Va Form 4676A PDF Details

As a veteran, it is your responsibility to ensure that you have fulfilled all the requirements for filing a VA Form 4676A. Filing this form with the Department of Veterans Affairs (VA) can help you access financial benefits or physical health resources available to veterans and their families. Understanding how to fill out the form correctly is critical in order to receive such assistance quickly and accurately. In this blog post, we'll discuss what information needs to be included on your VA Form 4676A and best practices when filling it out. By understanding the importance of completing these forms properly, it will help make sure that no stone is left unturned as you build an application package towards receiving veteran related benefits or medical care!

QuestionAnswer
Form NameVa Form 4676A
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesqualifications document sure sample, form qualifications blank, va qualifications statement, form employee supplemental

Form Preview Example

EMPLOYEE SUPPLEMENTAL QUALIFICATIONS STATEMENT

PRIVACY ACT NOTICE

The information requested is voluntary and is solicited under authority of 5 U.S.C. 3302 as promulgated by E.O. 10577, Rule VII, Section 7.1. This form will be the primary source document used to evaluate your qualifications and to rate and rank you for a specific position. I f you decline to provide the information requested, it may not be possible to evaluate your qualifications fully.

NAME (First, middle, last)

PRESENT POSITION (Title, grade, division/service)

POSITION APPLIED FOR (Title and grade)

ANNOUNCEMENT NO.

NOTE TO CANDIDATE

This form will be used as the primary source document for determining basic qualifications and for rating and ranking purposes. The information you gave on this form will be a main source for evaluating your qualifications and for determining how many points you receive in the rating and ranking process. Be sure to give complete and accurate information. If you don't furnish the information or your information is incomplete or inaccurate, it may not be possible to determine your qualifications or to give you full credit under the rating procedures. Additional guidance in completing this form is available from the Personnel Office, upon request.

INSTRUCTIONS

CANDIDATE - The rating factors or job elements listed below are those which will be used for this job. You should, therefore, describe in detail your experience, education, training, awards and other activities that demonstrate your possession of the rating factor(s) (KSAO's) or job element(s). Also, indicate with each response; (1) the document (SF 171, award, performance requirement, etc.); (2) the location of the document (official Personnel Folder (OPF), etc.); and (3) the past activity or employment (e.g., ABC Company, Washington, DC; from November 1975 to March 1978) which will support your response.

PERSONNEL - This form may be used for VA jobs by listing the specific rating factor(s) consisting of knowledge, skills, abilities, or other characteristics (KSAO's) or job elements, in the space below. The method of response desired for each rating factor (narrative, specific questions, check lists, fill in the blanks, etc.) should be clearly indicated.

RATING FACTORS AND APPLICANT'S RESPONSE (If additional space is needed, then use blank page attached)

VA FORM

4676A

SEP 1992 (R)

 

RATING FACTORS AND APPLICANT'S RESPONSE (Continued)

After completing this form, read it over carefully to make sure you have answered all questions and/or completed all items, your name is on all pages, and you have signed your name below. Since this form will be used as the primary source document in evaluating your qualifications, be sure that you have completed it as thoroughly and accurately as possible.

CERTIFICATION

I CERTIFY that all statements and information furnished in this Statement are true, complete and correct to the best of my knowledge and belief, and are made in good faith. I understand that statements or information furnished on this form are subject to verification and I agree to furnish supporting documents or information when so requested and/or names, addresses and

phone numbers (if known) of officials or other individuals who can substantiate the qualifications described above. I also understand that intentional mistatements or falsification may result in disciplinary action.

SIGNATURE OF APPLICANT

DATE

VA FORM 4676A, SEPTEMBER 1992, PAGE 2

RATING FACTORS AND APPLICANT'S RESPONSE (Continued)

After completing this form, read it over carefully to make sure you have answered all questions and/or completed all items, your name is on all pages, and you have signed your name below. Since this form will be used as the primary source document in evaluating your qualifications, be sure that you have completed it as thoroughly and accurately as possible.

CERTIFICATION

I CERTIFY that all statements and information furnished in this Statement are true, complete and correct to the best of my knowledge and belief, and are made in good faith. I understand that statements or information furnished on this form are subject to verification and I agree to furnish supporting documents or information when so requested and/or names, addresses and

phone numbers (if known) of officials or other individuals who can substantiate the qualifications described above. I also understand that intentional mistatements or falsification may result in disciplinary action.

SIGNATURE OF APPLICANT

DATE

VA FORM 4676A, SEPTEMBER 1992, PAGE 3

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This form will need specific information to be filled out, therefore you must take your time to enter what is expected:

1. Firstly, when filling in the va form qualifications, start with the form section that includes the subsequent blanks:

Tips to prepare form qualifications factors sample part 1

2. Once your current task is complete, take the next step – fill out all of these fields - RATING FACTORS AND APPLICANTS with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

How one can complete form qualifications factors sample step 2

3. Through this step, look at SIGNATURE OF APPLICANT, DATE, and VA FORM a SEPTEMBER PAGE. All these need to be taken care of with utmost awareness of detail.

Filling out section 3 of form qualifications factors sample

4. To go forward, the next part requires filling in a couple of form blanks. These comprise of RATING FACTORS AND APPLICANTS, which are essential to going forward with this particular form.

Tips to fill in form qualifications factors sample portion 4

5. The pdf needs to be concluded with this particular area. Further you'll find a comprehensive listing of blanks that require appropriate information to allow your document submission to be faultless: SIGNATURE OF APPLICANT, DATE, and VA FORM a SEPTEMBER PAGE.

form qualifications factors sample completion process detailed (portion 5)

In terms of VA FORM a SEPTEMBER PAGE and SIGNATURE OF APPLICANT, ensure that you take another look here. These two are the most significant ones in the page.

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