Njdmava Form 05A 1 – Fill Out and Use This PDF

The NJDMAVA Form 05A-1 serves as a crucial Civil Service Veterans Preference Claim Form provided by the New Jersey Department of Military and Veterans Affairs. It is designed for veterans, disabled veterans, their spouses, surviving spouses, and parents, offering them a pathway to claim preference in civil service positions within the state. By detailing personal information, service details, and disability status, the form plays a pivotal role in facilitating veterans' transition into civilian employment. To assert your veteran's preference and contribute towards securing a position that acknowledges your service and sacrifices, consider filling out the NJDMAVA Form 05A-1 by clicking the button below.

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Njdmava Form 05A 1 PDF Details

In the landscape of veterans' rights and benefits, the Njdmava 05A 1 form stands as a vital document, outlining the process through which veterans and their families can claim their deserved Civil Service preferences in New Jersey. Created by the New Jersey Department of Military and Veterans Affairs, this comprehensive form serves multiple purposes, guiding veterans, disabled veterans, their spouses, and even Gold Star parents through the application for Civil Service veteran's preference/status. Applicants are required to provide detailed personal information, relevant service details including periods of active duty, and, crucially, documentation like the DD214 form or equivalent proof of service and discharge status. Moreover, it addresses specific scenarios catering to disabled veterans, offering provisions for spouses and surviving spouses to claim entitlements, underscored by the necessity of submitting current proof of the veteran's disability. It also encompasses eligibility criteria based on active service durations across various conflicts and operations, extending preference to those who served in specific peacekeeping missions. This form encapsulates the intersection of military service recognition and state employment policy, mandating accuracy and truthfulness in its completion to connect veterans and their families with deserved benefits, thereby reflecting the broader commitment to honor military service and sacrifice.

Question	Answer
Form Name	Njdmava Form 05A 1
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	nj civil service employment form, Bosnia, dvs, 1994

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NEW JERSEY DEPARTMENT OF MILITARY & VETERANS AFFAIRS

CIVIL SERVICE VETERANS PREFERENCE CLAIM FORM

INSTRUCTIONS

Please print or type all answers Complete the first section and any other section(s) that apply to you Sign your name at the bottom Please mail this form and a copy of your Veterans Separation Papers (Form DD214) to NJ Dept of Military & Veterans Affairs, ATTN: DVS-VBB, P.O. Box 340, Trenton, NJ 08625- 0340 If you do not have Form DD 214, a copy can be obtained from the National Personnel Records Center. If your records have been destroyed, a letter from the National Personnel Records Center attesting to the destruction of your records and a notarized statement indicating the dates of active service, branch, rank, and type of discharge must be submitted.

1.	Your Name (Last, first, middle initial – Please Print)			2. Your Social Security Number	4.	Veteran’s Name (If you are not the veteran)

3.	Your address				5.	Veteran’s Social Security Number
					(If you are not the veteran)
Street		. . . . . . . . . . . . . . . . . . .	. . . . . .	. . . . . . . . . . . . . . . .
					6.	Date Starting Active	7. Date Ending Active
City		. . . . . . . State	. . Zip Code			Duty	Duty
City		. . . . . . . State	. . Zip Code
8.	Has veteran received a dishonorable discharge?		9. Branch of Service		10.	Rank at Discharge
	YES	NO

DISABLED VETERAN CLAIMANTS – If the veteran is eligible for or receiving 10% or more disability compensation or pension for a service connected disability incurred during one of the covered periods of service CURRENT PROOF OF DISABILITY IS REQUIRED.

11.	Give percent disability receiving			12.	Present location veteran’s disability records (V.A. Office)
	or entitled to receive	%
13.	Nature of Disability		⇒	14.	Claim Number

SPOUSE OF A DISABLED VETERAN - The spouse of veteran who is eligible for or receiving 10% or more disability compensation or pension for a service connected disability incurred during one of the covered periods is entitled to the same preference as the veteran provided the veteran is not in the employment of the State, or of any County, Municipality, or School District covered by the Department of Personnel and further provided that the veteran waives all preference as long as the spouse is employed by any of the aforementioned jurisdictions.

15.Are you presently married to the				16.Will the veteran waive the right to use of the D.V. Status in your favor?
Veteran named in Item 4 above?	YES	NO		YES	NO (If Yes, veteran must sign here)
17.Is the veteran now employed by the				⇒ Veteran’s Signature
State or any other Jurisdiction covered	YES	NO		⇒ Veteran’s Signature		. . . . . . . . . . . .	. . . . . . . . . . . . .
by the Department of Personnel

SURVIVING SPOUSE OF A DISABLED VETERAN (OR) SURVIVING SPOUSE OF A VETERAN WHO DIED IN SERVICE –
Until s/he remarries is entitled to the same preference as a disabled veteran. Copy of Death Certificate or Report of Casualty required.
18. Date of Death			19. Has a parent of the veteran named in Item 4 above used the parent's preference with the
18. Date of Death			New Jersey Department of Personnel?			YES	NO
			New Jersey Department of Personnel?			YES	NO

20. Were you married to the veteran named in			21. Have you remarried since the death
Item 4 above at the time of the veteran's death?	YES	NO	of this veteran?			YES	NO

SURVIVING SPOUSE OF A VETERAN WHO DID NOT DIE IN THE SERVICE – is entitled, until the surviving remarries, to the same preference to which the veteran, if living, would be entitled. Copy of Death Certificate required.

22.	Were you married to the veteran named in Item 4			23. Date of Death
	above at the time of the veteran's death?	YES	NO	23. Date of Death
	above at the time of the veteran's death?	YES	NO
24.	Have you remarried since the death of this veteran?	YES		NO

GOLD STAR PARENT - The parent of a veteran who died while in service is entitled to Disabled Veteran's Preference. If both a parent and spouse survive, the use of such preference by either shall suspend the right of the other. Report of Casualty required.

25.	Date of Death			27. Name and Address of surviving spouse	28. Has surviving spouse ever used the spouse's
26.	Was deceased veteran married?					Veterans Preference in securing public
		YES	NO			Employment in New Jersey?
							YES	NO
(If Yes, complete items 27 and 28)							YES	NO

CERTIFICATION: I certify that the statements made by me to the foregoing questions are true to the best of my knowledge and belief. If any of the statements in this application are false, I am aware that I am subject to criminal proceedings.

YOUR SIGNATURE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DATE . . . . . . . . . . . . . . . ... TELEPHONE . . . . . . . . . . . . . . . . . . . . . . . . . .

NJDMAVA Form 05A-1, 14 Aug 12

CIVIL SERVICE VETERAN’S PREFERENCE CLAIM FORM

To be eligible for veteran’s preference/status under New Jersey Law, one must have served on active duty during one of the following periods. Proper documentation is required (WD Form 53-55, DD Form 214, Honorable Discharge Certificate, and VA Disability Award Letter).

1.World War II: 90 days active duty on or after September 16, 1940 and must have begun on or before December 31, 1946.

2.Korean Conflict: 90 days active duty on or after June 23, 1950 and must have begun on or before January 31, 1955.

3.Vietnam Conflict: 90 days active duty on or after December 31, 1960 and must have begun on or before May 7, 1975.

To be eligible for veteran’s preference/status under New Jersey Law for the following peacekeeping missions, one must have served in Lebanon, Grenada, Panama, the Persian Gulf, Bosnia, Herzegovina, Haiti, Operation Enduring Freedom, or Operation Iraqi Freedom, or on board any ship actively engaged in patrolling the territorial waters of that nation for a period of at least 14 days beginning on or before the date of termination of that mission or operation. Proper documentation is required (DD Form 214, Honorable Discharge Certificate, and VA Disability Award Letter).

4.Lebanon Crisis: 14 days on or after July 1, 1958, commencing on or before November 1, 1958.

5.Lebanon: 14 days on or after September 26, 1982 and must have begun on or before December 1, 1987.

6.Grenada: 14 days on or after October 23, 1983 and must have begun on or before November 21, 1983.

7.Panama: 14 days on or after December 20, 1989 and must have begun on or before January 31, 1990.

8.Operation Desert Shield/Desert Storm: 14 days on or after August 2, 1990 to February 28, 1991.

9.Somalia: 14 days on or after December 5, 1992 and must have begun on or before March 31, 1994.

10.Bosnia and Herzegovina (Operation Joint Endeavor/Operation Joint Guard): 14 days on or after November 20, 1995 and on or before June 20, 1998.

11.Haiti (Operation Uphold Democracy): 14 days on or after September 19, 1994 and on or before March 31, 1995.

12.Operation Enduring Freedom: 14 days on or after September 11, 2001.

13.Operation Iraqi Freedom: 14 days on or after March 19, 2003.

14.Operations Southern and Northern Watch: 14 days on or after August 27, 1992

To be eligible for disabled veteran’s preference, one must be a “veteran” as described above and must have incurred a disability for which the veteran is receiving 10% or greater disability compensation from the US Department of Veterans Affairs. Spouses of disabled veterans, surviving spouses of disabled veterans or veterans and parents of veterans who died in service are eligible for preference, if the veteran would have been eligible for veteran’s preference. Proper documentation is required (DD Form 214, Honorable Discharge Certificate, and VA Disability Award Letter).

NOTE: Individuals whose only active service was for training (basic training, advanced training, officer candidate school, weekend drills, and annual training) in connection with a Reserve or National Guard obligation are not eligible for Veteran’s Preference/Status.

NOTE: Merchant Marine Personnel who served in World War II, and who present a DD-214 which establishes 90 days of active service during the period noted above, are entitled to Veteran’s Preference.

NJDMAVA Form 05A-1, 14 Aug 12

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05A-1 writing process explained (stage 1)

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05A-1 conclusion process outlined (portion 2)

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Njdmava Form 05A 1 – Fill Out and Use This PDF

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