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    I/II I9"11s O6 ( I"ed: Ethnicity and Race Identification

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    Amun Sobek Ra Eil
    SF-181 Race and Ethnicity Identification Form. "White" and "American Indian". Attachment Documents HJR194/Motu Proprio/ Pope Apology to Indigenous Peoples.

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    © All Rights Reserved
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    I/II I9"11s O6 ( I"ed: Ethnicity and Race Identification

    Uploaded by

    Amun Sobek Ra Eil
    417 views8 pages
    SF-181 Race and Ethnicity Identification Form. "White" and "American Indian". Attachment Documents HJR194/Motu Proprio/ Pope Apology to Indigenous Peoples.

    Original Title

    AmunSF181

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    SF-181 Race and Ethnicity Identification Form. "White" and "American Indian". Attachment Documents HJR194/Motu Proprio/ Pope Apology to Indigenous Peoples.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    417 views8 pages

    I/II I9"11s O6 ( I"ed: Ethnicity and Race Identification

    Uploaded by

    Amun Sobek Ra Eil
    SF-181 Race and Ethnicity Identification Form. "White" and "American Indian". Attachment Documents HJR194/Motu Proprio/ Pope Apology to Indigenous Peoples.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    U.S.

    Office of Personnel Management


    Guide to Personnel Data Standards
    Name (Last, First, Middle Initial)

    JENKINS WINSTON

    ETHNICITY AND RACE IDENTIFICATION

    (Please read the Privacy Act Statement and instructions before completing form.)

    UC l, / - JO

    1 Social Security Number

    I/II i9"11S o6(;i"ed

    Birthdate (Month and Year)

    07/1950

    Agency Use Only

    Privacy Act Stat!ment


    Ethnicity and race information is requested under the authority of 42 U.S.C. Section 2000e-16 and in compliance with
    the Office of Management and Budget's 1997 Revisions to the Standards for the Classification of Federal Data on Race
    and Ethnicity. Providing this information is voluntary and has no impact on your employment status, but in the instance
    of missing information, your employing agency will attempt to identify your race and ethnicity by visual observation.
    This information is used as necessary to plan for equal employment opportunity throughout the Federal government. It
    is also used by the U. S. Office of Personnel Management or employing agency maintaining the records to locate
    individuals for personnel research or survey response and in the production of summary descriptive statistics and
    analytical studies in support of the function for which the records are collected and maintained, or for related workforce
    studies.
    Social Security Number {SSN) is requested under the authority of Executive Order 9397, which requires SSN be used
    for the purpose of uniform, orderly administration of personnel records. Providing this information is voluntary and failure
    to do so will have no effect on your employment status. If SSN is not provided, however, other agency sources may be
    used to obtain it.
    Specific Instructions: The two questions below are designed to identify your ethnicity and race. Regardless of your answer to
    question 1, go to question 2.
    Question 1. Are You Hispanic or Latino? (A person of Cuban, Mexican, Puerto Rican, South or Central American, or other
    Spanish culture or origin, regardless of race.)
    0Yes No
    Question 2. Please select the racial category or categories with which you most closely identify by placing an "X" in the appropriate
    box. Check as many as apply.
    RACIAL CATEGORY
    (Check as many as apply)

    DEFINITION OF CATEGORY

    American Indian or Alaska Native

    A person having origins in any of the original peoples of North and South America
    (including Central America), and who maintains tribal affiliation or community
    attachment.

    0 Asian

    A person having origins in any of the original peoples of the Far East, Southeast
    Asia, or the Indian subcontinent including, for example, Cambodia, China, India,
    Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

    0 Black or African American

    A person having origins in any of the black racial groups of Africa.

    0 Native Hawaiian or Other Pacific Islander

    A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or
    other Pacific Islands.

    White

    A person having origins in any of the original peoples of Europe, the Middle East, or
    North Africa.
    Standard Form 181
    Revised August 2005
    Previous editions not usable
    42 U.S.C. Section 2000e-16
    NSN 7540-01-099-3446

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