EEO-4 Voluntary Self Identification Form
Phone: 805-736-3423 Fax: 805-735-7672
815 West Ocean Avenue, Lompoc, CA 93436
The Equal Employment Opportunity Commission (EEOC) requires all private employers with 100 or more employees as well as federal contractors and first-tier subcontractors with 50 or more employees AND contracts of at least $50,000 complete an EEO-4 report each year. Covered employers must invite employees to self-identify gender and race for this report.
Completion of this form is voluntary and will not affect your opportunity for employment, or the terms or conditions of your employment. This form will be used for EEO-4 reporting purposes only and will be kept separate from all other personnel records only accessed by the Human Resources department. Please return completed forms to the HR department.
If you choose not to self-identify your race/ethnicity at this time, the federal government requires the Housing Authority of the County of Santa Barbara to determine this information by visual survey and/or other available information.
Fields marked with * are required to submit the form.