Bc 170A Pdf No Download Needed Details

The BC 170A is a textbook that covers the required material for an introductory course in business communication. The book is written by James McCroskey, Tracy Barr, and Amy C. Edmonds with six editions so far published. It was first published in 1978 by Harper & Row Publishers. This edition of the text has been updated to reflect changes made to the national standards for undergraduate education at the end of 2013.

We have gathered some basic facts about the bc 170a. You'll have the estimated time it may take you to prepare the form and a few other details.

QuestionAnswer
Form NameBc 170A
Form Length6 pages
Fillable?Yes
Fillable fields215
Avg. time to fill out22 min 17 sec
Other namesbc 172 form, bc 170a pdf No Download Needed, census employment inquiry bc 170 form, form bc 172d

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Attachment 1

17238015

Census Jobs!

U.S. DEPARTMENT OF COMMERCE Economics and Statistics Administration U.S. CENSUS BUREAU

The Census Bureau is an Equal Opportunity Employer

A UNIQUE OPPORTUNITY: EARN MONEY WHILE YOU SERVE YOUR COMMUNITY

The U.S. Census Bureau offers employment opportunities for a variety of positions and durations to support the collection of data for the federal government. These positions may work varied schedules depending on assignments and job requirements. While working, you will serve your country and make a difference in your community.

Program

Description

Types of Work

Duration of Work

 

 

 

 

 

The Census Bureau conducts a count of the entire population

The Decennial Census

The Decennial Census

 

every 10 years, in years ending in "0." Throughout the decade,

program offers the

program offers the

 

tests are also conducted in various locations in preparation for the

following types of work:

following duration of

Decennial

Decennial Census.

Data Collection

work:

 

Short-term

Large recruitment efforts begin one or two years prior to the

Outreach

Census

 

population count. Decennial positions tend to pay more than other

Office

 

 

Census positions, but are short-term in nature. Positions most

 

 

 

often last several weeks.

 

 

 

 

 

 

 

The Census Bureau conducts surveys almost every day of the

The Current Survey

The Current Survey

 

year. Because of this, recruiting and hiring for these positions is

program offers the

program offers the

 

ongoing, and many employees have worked for the Census

following types of work:

following duration of

 

Bureau for over 10 years.

Data Collection

work:

Current

 

Long-term

Current Survey positions vary in length but could extend several

Office

Survey

weeks, months, or years, depending on the survey work available.

 

 

 

 

 

 

Applicants who are selected for Current Survey positions will be

 

 

 

notified of the duration of the work assignment during the

 

 

 

interview.

 

 

 

 

 

 

 

Beginning approximately two years after Decennial Census

The Special Census

The Special Census

 

operations (i.e., in 2022 after the 2020 Census is conducted), the

program offers the

program offers the

Special

Census Bureau may conduct Special Censuses in certain towns

following types of work:

following duration of

Census

and cities that contract with the Census Bureau to update their

Data Collection

work:

 

population count.

Short-term

 

Office

 

 

 

 

 

 

TYPES OF WORK

Data Collection: The majority of available positions at the Census Bureau involve data collection. Data collection involves working from home and interacting with the public. These jobs could involve the following tasks: knocking on doors to collect personal information and verifying household address listings. These jobs almost certainly require you to work nights, weekends, and whenever respondents are available. Limited data collection supervisory positions are also available for the Decennial Census and Special Census programs.

Outreach: These positions are only available for the Decennial Census program. These positions involve outreach to Census partners and potential applicants for Census jobs. Outreach work is conducted outside an office environment.

Office: For applicants who live close to one of the limited number of Census Bureau offices, there are a few office positions available. Office duties include a variety of clerical support tasks such as file maintenance, data entry, answering/making phone calls, word processing, shipping and receiving, processing payroll and personnel actions, and other administrative operations. Limited office supervisory positions are also available for the Decennial Census and Special Census programs.

CONFIDENTIALITY REQUIREMENT

If you are hired, the information you collect from the public will be confidential and must NOT be disclosed to anyone who has not been sworn in to protect Census Bureau information.

DURATION OF WORK

Short-term: Most positions are short-term and generally last several weeks.

Long-term: There are a limited number of long-term positions. Long-term positions vary in length, but could extend several weeks, months, or years, depending on the survey work available. Applicants who are selected for long-term positions will be notified of the duration during the interview.

TRAINING

If selected, you may be asked to attend a paid training session. You may be asked to travel for training and will be reimbursed. Certain positions may require you to complete automated self-studies online and/or classroom training that may require travel to another city on government per diem for several days, including overnight travel. Other positions may require on-the-job training, as well as refresher training sessions periodically.

PAY

Social Security deductions will be taken from your earnings. Federal, state, and local income taxes, where applicable, also will be deducted. You will be reimbursed for authorized out of pocket expenses, telephone, and other travel costs, such as parking fees, bus fares, etc., while on official business travel. If hired, you will receive specific information about pay from a Census representative.

FORM BC-170 (08-27-2018)

§28q0¤

17238023

Am I eligible for Census work?

1.You must be a United States citizen.

2.You must be 18 years old or older.

3.You must have a valid Social Security Number.

4.You must have a valid e-mail address. Any questions or issues with your application will be communicated via this email or by text message if provided. All job interviews and job offers will be conducted via the phone numbers you have provided.

5.You must answer assessment questions. For some positions, the assessment questions may be available in Spanish; however, an English Proficiency Test may also be required.

6.Male applicants born after December 31, 1959, must be registered with the Selective Service System.

7.You must pass a Census Bureau performed criminal background check and review of criminal records (including fingerprinting) as part of the hiring process.

8.You may not engage in any partisan political activity while on duty.

9.Your current employment (including law and regulatory enforcement jobs) will be reviewed on a case-by-case basis for compatibility with Census Bureau employment.

10.Since not all people will be home during the day, you must be available to work days, evenings, and/or weekends. Visits will usually be no later than 9:00 p.m. You generally will have flexibility to choose which hours to work during these productive time periods.

How do I complete the BC-170, U.S. Census Employment Application?

1. Print clearly using a black or blue

 

pen. We cannot accept your form

A B C

if it is not legible. Print neatly in

 

uppercase. For example

2.Follow the instructions provided with every item. If you do not answer all questions fully and correctly, you may delay the processing of your application.

3.Enter one letter or number within each white block or complete the information on the line provided.

Below are a few explanatory notes for some of the items:

Section A – Applicant Profile

Item 3. Enter your street address followed by your city, county, state and ZIP code. Enter the State postal abbreviation for the state in which you live, for example, MS for Mississippi.

Item 6. Enter your e-mail address. E-mail is the primary way you will receive information, should you be offered a position.

Item 7. Enter your contact number(s) in the appropriate fields, and Mark (X) if Mobile.

Item 9a. Enter your Date of Birth. For example, enter July 6, 1952 as follows:

Month

 

Day

 

Year

 

0 7

 

0 6

 

1

9 5 2

 

 

 

 

 

 

The Application Process (Next Steps)

The application process includes the following forms:

1.BC-170 – U.S. Census Employment Application

2.BC-171 – Additional Applicant Information

All applicants will be required to answer assessment questions.

What are the assessment questions like?

The assessment questions are designed to indicate your fit for a variety of Census jobs. By submitting one application and answering a basic set of assessment questions, you may be considered for several positions. The assessment is physically accessible to people with disabilities. If you need a reasonable accommodation for any part of the application and hiring process, please find the information listed in the box below.

Privacy Act and Burden Statement

Solicitation of your personal information is authorized by Title 13 U.S.C., Chapter 1, Subchapter II, Section 23a and c; Title 5 U.S.C., Part II, Chapter 13; Title 5 U.S.C., Part III, Chapter 33, Subchapter 1, Section 1 and 20; and Executive Orders 9397, 10566.

The purpose of collecting this information is primarily to determine your qualifications for employment and may also be used to identify you to other sources asked to comment on your qualifications, e.g. educational institutions, former employers, and enforcement agencies, or to a court during legal proceedings. Personal information collected includes your Social Security Number (SSN), name, address, date of birth, telephone number, etc.

Disclosure of the information provided to us may be shared with other Census Bureau staff for the work-related purposes identified in this statement as permitted under the Privacy Act of 1974 (5 U.S.C. Section 552a). Disclosure of this information is also subject to the published routine uses as identified in the Privacy Act System of Record Notice OPM/GOVT-5, Recruiting, Examining, and Placement Records.

Furnishing this information is voluntary, but failure to provide any part or all of the data requested will result in you receiving no further consideration for employment.

Public reporting burden for this collection of information is estimated to average 15 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 this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: Paperwork Reduction Project 0607-0139, Field Division Correspondence Liaison, U.S. Census Bureau, 4600 Silver Hill Road, 5th Floor, Washington, DC 20233-1500. You may E-mail comments to FLD.Decennial.Oversight@census.gov; use "Paperwork Reduction Project 0607-0139" as the subject.

The eight digit OMB number on page 3 of this form confirms our authority to collect this information.

For more information, contact:

FORM BC-170 (08-27-2018)

Page 2§28q8¤

OMB No. 0607-0139

NOTE

THE ACCURACY OF YOUR STATEMENTS WILL BE VERIFIED.

 

 

 

 

 

 

 

17238031

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FORM BC-170

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

U.S. DEPARTMENT OF COMMERCE

(08-27-2018)

 

U.S. CENSUS EMPLOYMENT APPLICATION

Economics and Statistics Administration

 

 

 

 

 

 

 

U.S. CENSUS BUREAU

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section A – APPLICANT PROFILE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.

Social Security Number

 

 

 

 

 

 

 

5. Nearest cross streets to your home address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Cross Street A

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Legal Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Cross Street B

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Last Name

 

 

 

Suffix

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6. E-mail address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

First Name

 

 

 

MI

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7a. Phone information

 

 

 

 

 

 

 

 

 

 

 

Mark (X)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

Home address

 

 

 

 

 

 

 

 

Area code

Number

 

 

 

 

 

 

Mark (X)

 

in only

 

 

 

 

 

 

 

 

 

 

 

 

 

 

one box to

 

Please do NOT enter a PO Box or other non-physical address. Hiring may

 

 

Primary

 

 

 

 

 

 

 

 

 

if Mobile

receive text

 

be partly based on where you live. E-911 addresses, street addresses and

 

 

 

 

 

 

 

 

 

 

 

 

Phone

messages

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RFD numbers are acceptable (include apartment number, if any).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Secondary

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address Continued

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address Continued

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

b. Do we have permission to text you on your mobile

 

 

 

 

 

 

 

 

 

 

 

 

 

phone?*

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

 

 

 

 

 

 

 

 

Yes

*Standard data fees and text messaging rates may apply

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

No

based on your plan with your mobile phone carrier.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8. Sex Mark (X) in one box only.

 

 

 

 

 

 

 

 

 

 

 

 

 

County, Parish, Borough, or Municipio (Puerto Rico)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Female

 

 

 

Male

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9a. Date of birth

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Month

Day

 

 

Year

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4. Mailing address (if different from Item 3)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

b. Place of birth

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address Continued

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State or country

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address Continued

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FOR OFFICE USE ONLY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A. Office/FSA

 

 

 

 

B. FIPS State

 

 

 

 

C. FIPS County

 

City

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

County, Parish, Borough, or Municipio (Puerto Rico)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D. Census Tract

 

 

 

 

E. BCU

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

F. Veteran’s proof verified and attached

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10a. Are you a citizen or national of the United States?

Yes SKIP to Item 11.

No – Provide country of citizenship. C

b.Are you a lawful permanent resident of the United States?

Yes – Specify Alien Registration No./USCIS No. C

No

11.FOR MALES ONLY: If you are a male born after December 31, 1959, and you want to be employed by the Federal Government, you must be registered with the Selective Service System. Mark (X) in one box only.

I certify that I am registered – Please enter your number below. C

Selective Service Number

I certify that I am not registered. Please provide explanation in Section D or attach documentation of exemption.

Note: To find your Selective Service Number, please visit the Selective

Service website: https://www.sss.gov. If you would like to submit a paper copy of your supporting documentation for selective service exemption, please contact the office noted on the cover page of this form.

12.Military Service

a.Do you claim veterans’ preference? Mark (X) in one box only.

No preference – SKIP to Item 13.

Yes

b.Veterans’ preference categories? Mark (X) in one box only.

5-point. Veteran is entitled to 5-point preference. (TP)

10-point/Disability. Veteran is entitled to 10-point preference due to a service-connected disability (includes recipient of the Purple Heart who is not rated as having a compensable disability of 10 percent or more). (XP)

10-point/Compensable. A veteran who served at any time and who has a compensable service-connected disability rating of at least 10 percent but less than 30 percent. (CP)

10-point/Other. Persons entitled to 10-point preference in this category: (1) Both the spouse and mother of a veteran occupationally disabled because of a service-connected disability; and (2) the widow/widower and mother of a deceased wartime veteran. (XP)

10-point/Compensable/30 Percent. Veteran is entitled to

10-point preference due to a compensable service-connected disability of 30 percent or more. (CPS)

Sole Survivorship Preference Eligible. No points awarded. A service member who is released or discharged from the Armed Forces after August 29, 2008, at the request of the member who is the only surviving child in a family in which the father or mother or one or more siblings

(1)served in the Armed Forces; (2) was killed, died as a result of wounds, accident, disease, is in a captured or missing in action status, or is permanently 100 percent disabled or hospitalized on a continuing basis (and is not employed gainfully because of the disability or hospitalization); and (3) death, status, or disability did not result from the intentional misconduct or willful neglect of the parent or sibling and was not incurred during a period of unauthorized absence. (SSP)

Military Service – Continued

Note: For more information and/or to determine if you are eligible for Veteran’s Preference, please visit https://www.fedshirevets.gov/job/vetpref/index.aspx. You must provide acceptable documentation of your preference or appointment eligibility. Acceptable documentation includes:

A copy of your DD-214, "Certificate of Release or Discharge from Active Duty," which shows dates of service and discharge under honorable conditions.

A "certification" that is a written document from the Armed Forces that certifies the service member is expected to be discharged or released from active duty service in the Armed Forces under honorable conditions no later than 120 days after the date the certification was signed.

If you claim 10 point preference or sole survivorship, you must complete a Standard Form 15 (SF-15), which is available online or at any Federal Job Information Center. Submit a complete SF-15 and include the applicable documentation required (listed on page 2 of the SF-15).

A letter from the Department of Veterans Affairs reflecting your level of disability for preference eligibility.

Note: You may submit your application prior to providing the necessary Veterans’ Preference supporting documentation. If you need to submit paper copies of your documentation for Veterans’ Preference, please contact the office noted on the cover page of this form. Please note that you will not receive additional points until we verify your provided documentation.

Section B – GOVERNMENT EMPLOYMENT HISTORY

13.Have you ever worked for the Census Bureau?

Yes – Indicate most recent title and dates of employment. C

Title

Month

Year

Month

Year

TO

No

14.Are you currently employed by a Federal government agency?

Yes – Indicate hire date, agency and title. C

Hire Date

Month Year

AgencyTitle

No

15.Are you currently employed by a state, local or tribal government agency?

Yes – Indicate current title and agency. C

Title

Agency

 

 

 

No

FORM BC-170 (08-27-2018)

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16.Are you currently an elected official of any government agency?

Yes – Indicate current title and agency. C

Title

Agency

 

 

 

No

17.Are you currently employed by a law enforcement agency?

Yes – Indicate current title and agency. C

Title

Agency

 

 

 

No

18.Are you a retiree receiving a Federal annuity? If you are an annuitant, your salary or annuity may be reduced upon employment. Social Security payments are NOT considered a Federal annuity.

Yes – Indicate the agency and explain in Section D. C

No

19.Have you worked for the Federal government or military and received a Voluntary Separation Incentive Payment (VSIP) or "Buyout" within the past 5 years?

The majority of individuals who accept re-employment with the Federal government within 5 years of receiving the VSIP/buyout amount must repay the gross amount of the separation pay prior to reemployment.

I have NOT received a VSIP/Buyout from a prior Federal appointment within the past 5 years.

I have received a VSIP/Buyout from a prior Federal appointment within the past 5 years. I understand that I must repay the full amount before I may be reappointed.

If paid in full, you must provide proof of payment.

Indicate VSIP/buyout Year

Agency

20.Do any of your relatives currently work for the Census Bureau? Include – Parents, spouse, children, grandparents, siblings (include half), aunts, uncles, first cousins, nephews, nieces, in-laws and step relatives.

Yes – If yes, indicate relationship, current title, first/last name and location. C

Relationship

 

Current Title

 

 

 

Section C – LANGUAGE SKILLS AND AVAILABILITY

21.Some Census Bureau jobs require employees to conduct the Census interview by reading and recording responses to questions in a language other than English. The employee must be able to convince individuals who speak no English to respond to the interview by explaining the purpose and importance of the census. Employees will receive Census job-related training, but not language training.

Are you fluent in any language where you can hold a conversation, read and record responses, and respond to questions in that language? If so, indicate the language(s) below and mark (X) to all that apply.

Fluent

Language(s)

Dialect

Speak

Read

Write

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Please include American Sign Language.

If you need to add additional languages continue in Section D.

22.Indicate the type(s) of transportation available for your use – Mark (X) ALL that apply.

Automobile

Check if 4-Wheel Drive

Airplane

Boat

ATV (All terrain vehicle)

Other – Describe C

None

23a. When are you available to work? Census field work will usually require you to work evenings and weekends. Some positions will require shift work. Hiring for some positions is based, in part, on your availability. Mark (X) in All that apply.

Evenings

Weekends

Weekdays

b.Total hours per week you are willing to work, up to and including 40.

First Name

 

Last Name

 

 

 

If you have additional information continue in Section D.

City

 

State

 

 

 

No

If you need to add additional relatives continue in Section D.

FORM BC-170 (08-27-2018)

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Section D – ADDITIONAL INFORMATION (please list item number)

Section E – SIGNATURE, CERTIFICATION, AND RELEASE OF INFORMATION

YOU MUST SIGN THIS APPLICATION IN DARK INK. Read the following carefully before you sign. A false statement on any part of your application may be grounds for not hiring you, or for firing you after you begin work. Also, you may be punished by fine or imprisonment (U.S. Code, Title 18, Section 1001).

I understand that any information I give may be investigated as allowed by law or Presidential order. I consent to the release of information about my ability and fitness for federal employment by employers, schools, law enforcement agencies and other individuals and organizations, to investigators, personnel staffing specialists, and other authorized employees of the Federal Government. I certify that, to the best of my knowledge and belief, all of my statements are true, correct, complete, and made in good faith.

Signature

Date signed

Print name

FORM BC-170 (08-27-2018)

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FORM BC-170 (08-27-2018)

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FORM BC-170 (08-27-2018)

Page 8§28qq¤

How to Edit Bc 170A

Our best web developers worked hard to set-up the PDF editor we are now delighted to present to you. The software allows you to easily create bc 170 and saves valuable time. You only need to adhere to this guide.

Step 1: Select the orange "Get Form Now" button on the web page.

Step 2: Now, you're on the document editing page. You may add text, edit existing information, highlight specific words or phrases, place crosses or checks, insert images, sign the form, erase unrequired fields, etc.

The next sections will compose the PDF document that you will be filling in:

example of empty fields in bc 170 census

Fill in the State, ZIP Code, Branch, Street address or RFD number, Veterans’ preference categories, 5-point preference – Attach your, 10-point preference – Follow, 10-point (disability) pref, 10-point (compensable disability), 10-point (compensable disability), 10-point (other) pref, Kind of discharge, Honorable or general under, Other – Explain in item 34, and Mark (X) one box field using the data requested by the platform.

Finishing bc 170 census step 2

Determine the crucial particulars in the FOR MALES ONLY: Selective Service, I certify that I am registered, I certify that I am not, Day, Evening, Other phone, FOR OFFICE USE ONLY, Raw Scores Basic Skill Test, Mock Interview, Structured Interview, Regional Office, FIPS State, FIPS County, Veteran’s proof, and Verified & Attached segment.

part 3 to completing bc 170 census

The High school diploma/GED, Technical degree/Trade school, Yes – Indicate name of agency, Associate’s degree, Bachelor’s degree, Master’s degree, Doctoral degree, Complete when a Technical/Trade, Degree (if any), Year, received, Name of institution, City, State or country, and Do you receive retirement or have space is the place where both parties can put their rights and obligations.

Filling out bc 170 census stage 4

Fill in the file by looking at the following sections: Morning (8 a, Total hours per week you are, Section D – LANGUAGES, Some census survey jobs require, Language(s), Speak, Read, Write, Section E – TRANSPORTATION, 24a, your use – Mark (X) all that apply, Automobile, 4-Wheel drive, Airplane, and Boat.

part 5 to entering details in bc 170 census

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