Michael - 20160607 - 0001
Michael - 20160607 - 0001
(Please read the Privacy Act statement and instructions before completing form.)
,ll,l L,
Only
Agency Use^r
[Y\:.1^^*
P\
02" o5-
lcl"7 L,
This information is used as necessary to plan for equal employment opportunity throughout the Federal government. lt
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 prrporb 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. lf SSN is not provided, however, other agency sources may be
used to obtain
it.
.rt"r"ti""t fne 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
Sp""iti"
fJ ves
No
o*.ategorieswithwhichyoumoStc|ose|yidentifybyplacingan..X,,intheappropriate
box. Check as many as apPly.
RACIAL CATEGORY
(Check as many as apply)
DEFINITION OF CATEGORY
A person having origins in any of the original peoples of North and South America
(including Cential America), and who maintains tribal affiliation or community
attachment.
Eas-t, Southeast
Asia, or the lndian iubcontinent including, for example, Cambodia, China, lndia,
Japan, Korea, Malaysia, Pakistan. the Philippine lslands, Thailand, and Vietnam'
fJ
A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or
wnite
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
a*
'ji;L/
-099-3446
E1/19/281E L0:35
TII''IE
HAI''IE
I Hr1
TEL
SEE. #
uI,/t!
1u:.i?
ftrr,a'-r-rE-,ft-'-'
DUEATIEI'I
Eti: E?:
DATE, TIF{E
'1
l- iLliJ
PAGE(5}
tlr
-rJ:OLf
r_
f'
-lE
RESULT
trl.i
lvloDE
STiXt'lDARIr
r#
FEDEH I]FF]CE
31 477882E1
31_ 477E?23A
uEs314K3J529r_
Office
{r,
Number of
pages
To:
From:
Name
Name
Iompany
HI r t [:,tr{o*.tirrr_h [Ftaef
Telephone 3 l-l-t #l:f4{0
company
Telephone
Fax ?q-,:JqS^J.fiPf
Comments
fedex.corn
I Boo.GoFedEx r B00.4ES.3mg
El0lSFBCEx.Allrilht8teE.n,Bj.p,cd!61r,!eDii9B6n(h!uBv0,ytllrglcnE:i0Fiilma
,llllJl[rrlruilU{il1il=
Frx. lntsrnatisnal
Ssnd
"=^F""-".,;}r,;7
rr
110'Irrcs.xx._u**
l\t\
H. RES. l94
IN TIIIi IIOI-Si]
OF' IIEI'HI]SIiNT.\'I'IYES
RESOLUTION
Apologizing fbl' the ettslar'('lilt'Ilt itud rilciill scgrty,^ation of
,\frit'irr t-.\ t t ti't'it'tt t s,
t
\\-ere
colo-
\\'hereas slrn'er'.r' in r\ntericir l'eselnblecl tto otl)el' fiit'tti of irn-oluutai.\- sela-itu(lc l<noxri iii histor1,, irs Aft'iealls \Ytrre Cal)-
\\'hereas Afrittatrs forcted ittto slttvel'l- \\'ere bmttrlizecl, lrurniliatecl, clehuilanizecl, ancl subjectecl to the inclignitv of
bc'ing stripl.recl of thcit' names aud heritage;
\\-hereets ertsltrr,ecl flzrtnilies \\rere
beeri
\Vhereas after emattcilttttioli trorn 246 1-ears tlf slaver"v, African-Americans soorl szt\\. the fleeting' political, social, and
econotuic gains thef inttcle ch'Lring Reconstruction cl'isgerertecl ltt- I'irr--Llerrt racisnr. l1'nchings, clisertfrettltrltisetleitt,
\Ylrei'r,as
ettgettclerecl bv sltrr,e$-;
clal';
\\hereas Africait-Artericans coutimLe to sufft-'r' from the conseqllelt(ies 6f slzs'er1' attd Jirn (ly9rv-l6rrg aftep bgtlr sys.HRES 194 IH
'!
;j
ialh' alrol isl r ed-f l iy1y1loli L.r ronnr iris cla nra ge
and loss, botlr tangible ancl intangible. irrclurlirrg the loss
of' lurnrtrn clignitv ancl libt,rt.r,, the fnrstt'atioir of cilr'(,el's
trntl ltrof'essiorial liles, arrcl tlre Lrrrq'-telni lr;ss of iirconie
and ollltortuuitr-:
\\-1rct'eas the
tlill to Lioree Islantl, St,rregal, a fbmrer slavc port, Pi'ttsirleirt Gcoi'ge \\', I']trsh ac-
\\'hcrr:as l'r't,sirlent Iiiil (lliiiton also ;rclnrorr'lt,tlgctl the tJcril)seittrtl ploblerrLs tarist'('[ l,lr- tire t.orrtirnrirrg' lt'gac1- of ltrt:isin agairist -\flit.an-,\nrerir.irrrs tlrat heg'arr s-itlr sialen'
n'ltcit hc irritiatccl a national rlitrlogrre alroul ract:
\\-hercas tr genuirie apologr is trn iurl;ortant turcl tiecessrll'\'
first stelt irr tlre 1)r'o(.ess of raciai ret.orrr.iliittiorr;
\Yht'reas art apologt for ccntui'ics of ltnrtal rlcinrmanizatiorr
aricl irljr-Lstices cannot el'itsc the past, but corrlession of
tlte rt'rottgri (:olnrnittetl citn speecl rarriarl lrealitig rur(l re(i-
it is irnlrortalt f'oi' this (,ourrtn'. u'hir,h legally l.(.(1og.rtizeti sltlYt't't' titrotrslt its ('oirstitutiurr airrl its lilu-s, tri
Inill<e it fot'ttrti] apologr' lirr sltn'trv atrrtl firl its su(.(.essol..
,Iir, C.on', lio that it cAlI r)l()\'e f<rrr'anl a*d scrcli r,.conciliation, justice, urirl hai.rrrorn- for. irll of its citizens:
\\'lrercas
1
2
3
4
5
6
7
8
9
10
11
12
13
it
(1)
llousc of'lteltr.t,serrtatir.
aclitto,,'lt'dg-t:s
the
hrrrrlutnenttrl injristics.
Jim Cr.ou';
(2)
1.1o
.HR-ES 194
III
o(.(,ur.r,L.rI(.e
of lrtrnrurr
r.ig.lrts