Get Va 4939 2013-2025

This guide provides clear and comprehensive instructions for filling out the VA Form 4939, Complaint of Employment Discrimination, online. Whether you are a current employee, former employee, or applicant, following these steps will help you navigate the form effectively.

Follow the steps to complete your form accurately and efficiently.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred digital interface.
2. Begin by entering your name in the designated field. Please include your last name, first name, and middle initial. Ensure that you print clearly.
3. Input your mailing address in the next field, making sure to provide complete and accurate information.
4. Provide your email address in the specified section to ensure you receive updates regarding your complaint.
5. List your work telephone number including the area code. This helps facilitate any immediate communication if required.
6. Enter your home telephone number, also including the area code.
7. Indicate your status by choosing one of the options: VA employee, applicant for employment, or former VA employee.
8. Fill in your job title, series, and grade if applicable. This contextual information may be crucial for your complaint.
9. Detail the name and address of the VA facility where you believe discrimination occurred. Accurate details are essential.
10. In the section for basis, list all applicable reasons for your complaint, specifying any relevant information such as race, gender, disability, etc.
11. Describe the claims related to employment actions that you believe were discriminatory, being careful not to include sensitive information violating privacy laws.
12. Note the date or dates when the occurrences took place that led to this complaint. Accurate documentation is crucial.
13. Outline the remedies you seek as a result of this complaint. Use additional sheets if necessary.
14. If you have a representative assisting you, indicate this and provide their contact information as requested.
15. Confirm whether you have contacted an EEO Counselor regarding your claims and include their name and contact information if applicable.
16. Should your complaint require explanation for any untimeliness, provide this information in the specified area.
17. Include your signature to validate the form, followed by the date you completed it.
18. Once the form is fully completed, prepare to save any changes, download, print, or share the document as needed.

Complete your VA Form 4939 online today for an efficient complaint process.