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Are you legally authorized to work for any employer in the United States? *
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Yes
No
If you answered yes to the above, will you now or in the future require sponsorship for an employment-authorized visa status? *
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Yes
No
Are you aware of any convictions or charges that may surface during the background check? *
Any affirmative responses should be discussed with Human Resources to understand the specific facts and circumstances. As an employee/contractor of a FINRA registered broker-dealer you will be subject to fingerprinting and a lifetime FBI criminal background check.
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Are you currently or have you been in the past three years, a Government Official* or employed by a financial regulator? *
*Government Official includes any officer, employee or person acting in an official capacity for or on behalf of the following, or any instrumentality thereof: Government agencies, ministries, instrumentalities, and administrative, judicial or legislative bodies; Public or supranational international organizations, such as the United Nations or the European Investment Bank; Entities, including businesses, that are partially (at least 50%) or wholly-owned or controlled by a government or governmental agency (SOEs); A body which exercises regulatory oversight or investigative or disciplinary authority over Natixis or Solomon Partners; Political parties, including candidates of the party and political campaigns; or Ruling families and monarchies in foreign jurisdictions.
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Yes
No
If yes, please give the details:
On the basis of employment as a Government Official* or employee of a financial regulator, are you subject to any post-employment restrictions (including but not limited to, cooling off period, non-disclosure of confidential information, recusal requirements, etc.)? *
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Yes
No
If yes, please give the details:
Are you an immediate family member or close associate (a current or former business partner, colleague, co-owner, close consultant, or advisor) of any Government Official* who has the ability to directly or indirectly influence the aware of business to Natixis and/or exercise decision making authority that impacts the firm? *
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Yes
No
If yes, please give the details:
Are you currently subject to a confidentiality agreement or any other restrictions that would potentially prevent or limit you from performing your duties or require recusal in certain situations? *
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Yes
No
If yes, please give the details:
Confirm you understand that falsifying information or making a material omission on an employment application is grounds for an offer of employment to be rescinded or immediate termination of employment after employment has begun. *
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Yes
No
Solomon Partners requires all of its employees to be fully vaccinated from Covid-19, subject to customary religious or medical exemptions. You will be required to provide proof of vaccination through our HR electronic portal on your start date.
Please confirm that you understand this policy and are fully vaccinated from Covid-19. *
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Yes
No
If you are not vaccinated, please elaborate in the following box:
Voluntary Self-Identification For government reporting purposes, we ask candidates to respond to the below self-identification survey.
Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiring
process or thereafter. Any information that you do provide will be recorded and maintained in a
confidential file.
As set forth in Solomon Partners - Experienced Professionals’s Equal Employment Opportunity policy,
we do not discriminate on the basis of any protected group status under any applicable law.
Gender
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Are you Hispanic/Latino?
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Please identify your race
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Race & Ethnicity Definitions
If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection.
As a government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measure
the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categories
is as follows:
A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.
A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.
An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.
An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.
Veteran Status
Please select I am not a protected veteran
I identify as one or more of the classifications of a protected veteran
I don't wish to answer
Voluntary Self-Identification of Disability
OMB Control Number 1250-0005
Expires 04/30/2026
Why are you being asked to complete this form?
We are a federal contractor or subcontractor. The law requires us to provide equal employment opportunity to qualified people with disabilities. We have a goal of having at least 7% of our workers as people with disabilities. The law says we must measure our progress towards this goal. To do this, we must ask applicants and employees if they have a disability or have ever had one. People can become disabled, so we need to ask this question at least every five years.
Completing this form is voluntary, and we hope that you will choose to do so. Your answer is confidential. No one who makes hiring decisions will see it. Your decision to complete the form and your answer will not harm you in any way. If you want to learn more about the law or this form, 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?
A disability is a condition that substantially limits one or more of your “major life activities.” If you have or have ever had such a condition, you are a person with a disability. Disabilities include, but are not limited to:
Alcohol or other substance use disorder (not currently using drugs illegally)
Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, HIV/AIDS
Blind or low vision
Cancer (past or present)
Cardiovascular or heart disease
Celiac disease
Cerebral palsy
Deaf or serious difficulty hearing
Diabetes
Disfigurement, for example, disfigurement caused by burns, wounds, accidents, or congenital disorders
Epilepsy or other seizure disorder
Gastrointestinal disorders, for example, Crohn's Disease, irritable bowel syndrome
Intellectual or developmental disability
Mental health conditions, for example, depression, bipolar disorder, anxiety disorder, schizophrenia, PTSD
Missing limbs or partially missing limbs
Mobility impairment, benefiting from the use of a wheelchair, scooter, walker, leg brace(s) and/or other supports
Nervous system condition, for example, migraine headaches, Parkinson’s disease, multiple sclerosis (MS)
Neurodivergence, for example, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, dyslexia, dyspraxia, other learning disabilities
Partial or complete paralysis (any cause)
Pulmonary or respiratory conditions, for example, tuberculosis, asthma, emphysema
Short stature (dwarfism)
Traumatic brain injury
Disability Status
Please select Yes, I have a disability, or have had one in the past
No, I do not have a disability and have not had one in the past
I do not want to answer
PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.
