Voluntary Self-Identification of Disability
Form CC-305
OMB Control Number 1250-0005
Page 1 of 1
Expires 05/31/2023
Why are you being asked to complete this form?
We are a federal contractor or subcontractor required by law to provide equal employment opportunity to qualified people
with disabilities. We are also required to measure our progress toward having at least 7% of our workforce be individuals
with disabilities. To do this, we must ask applicants and employees if they have a disability or have ever had a disability.
Because a person may become disabled at any time, we ask all of our employees to update their information at least
every five years.
Identifying yourself as an individual with a disability is voluntary, and we hope that you will choose to do so. Your answer
will be maintained confidentially and not be seen by selecting officials or anyone else involved in making personnel
decisions. Completing the form will not negatively impact you in any way, regardless of whether you have self-identified in
the past. For more information about this form or the equal employment obligations of federal contractors under Section
503 of the Rehabilitation Act, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs
(OFCCP) website at www.dol.gov/ofccp.
How do you know if you have a disability?
You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially
limits a major life activity, or if you have a history or record of such an impairment or medical condition. Disabilities
include, but are not limited to:
• Autism
• Deaf or hard of hearing
• Missing limbs or partially missing
• Autoimmune disorder, for example,
• Depression or anxiety
limbs
lupus, fibromyalgia, rheumatoid
• Diabetes
• Nervous system condition for
arthritis, or HIV/AIDS
example, migraine headaches,
• Epilepsy
• Blind or low vision
Parkinson’s disease, or Multiple
• Gastrointestinal disorders, for
sclerosis (MS)
• Cancer
example, Crohn's Disease, or
• Psychiatric condition, for example,
• Cardiovascular or heart disease
irritable bowel syndrome
bipolar disorder, schizophrenia,
• Celiac disease
• Intellectual disability
PTSD, or major depression
• Cerebral palsy