Update on Revised Self-Identification Survey Forms for New Hires, Effective November 1, 2014

Monday, October 27 2014

To:     Business Officers, Administrative Assistants and PPS Preparers

Fr:      Cindy Doherty, Director, Academic Personnel

          Cynthia Seneriz, Acting Director, Human Resources

Re:     Update on Revised Self-Identification Survey Forms for New Hires, Effective November 1, 2014


The University of California (UC), as a federal contractor, is required to maintain and analyze data on the race, ethnicity, veteran, and disability status of employees in compliance with the provision of Executive Order 11246 to the Office of Federal Contract Compliance Programs (OFCCP).

Legislative changes issued earlier this year by the OFCCP, which became effective on March 24, 2014, require that federal contractors revise surveys used to collect information regarding veteran status from applicants and employees.

In order to comply with these legislative changes, UC was required to make changes to the “Voluntary Self‐Identification of Race, Ethnicity and Veteran Status form” (Form U5605) in order to include updates to protected veteran categories that we need to collect for compliance.   Additionally, the form was revised to consolidate the collection of race and ethnicity information, and the name of the form was changed from Demographic Data Transmittal form to more accurately reflect the specific information that we are asking new employees to provide us with.  The new form is available on the HR website at  This form will also be available on the UCnet website soon. 

Furthermore, federal contractors and subcontractors MUST use a form developed by the OFCCP to survey for disability ‐ “Voluntary Self‐identification of Disability Form” (Form CC 305‐OMB Control Number 1250‐0005).  The agency mandates the use of this form to survey disability status at both the pre- and post‐offer stages.  The new form is available on the HR website at

Each location must incorporate the use of these forms in their on-boarding process for academic and staff employees hired on or after November 1, 2014. 

Changes to the Payroll Personnel System (PPS), Employee Data Base (EDB), Web New Hire Application, Corporate Personnel Systems, and Corporate Data Warehouse were implemented to accommodate the data entry of new codes.  Payroll patches to execute the appropriate systems modifications have already been distributed to each location for implementation.

Mail List: