8 % Salary Reduction Reimbursement: Employee Information

1
Welcome GVI employees. This form is to collect Employee Information relevant to the reimbursement of the 8% reduction in pay that is owed to government employees who worked in the central government and/or the Virgin Islands Legislature between June 1, 2011 to September 30, 2013.
2
Employee Name* This field is required.
First Name
Middle Name
Last Name
3
Last 4 digits of Employee Social Security Number* This field is required.
4
Employee ID Number* This field is required.
5
Employee Phone Number* This field is required.
Area Code
Phone Number
6
Email* This field is required.
example@example.com
Confirm Email
7
What is the official name of the agency that you worked for from June 1st, 2011 to September 30th, 2013* This field is required.Agency must be a part of the Central Government or the Virgin Islands Legislature
8
If possible, please upload any documentation showing proof of your 8% reduction in salary.The can Include a NOPA, check stub or any agency records that you may have.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
9
Please upload your government Issued ID* This field is required.Passport, Drivers License or Voters Registration card
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
Should be Empty: