Omb control number 1250 0005-2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by reading the introduction carefully. It explains why you are being asked to complete this form and reassures you about the confidentiality of your responses.
  3. In the section titled 'Do I have a disability?', review the list of conditions provided. This will help you determine if you should check 'YES' or 'NO'.
  4. Select one of the options: 'YES, I HAVE A DISABILITY', 'NO, I DON’T HAVE A DISABILITY', or 'I DON’T WISH TO ANSWER' by clicking on the appropriate checkbox.
  5. Enter your name and today's date in the designated fields at the bottom of the form.
  6. If applicable, indicate if you require reasonable accommodation by providing details in the space provided.

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