing the form with the employee's signature and date.
16. Finally, ensure all information is correct, then save changes, download, print, or share the completed form as required.

Start filling out your VA Form 0860 online today to ensure your allegations are addressed promptly.