Interactive Form - USERRA Notification to Employer

A computer generated image of a series of papers layered on top of each other. The top paper is a check list with red check-marks on it.

As a member of the Armed Forces, Reserves, National Guard or other uniformed services, you have some job protections when you are called into military service.

This law is called the Uniformed Services Employment and Reemployment Rights Act (USERRA).  It seeks to protect your civilian job and benefits when your unit is activated. It also says that you should not suffer job discrimination because you were called away to service.

This is an easy-to-use interactive form. The program will create a letter and instructions. You can use this to notify your employer that you will be absent from work due to active duty service.

All you need to do is:

  1. Answer a few simple questions. 
  2. Print out your form. 
  3. Proofread and sign it.
  4. Attach copy of Activation Orders. 
  5. Make copies for your own records. 
  6. Send the original, with attachments, to your employer.

Do I qualify for this benefit?

  • This benefit applies to almost everyone in the uniformed services. 
  • It applies to all employers in the public and private sectors, including federal employers.
  • It applies to military service, whether the service is voluntary or involuntary. 
  • It does not apply to state activation of a National Guard member. But many states have similar laws that will apply.


  • Interactive Form Packet is currently unavailable.
  • Sample Form is attached.


IMPORTANT NOTICE: You must have Microsoft Word or Word Viewer installed on your computer to use the interactive form packet. You can download Word Viewer for free here.

You must have Adobe Reader to view the sample form packet. You can download Adobe Reader for free here.


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 Resource Date: November 2015

Attachment Size
STATIC FORM PACKET - USERRA - Activation Letter.pdf366.93 KB 366.93 KB