What is your present job and pay grade/step (if known)?

What was your and pay grade/step (if known)?

What job and pay grade (if known) did you apply to?

How many days do you presently telework?

In 1–3 sentences, what is the discriminatory/retaliatory event (or pattern) and when did it occur? Have you contacted an EEO counselor? If yes, provide the date of first contact and the EEO office/location (if known). f no/not sure, tell us what steps you’ve taken (if any). What is the main issue type? (Example: non-selection; harassment/hostile environment; proposed discipline/decision; reassignment; performance; other.) Tell us what protected basis(es) you believe caused the discrimination/harassment/retaliation (all that apply). Examples: race, color, sex (incl pregnancy and sexual orientation), national origin, religion, age (40+), disability, genetic information, reprisal/prior EEO activity or particiation.

What type of action was proposed/decided? Removal, demotion, or suspension? What action stage are you dealing with (proposed or decided), and what is the effective date (if any)? When did you receive the proposal/decision letter (if different), and what deadline (if any) is stated? Is a union grievance involved for the same matter? If yes, tell us the filing date and current status.

What wrongdoing did you disclose, to whom, and when? What retaliation happened (and when)? (Example: discipline/threat; non-selection; reassignment; investigation/hostile treatment; other.) Have you already filed with OSC? If yes, provide the date filed and current status.

What accommodation did you request, and what job functions are affected? When did you request it, and what has the agency done since then? (Approved/denied/delayed/interactive process; include dates if known.) Do you have medical documentation supporting the limitation/need? If yes, briefly describe what it says and who provided it.