TWIST ID. Selective Service Letter / Registration Letter

Transcription

1 WIOA BASIC ELIGIBILITY Job seekers must meet the following Basic Eligibility requirements and furnish proof of each eligibility criteria with one of the listed Acceptable Documentation source documents. Although a job seeker's Social Security number is not considered Basic Eligibility criteria, it must still be verified. BIRTH DATE / AGE NAME BASIC ELIGIBILITY SOCIAL SECURITY NUMBER AUTHORIZED TO WORK IN THE UNITED STATES Note: Authorization to work in the United States can be verified through eligibility for UI Benefits. Documentation of this eligibility is included on the Authorized to Work in the US Form. SELECTIVE SERVICE REGISTRATION For Males born on or after January 1, 1960 VETERAN STATUS (Federal/State Qualified Veteran/Spouse of Veteran) See WD (11/3/11) or Veteran Status Tab of this workbook for full definition of Eligible Veteran Selective Service Letter / Registration Letter Proof of Spousal Relationship (TWDB Definition) Marriage Certificate Spouse Military ID Card (look for Sponsor name) APPLICATION DATE BASIC ELIGIBILITY DOCUMENTATION Social Security Card Self Attestation, appearing in TWIST through customer's entry in WIT Social Security Benefits DD 214, DD 215, Report of Transfer/Discharge/Disability W 2 Form Employment Records showing SSN Employer Statement/Contact with employer noted in TWIST CN Letter from Social Service Agency Telephone Verification from Official Source Completed Authorized to Work (ATW) in the United States Form Expedited WIA DW: for UI Claimants Only Attach either to the ATW Form: UI Screen Current Claimant Status (CTCS) or JSMS: UI Claims Functions and enter the following Codes to get to CTCS screen: CT; RI; CS. Enter SSN and F11 view "Redet" date for last UI eligibility date Print this screen for eligibility verification. UI Award Letter Expedited WIA DW: for UI RRES Only Attach either to the ATW Form: Copy of WIT screen showing: RRES indicator Screen print of RRES Outreach List Copy of RRES Outreach Letter Valid Driver's License (listing DOB) Federal, State, or Local Government Identification Card Birth Certificate DD 214, DD 215, Report of Transfer/Discharge/Disability Passport Public Assistance/Social Service Records Work Permit School Records/Identification Card Hospital Record of Birth Baptismal Record Native American Tribal Document Other official document issued by a federal, state, or local government agency, such as discharge documents from TDCJ with date of birth. Internet Verification / Registration ( Telephone Verification ( / ) DD 214, DD 215, Report of Transfer/Discharge/Disability Self Attestation Form, including any required documentation DD 214, DD 215 (with proof of spousal relationship, if needed) Priority of Service Self Attestation Form WIOA Basic Eligibility Documentation Log SEP 2015 Page 1 of 20

2 WIOA ADULT SERVICE PRIORITY & ELIGIBILITY Note: Adults (18 or older) must meet Basic Eligibility and any Board priority policy criteria. PRIORITY GROUP 1a Must meet only one Criteria to be eligible (No income required) Temporary Assistance for Needy Families (TANF) receives or has received in the past 6 months. Supplemental Security Income (SSI) receives or has received in the past 6 months. Other Public Assistance Homeless ADULT NAME Supplemental Nutrition Assistance for Needy Families (SNAP) receives or has received in the past 6 months. Foster Care / Former Foster Care Youth Crossmatch with TWIST TANF screens Printout of TIERS screen maintained in case Copy of out of state HHSC/public assistance documentation maintained in case and referenced in TWIST CN. TWIST Legacy Search (P/O Intake Common Public Assistance or TANF History screen) Printout of TIERS screen maintained in case Letter from SNAP Disbursing Agency Telephone verification Copy of authorization to receive cash public assistance Public Assistance record Record of Social Security benefits Telephone Verification Form Authorization to receive cash public assistance Public assistance check Medical card showing cash grant status Refugee assistance records Local cash assistance program Self Attestation, appearing in TWIST through entry in WIT Verbal declaration, entered into TWIST CN Written statement from an individual or social services agency providing residence shelter maintained in file and entered in TWIST CN Verbal declaration, entered into TWIST CN Basic Skills Deficient Assessed by a generally accepted standardized test Work Readiness Credential Threshold Score of < 75% School Records Unable to compute or solve problems or read, write, or speak English at a level necessary to function on the job, BSD CATEGORY RESERVED PENDING BOARD POLICY DECISION in the individual's family or in society. If not eligible under one of the above 1a Priority Groups, move to Priority Group 1b WIOA ADULT PRIORITY ELGIBILITY SEP 2015 Page 2 of 20

3 WIOA ADULT SERVICE PRIORITY & ELIGIBILITY Note: Adults (18 or older) must meet Basic Eligibility and any Board priority policy criteria. ADULT NAME Individuals with Disabilities PRIORITY GROUP 1b Disability Status, Income and Family Size Required INDIVIDUAL / FAMILY INCOME Income and Family Size At or below current 70% LLSIL Note: Documentation should be provided for each applicable income source. N/A If using TANF, SNAP, SSI, Homeless, or Foster Youth to determine Low Income Individual. INDIVIDUAL STATUS / FAMILY SIZE Alimony Agreement Award Letter from Veterans Affairs with statement of monetary amount Bank Statement Compensation Award Letter Employer Statement / Contact with employer noted in TWIST CN Family or Business Financial Records Pay Stubs Pension Statements Public Assistance Records/Print Out Quarterly Estimated Tax for Self Employed Persons (Schedule C) UI Documents and/or Print Out Court award letter Self Employment Verification Form Other official document issued by a federal, state, or local government agency such as the Texas Department of Housing and Community Affairs, indicating monetary amount of assistance. To be used only in the absence of any of the documents listed above. (Per Policy clarification #784, 9/28/12) Self Attestation of Family Status Form Birth Certificates Decree of Court Divorce Decree Marriage Certificate Disabled If a disabled individual proves to be ineligible due to family income criteria, that individual must, for purposes of income eligibility determination, be considered an unrelated individual who is a family unit of one, consistent with the definition of low income individual at WIOA 3(25). If not eligible under one of the above 1a or 1b Priority Groups, move to Priority Group 1c WIOA ADULT PRIORITY ELGIBILITY SEP 2015 Page 3 of 20

4 WIOA ADULT SERVICE PRIORITY & ELIGIBILITY Note: Adults (18 or older) must meet Basic Eligibility and any Board priority policy criteria. PRIORITY GROUP 1c Just Income & Family Size Required ADULT NAME INDIVIDUAL / FAMILY INCOME Income and Family Size At or below current 70% LLSIL Note: Documentation should be provided for each applicable income source. N/A If using TANF, SNAP, SSI, Homeless, or Foster Youth to determine Low Income Individual. INDIVIDUAL STATUS / FAMILY SIZE Alimony Agreement Award Letter from Veterans Affairs with statement of monetary amount Bank Statement Compensation Award Letter Employer Statement / Contact with employer noted in TWIST CN Family or Business Financial Records Pay Stubs Pension Statements Public Assistance Records/Print Out Quarterly Estimated Tax for Self Employed Persons (Schedule C) UI Documents and/or Print Out Court award letter Self Employment Verification Form Other official document issued by a federal, state, or local government agency such as the Texas Department of Housing and Community Affairs, indicating monetary amount of assistance. To be used only in the absence of any of the documents listed above. (Per Policy clarification #784, 9/28/12) Self Attestation of Family Status Form Birth Certificates Decree of Court Divorce Decree Marriage Certificate Disabled If a disabled individual proves to be ineligible due to family income criteria, that individual must, for purposes of income eligibility determination, be considered an unrelated individual who is a family unit of one, consistent with the definition of low income individual at WIOA 3(25). If not eligible under one of the above 1a, 1b or 1c Priority Groups, move to Priority Group 2 WIOA ADULT PRIORITY ELGIBILITY SEP 2015 Page 4 of 20

5 WIOA ADULT SERVICE PRIORITY & ELIGIBILITY Note: Adults (18 or older) must meet Basic Eligibility and any Board priority policy criteria. PRIORITY GROUP 2 Board Designated Priority Groups: No Income or Family Size required ADULT NAME Child Care Assistance receives or has received in the past 6 months. CHIPS receives or has received in the past 6 months. Medicaid receives or has received in the past 6 months. Public Housing receives or has received in the past 6 months. Section 8 receives or has received in the past 6 months. WIC receives or has received in the past 6 months. Eligibility Certification Letter Eligibility Certification Letter Telephone Verification Form Printout of TIERS screen maintained in case Eligibility Certification Letter Telephone Verification Form Lease Agreement Eligibility Certification Letter Telephone Verification Form Lease Agreement Eligibility Certification Letter Telephone Verification Form Eligibility Certification Letter Telephone Verification Form If not eligible under one of the above 1a, 1b, 1c or 2 Priority Groups, move to Priority Group 3 WIOA ADULT PRIORITY ELGIBILITY SEP 2015 Page 5 of 20

6 WIOA ADULT SERVICE PRIORITY & ELIGIBILITY Note: Adults (18 or older) must meet Basic Eligibility and any Board priority policy criteria. PRIORITY GROUP 3 Board Designated Priority Group: Must document both Income and Family Size ADULT NAME INDIVIDUAL / FAMILY INCOME Income and Family Size At or below current 85% State Median Income ot each applicable income source. N/A If using TANF, SNAP, SSI, Homeless, or Foster Youth to determine Low Income Individual. INDIVIDUAL STATUS / FAMILY SIZE Alimony Agreement Award Letter from Veterans Affairs with statement of monetary amount Bank Statement Compensation Award Letter Employer Statement / Contact with employer noted in TWIST CN Family or Business Financial Records Pay Stubs Pension Statements Public Assistance Records/Print Out Quarterly Estimated Tax for Self Employed Persons (Schedule C) UI Documents and/or Print Out Court award letter Self Employment Verification Form Other official document issued by a federal, state, or local government agency such as the Texas Department of Housing and Community Affairs, indicating monetary amount of assistance. To be used only in the absence of any of the documents listed above. (Per Policy clarification #784, 9/28/12) Self Attestation of Family Status Form Birth Certificates Decree of Court Divorce Decree Marriage Certificate Disabled If a disabled individual proves to be ineligible due to family income criteria, that individual must, for purposes of income eligibility determination, be considered an unrelated individual who is a family unit of one, consistent with the definition of low income individual at WIOA 3(25). If not eligible under one of the above 1a, 1b, 1c, 2, or 3 Priority Groups, move to Priority Group 4 PRIORITY GROUP 4 Board Designated Priority Group: No Income/Family Size required SPOUSE OF A DISLOCATED WORKER DEPENDENT CHILD OF A DISLOCATED WORKER AND AND Marriage Certificate Must include the Dislocated Worker Eligibility Documentation Log showing that SPOUSE meets ONE Category for Eligibility Birth Certificate Must include the Dislocated Worker Eligibility Documentation Log showing that PARENT meets ONE Category for Eligibility WIOA ADULT PRIORITY ELGIBILITY SEP 2015 Page 6 of 20

7 WIOA DISLOCATED WORKER ELIGIBILITY Note: DW must meet Basic Eligibility, Board priority policy criteria, and one of the following criteria either Category 1, 2, 3, 4, or 5. CATEGORY 1 CATEGORY 1 Expedited Eligibility CATEGORY 1 Military Members Unemployment Insurance Eligible for, or has exhausted UI Expedited eligibility is available for tradeaffected workers and UI claimants who have been profiled and determined likely to exhaust benefits. This includes verification of Authorization to Work in the US and Category 1 DW eligibility. Expedited Eligibility Separating military service members may qualify under DW Category 1 if they are: and DISLOCATED WORKER NAME ELIGIBILITY CRITERIA Terminated / Laid Off / Received Notice of Termination / Layoff Can show attachment to workforce but ineligible for UI due to insufficient earnings or worked for an employer not covered under state UI law. Unlikely to Return to Previous Industry / Occupation due to no growth or decline in job openings or employment search. Note: Must also complete Authorization to Work Form and verify Age and Selective Service See Basic Eligibility Tab. Discharged under conditions other than dishonorable, whether voluntarily or involuntarily; or Nonretirees; Satisfy other WIOA criteria for DW eligibility, including the requirement that the individual is unlikely to return to his/her previous industry or occupation TWIST Rapid Response List Notice of Layoff Public Announcement WARN Notice Employer Verification Verbal declaration, entered into TWIST CN UI Screen Current Claimant Status (CTCS) UI Award letter Board Determination Telephone/written verification of employment/layoff from employer (can use: Telephone Verification/Document Inspection Form / Verification of Termination or Layoff Dislocated Worker Form ) Self Attestation Form copy in file & referenced in TWIST CN TWC approved Labor Market analysis TWC Labor Market Information Job Search Self Attestation, appearing in TWIST through customer's self reported date of dislocation in WIT Telephone or written verification from employer (can use: Telephone Verification/Document Inspection Form / Verification of Termination or Layoff Dislocated Worker Form ) Self Attestation Form copy in file & referenced in TWIST CN Employer Notice of Layoff Copy of WIT screen showing: RRES indicator (red square with Black Dollar Sign) Screen print of RRES Outreach List Copy of RRES Outreach Letter An open TAA occupational or educational training service DD 214, DD 215 Transfer/Discharge/Disability WIOA Dislocated Worker Eligibility Documentation Log SEP 2015 Page 7 of 20

8 WIOA DISLOCATED WORKER ELIGIBILITY Note: DW must meet Basic Eligibility, Board priority policy criteria, and one of the following criteria either Category 1, 2, 3, 4, or 5. or DISLOCATED WORKER NAME Permanent closure of plant/facility/enterprise Substantial layoff Notice of Layoff WARN Notice Telephone or written verification from employer (can use: Telephone Verification/Document Inspection Form / Verification of Termination or Layoff Dislocated Worker Form ) CATEGORY 2 Closure/Layoff or Notified of a planned closure (within 180 days if notice) either through the employer or through the media; General announcement made by employer that the facility will close with no date given or date beyond 180 days of notice Customer's self reported date of dislocation in WIT TWIST Rapid Response List Notice of Layoff Documentation from media source Documentation from State Dislocated Worker Services Employer Verification Telephone/written verification from official source (can use: Telephone Verification/Document Inspection Form ) Self Attestation Form, referenced in TWIST CN Verbal declaration, entered into TWIST CN Customer's self reported date of dislocation in WIT TWIST Rapid Response List Notice of Layoff Documentation from media source Telephone or written verification from employer (can use: Telephone Verification/Document Inspection Form / Verification of Termination or Layoff Dislocated Worker Form) Self Attestation Form, referenced in TWIST CN Verbal declaration, entered into TWIST CN WIOA Dislocated Worker Eligibility Documentation Log SEP 2015 Page 8 of 20

9 WIOA DISLOCATED WORKER ELIGIBILITY Note: DW must meet Basic Eligibility, Board priority policy criteria, and one of the following criteria either Category 1, 2, 3, 4, or 5. CATEGORY 3 Previously Self Employed CATEGORY 4 Displaced Homemaker and or and or DISLOCATED WORKER NAME Previously self employed presently unemployed because of general economic conditions in residing community permanently dislocated because of natural disaster. An individual who: has been providing unpaid services to family members in the home; is unemployed or underemployed and is experiencing difficulty in obtaining or upgrading employment; has been dependent on the income of another family member but is no longer supported by that income is the dependent spouse of a member of the Armed Forces on active duty and whose family income is significantly reduced because of: > deployment > call or order to active duty > permanent change of station, or > the service connected death or disability of military spouse. Business License / Permit IRS Documentation TWC Verification Telephone Verification Form from official source Self Employment Verification Form and TWC Labor Market Information Unemployment Rate Other TWC Approved Labor Market Analysis Failure of Business Supplier Failure of Business Customer Depressed Prices or Market Telephone verification from official source (can use: Telephone Verification/Document Inspection Form ) or Federal / State Declaration of Disaster TWC Confirmed Disaster and Permanent dislocation Telephone verification from official source (can use: Telephone Verification/Document Inspection Form ) Verbal declaration, entered into TWIST CN Self Attestation Form, referenced in TWIST CN CATEGORY 5 Spouse of Military Members An individual who: or is the spouse of a member of the Armed Forces on active duty and who has experienced a loss of employment as a direct result of relocation to accommodate a permanent change in duty station of such member, is the spouse of a member of the Armed Forces on active duty and who is unemployed or underemployed and experiencing difficulty finding or upgrading employment. Self Attestation Form, referenced in TWIST CN DD 214, Certificate of Release or Discharge from Active Duty Verbal declaration entered in TWIST CN Board Defined or DD 214 plus proof of dates of previous employment (employer letter, telephone verification from employer) Proof of job search activities Self Attestation Form, referenced in TWIST CN WIOA Dislocated Worker Eligibility Documentation Log SEP 2015 Page 9 of 20

10 WIOA OUT OF SCHOOL YOUTH SERVICE PRIORITY & ELIGIBILITY Youth years old must meet Basic Eligibility and any Board priority policy criteria. Not Attending Any School Offender Homeless YOUTH NAME AND must meet one of the following criteria in Category 1 CATEGORY 1 Customer only needs to meet one Criteria in this section. If they do not, go to Category 2 School Dropout Within the age of compulsory school attendance (16 18), but has not attended school for at least the most recent calendar quarter of the most recent school year Pregnant Youth Parenting Youth Foster Care / Former Foster Care Youth Individuals with Disabilities Must also complete Category 1b Income Individuals with a disability are considered a family of one Self Attestation Form referenced in TWIST CN and maintained in file School attendance records School dropout letter Telephone Verification Form with school official (can use: Telephone Verification/Document Inspection Form ) Self Attestation Form referenced in TWIST CN and maintained in file School attendance record Self Attestation Form, referenced in TWIST CN and maintained in file Documentation from juvenile or adult criminal justice system Telephone/written verification with court representatives (can use: Telephone Verification/Document Inspection Form ) Verbal declaration entered into TWIST Program Detail screen under the Characteristics tab and noted in TWIST CN Self Attestation Form referenced in TWIST CN and maintained in file Self Attestation, appearing in TWIST through entry in WIT Verbal declaration entered into TWIST Program Detail screen under the Characteristics tab and noted in TWIST CN Written statement from an individual or social services agency providing residence shelter maintained in file and entered in TWIST CN Verbal declaration entered into TWIST Program Detail screen under the Characteristics tab and noted in TWIST CN Staff observation entered into TWIST Program Detail screen under the Characteristics tab and noted in TWIST CN Self Attestation Form, entered into TWIST Program Detail screen under the Characteristics Tab and noted in TWIST CN with original in file. Birth Certificate Baptismal record Hospital record of birth Public assistance/social service records School identification card HHSC TANF or SNAP screen print showing the individual and child Other official document issued by a state or local government agency or court which demonstrates the individual is the child's parent or legal guardian, such as a copy of a signed Acknowledgement of Paternity form that has been filed with the Bureau of Vital Statistics or a copy of legal documents indicating guardianship or adoption Step Parent Copy of an official document issues by a state or local government agency or court that names the child and the child's parent such as a birth certificate or adoption record AND proof of marriage to the child's parent such as their marriage certificate or common law marriage certificate Verbal declaration, entered into TWIST CN It is only necessary to document that the individual has a disability. Detailed information about the disability is not necessary. WIA PRIORITY OF SERVICE - ELIGIBILITY JAN 2013 Page 10 of 20

11 WIOA OUT OF SCHOOL YOUTH SERVICE PRIORITY & ELIGIBILITY Youth years old must meet Basic Eligibility and any Board priority policy criteria. CATEGORY 2 Complete only if Customer doesn't meet any Criteria in Category 1. Must complete Income for Individuals with Disabilities YOUTH NAME HIGH SCHOOL DIPLOMA/GED Supplemental Nutrition Assistance for Needy Families (SNAP) receives or has received in the past 6 months. Supplemental Security Income (SSI) INDIVIDUAL / FAMILY INCOME Income and Family Size At or below current 70% LLSIL Note: Documentation should be provided for each applicable income source. N/A If using TANF, SNAP, SSI, Homeless, or Foster Youth to determine Low Income Individual. INDIVIDUAL STATUS / FAMILY SIZE Copy of Diploma School Record AND Basic Skills Deficient or English Language Learner AND must meet the Low Income Status based on one of the following Public Assistance sources or Income/Family Size calculation at or below 70% LLSIL Basic Skills Deficient Assessed by a generally accepted standardized test School Records English Language Learner CATEGORY 2 LOW INCOME - MUST MEET ONE OF THE FOLLOWING CRITERIA Temporary Assistance for Needy Families (TANF) receives or has received in the past 6 months. Other Public Assistance receives or has received in the past 6 months Note: Self Attestation Form only to be used in the absence of any other documents per policy clarification #784, 9/28/12 and WIA Documentation Log, Self Attestation Form Instructions. Crossmatch with TWIST TANF screens Printout of TIERS screen maintained in case Copy of out of state HHSC/public assistance documentation maintained in case and referenced in TWIST CN. TWIST Legacy Search (P/O Intake Common Public Assistance or TANF History screen) Printout of TIERS screen maintained in case Letter from SNAP Disbursing Agency Telephone Verification Form Copy of authorization to receive cash public assistance Public Assistance record Record of Social Security benefits Telephone Verification Form Authorization to receive cash public assistance Public assistance check Medical card showing cash grant status Refugee assistance records Local cash assistance program Alimony Agreement Award Letter from Veterans Affairs with statement of monetary amount Bank Statement Compensation Award Letter Employer Statement / Contact with employer noted in TWIST CN Family or Business Financial Records Pay Stubs Pension Statements Public Assistance Records/Print Out Quarterly Estimated Tax for Self Employed Persons (Schedule C) UI Documents and/or Print Out Court award letter Self employment Verification Form Official document issued by federal, state, or local government agency such as the Texas Dept of Housing and Community Affairs, indicating monetary amount of assistance. Birth Certificates Decree of Court Divorce Decree Marriage Certificate Disabled If a disabled individual proves to be ineligible due to family income criteria, that individual must, for purposes of income eligibility determination, be considered an unrelated individual who is a family unit of one, consistent with the definition of lowincome individual at WIOA 3(25). Self Attestation of Family Status Form WIA PRIORITY OF SERVICE - ELIGIBILITY JAN 2013 Page 11 of 20

12 WIOA OUT OF SCHOOL YOUTH SERVICE PRIORITY & ELIGIBILITY Youth years old must meet Basic Eligibility and any Board priority policy criteria. CATEGORY 3 Complete only if Youth does not meet Criteria in Category I or Category 2 YOUTH NAME Additional Assistance Needed Note: Assistance needed to complete an educational program, or to secure and hold employment INDIVIDUAL / FAMILY INCOME Income and Family Size At or below current 70% LLSIL Note: Documentation should be provided for each applicable income source. INDIVIDUAL STATUS / FAMILY SIZE Board defined documentation Needs Additional Educational Assistance (youth 16-24) Self-Attestation Form - written statement from youth who is the first generation in the family to attend college and requires educational assistance in order to complete his/her college degree/certificate - copy in file and referenced in TWIST CN Parent/legal guardian or youth's Self-Attestation Form -written statement requesting additional assistance to complete an educational program - copy in file and referenced in TWIST CN Needs Additional Employment Assistance (youth 16-24) Self-Attestation Form -written statement of unsuccessful efforts in obtaining and/or retaining employment - copy in file and referenced in TWIST CN Self-Attestation Form - written statement of lack of work skills to qualify for a promotion at current job or secure a different job with wages at levels higher than current wages - copy in file and referenced in TWIST CN Alimony Agreement Award Letter from Veterans Affairs with statement of monetary amount Bank Statement Compensation Award Letter Employer Statement / Contact with employer noted in TWIST CN Family or Business Financial Records Pay Stubs Pension Statements Public Assistance Records/Print Out Quarterly Estimated Tax for Self Employed Persons (Schedule C) UI Documents and/or Print Out Court award letter Self employment verification form Other official document issued by a federal, state, or local government agency such as the Texas Department of Housing and Community Affairs, indicating monetary amount of assistance. To be used only in the absence of any of the documents listed above. (Per Policy clarification #784, 9/28/12) Birth Certificates Decree of Court Divorce Decree Marriage Certificate Disabled If a disabled individual proves to be ineligible due to family income criteria, that individual must, for purposes of income eligibility determination, be considered an unrelated individual who is a family unit of one, consistent with the definition of lowincome individual at WIOA 3(25). Self Attestation of Family Status Form WIA PRIORITY OF SERVICE - ELIGIBILITY JAN 2013 Page 12 of 20

13 WIOA IN SCHOOL YOUTH SERVICE PRIORITY & ELIGIBILITY Youth attending school ages must meet Basic Eligibility and any Board priority policy criteria. In School Youth must meet one Criteria in Category 1 OR all of Category 2 AND one Criteria in Category 3 CATEGORY 1 If customer doesn't meet any Criteria in this Category, go to Category 2 YOUTH NAME Temporary Assistance for Needy Families (TANF) receives or has received in the past 6 months. Supplemental Nutrition Assistance for Needy Families (SNAP) receives or has received in the past 6 months. Supplemental Security Income (SSI) receives or has received in the past 6 months. Other Public Assistance Homeless Free or Reduced Price School Lunch Foster Care / Former Foster Care Youth Individuals with Disabilities Must also complete Income in Category 2 Individuals with a disability are considered a family of one Crossmatch with TWIST TANF screens Printout of TIERS screen maintained in case Copy of out of state HHSC/public assistance documentation maintained in case and referenced in TWIST CN. TWIST Legacy Search (P/O Intake Common Public Assistance or TANF History screen) Printout of TIERS screen maintained in case Letter from SNAP Disbursing Agency Telephone Verification Form Copy of authorization to receive cash public assistance Public Assistance record Record of Social Security benefits Telephone Verification Form Authorization to receive cash public assistance Public assistance check Medical card showing cash grant status Refugee assistance records Local cash assistance program Self Attestation, appearing in TWIST through entry in WIT Verbal declaration, entered into TWIST CN Written statement from an individual or social services agency providing residence shelter maintained in file and entered in TWIST CN School Records Verbal declaration, entered into TWIST CN It is only necessary to document that the individual has a disability. Detailed information about the disability is not necessary. WIA PRIORITY OF SERVICE - ELIGIBILITY JAN 2013 Page 13 of 20

14 WIOA IN SCHOOL YOUTH SERVICE PRIORITY & ELIGIBILITY Youth attending school ages must meet Basic Eligibility and any Board priority policy criteria. In School Youth must meet one Criteria in Category 1 OR all of Category 2 AND one Criteria in Category 3 CATEGORY 2 Both Income and Family Size documentation must be gathered YOUTH NAME INDIVIDUAL / FAMILY INCOME Income and Family Size At or below current 70% LLSIL Note: Documentation should be provided for each applicable income source. INDIVIDUAL STATUS / FAMILY SIZE Alimony Agreement Award Letter from Veterans Affairs with statement of monetary amount Bank Statement Compensation Award Letter Employer Statement / Contact with employer noted in TWIST CN Family or Business Financial Records Pay Stubs Pension Statements Public Assistance Records/Print Out Quarterly Estimated Tax for Self Employed Persons (Schedule C) UI Documents and/or Print Out Court award letter Self employment verification form Other official document issued by a federal, state, or local government agency such as the Texas Department of Housing and Community Affairs, indicating monetary amount of assistance. To be used only in the absence of any of the documents listed above. (Per Policy clarification #784, 9/28/12) Birth Certificates Decree of Court Divorce Decree Marriage Certificate Disabled If a disabled individual proves to be ineligible due to family income criteria, that individual must, for purposes of income eligibility determination, be considered an unrelated individual who is a family unit of one, consistent with the definition of low income individual at WIOA 3(25). Self Attestation of Family Status Form WIA PRIORITY OF SERVICE - ELIGIBILITY JAN 2013 Page 14 of 20

15 WIOA IN SCHOOL YOUTH SERVICE PRIORITY & ELIGIBILITY Youth attending school ages must meet Basic Eligibility and any Board priority policy criteria. In School Youth must meet one Criteria in Category 1 OR all of Category 2 AND one Criteria in Category 3 CATEGORY 3 BARRIERS TO EMPLOYMENT Youth must meet one Criteria in Category 3 in addition to Category 1 or Category 2 YOUTH NAME Offender Homeless Pregnant Youth Parenting Youth Foster Care / Former Foster Care Youth Individuals with Disabilities Must also complete Income in Category 2 Individuals with a disability are considered a family of one Basic Skills Deficient English Language Learner YOUTH MUST MEET ONE OF THE FOLLOWING IN CATEGORY 3 Verbal declaration entered into TWIST Program Detail screen under the Characteristics tab and noted in TWIST Case Notes Self Attestation Form referenced in TWIST Case Notes and maintained in file Documentation from juvenile or adult criminal justice system Telephone/written verification with court representatives (can use: Telephone Verification/Document Inspection Form ) Self Attestation, appearing in TWIST through entry in WIT Verbal declaration entered into TWIST Program Detail screen under the Characteristics tab and noted in TWIST Case Notes Written statement from an individual or social services agency providing residence shelter maintained in file and entered in TWIST CN Verbal declaration entered into TWIST Program Detail screen under the Characteristics tab and noted in TWIST Case Notes Staff observation entered into TWIST Program Detail screen under the Characteristics tab and noted in TWIST Case Notes Self attestation, entered into TWIST Program Detail screen under the Characteristics tab and noted in TWIST Case Notes with original in file Birth certificate Baptismal record Hospital record of birth Public assistance/social service records School identification card HHSC TANF or SNAP screen print showing the individual and child Other official document issued by a state or local government agency or court which demonstrates the individual is the child's parent or legal guardian, such as a copy of a signed Acknowledgement of Paternity form that has been filed with the Bureau of Vital Statistics or a copy of legal documents indicating guardianship or adoption Step Parent Copy of an official document issues by a state or local government agency or court that names the child and the child's parent such as a birth certificate or adoption record AND proof of marriage to the child's parent such as their marriage certificate or common law marriage certificate Verbal declaration, entered into TWIST CN It is only necessary to document that the individual has a disability. Detailed information about the disability is not necessary. Assessed by a generally accepted standardized test School Records Self Attestation Form copy in file and referenced in TWIST CN WIA PRIORITY OF SERVICE - ELIGIBILITY JAN 2013 Page 15 of 20

16 WIOA IN SCHOOL YOUTH SERVICE PRIORITY & ELIGIBILITY Youth attending school ages must meet Basic Eligibility and any Board priority policy criteria. In School Youth must meet one Criteria in Category 1 OR all of Category 2 AND one Criteria in Category 3 CATEGORY 4 RESTRICTED REQUIRES MANAGEMENT APPROVAL Complete only if Youth does not meet Criteria in CATEGORY I or CATEGORY 2 YOUTH NAME Additional Assistance Needed INDIVIDUAL / FAMILY INCOME Income and Family Size At or below current 70% LLSIL Note: Documentation should be provided for each applicable income source. INDIVIDUAL STATUS / FAMILY SIZE Board defined documentation THIS CATEGORY REQUIRES MANAGEMENT APPROVAL BEFORE PROCESSING LIMITED TO ONLY 5% OF IN SCHOOL YOUTH ENROLLED Note: Assistance needed to complete an educational program, or to secure and hold employment Needs Additional Educational Assistance (youth 14-21) Self-Attestation Form - written Statement from school that youth needs additional assistance to advance a grade level or to advance grades in English, Math, or Reading - copy in file and referenced in TWIST CN Parent/legal guardian or youth's Self-Attestation Form - written statement requesting additional assistance to complete an educational program - copy in file and referenced in TWIST CN Needs Additional Employment Assistance (youth 14-21) Self-Attestation Form - written statement of unsuccessful efforts in obtaining and/or retaining employment - copy in file and referenced in TWIST CN Self-Attestation Form - written statement of lack of work skills to qualify for a promotion at current job or secure a different job with wages at levels higher than current wages - copy in file and referenced in TWIST CN Alimony Agreement Award Letter from Veterans Affairs with statement of monetary amount Bank Statement Compensation Award Letter Employer Statement / Contact with employer noted in TWIST CN Family or Business Financial Records Pay Stubs Pension Statements Public Assistance Records/Print Out Quarterly Estimated Tax for Self Employed Persons (Schedule C) UI Documents and/or Print Out Court award letter Self employment verification form Other official document issued by a federal, state, or local government agency such as the Texas Department of Housing and Community Affairs, indicating monetary amount of assistance. To be used only in the absence of any of the documents listed above. (Per Policy clarification #784, 9/28/12) Birth Certificates Decree of Court Divorce Decree Marriage Certificate Disabled If a disabled individual proves to be ineligible due to family income criteria, that individual must, for purposes of income eligibility determination, be considered an unrelated individual who is a family unit of one, consistent with the definition of low income individual at WIOA 3(25). Self Attestation of Family Status Form WIA PRIORITY OF SERVICE - ELIGIBILITY JAN 2013 Page 16 of 20

17 NOTE: DD-214 can be ordered online via: WD 35-11, 11/3/11 - Priority of Service for Eligible Veterans - Update Boards must ensure that the following definitions are used when implementing priority of service: Eligible Veteran any one of the following: Federal/state qualified veteran a person who served in the active military, naval, or air service, and who was discharged or released there from under conditions other than dishonorable as specified at 38 U.S.C. 101(2). Active services include full-time duty in the National Guard or a Reserve component, other than full-time for training purposes. [Note: This definition does not apply to eligibility for services provided by Disabled Veterans Outreach Program/Local Veterans Employment Representatives staff. ] Federal qualified spouse the spouse of: (1) any veteran who died of a service-connected disability; (2) any member of the Armed Forces serving on active duty who, at the time of application for the priority, is listed in one or more of the following categories and has been so listed for a total of more than 90 days: (i) missing in action; (ii) captured in line of duty by a hostile force; or (iii) forcibly detained or interned in line of duty by a foreign government or power; (3) any veteran who has a total disability resulting from a service-connected disability, as evaluated by the U.S. Department of Veterans Affairs; (4) any veteran who died while a disability, as indicated in paragraph (3) of this section, was in existence. Boards must be aware that the spouse of a living veteran or service member (definitions 2 or 3 above) will lose his or her eligibility if the veteran or service member loses the status that is the basis for eligibility. For example, the spouse of a veteran with a total service-connected disability will not be eligible if the veteran s disability is revised to a lower level. Similarly, a spouse whose eligibility is derived from a living veteran or service member will lose his or her eligibility upon divorce from the veteran or service member. State qualified spouse a spouse: (1) who meets the definition of federal qualified spouse; or (2) of any member of the armed forces who died while serving on active military, naval, or air service. Texoma WDB Proof of Spousal Relationship: Marriage Certificate Spouse Military ID Card (look for Sponsor name)

18 WORKFORCE SOLUTIONS TEXOMA WIOA ELIGIBILITY ABBREVIATIONS/ACRYNOMS ADU Adult CN TWIST Counselor Notes DW Dislocated Worker TWIST The Workforce Information System of Texas WIOA Workforce Innovation and Opportunity Act WIT WorkIn Texas.com YOU Youth INSTRUCTIONS 1) 2) All customers must meet Basic Eligibility requirements prior to receiving Individualized Career Services (previously WIA intensive/training services). Each WIOA Adult, Dislocated Worker, or Youth, must also meet requirements contained in their respective spreadsheet(s) prior to receiving Individualized Career Services (previously WIA intensive/training services). 3) The following must be maintained in the Cabinet file under the Eligibility Tab: 3a) A copy of the Documentation Log Worksheets (Basic Eligibility and appropriate DW, ADU or YOU worksheet) with checkboxes checked for each eligibility factor 3b) Copies of each documentation gathered to support each checkbox. Each document should be numbered in the document title that corresponds to the appropriate document source placed in TWIST Program Detail, Documentation tab - i.e., ATW Form #1, DL #2; WIT RRES Orientation Schedule P/S Doc #3. REFERENCES TWC's WIOA Eligibility Documentation Log Note: Most Recent Version TWC's WIOA Guidelines for Adults, Dislocated Workers, and Youth Note: Most Recent Version WIA Documentation Log - References Instructions JAN 2013

19 Veterans ADULT ELIGIBILITY PRIORITY: Public Assistance recipients and other low-income adults TANF (receives or has received in past 6 months) SNAP (receives or has received in past 6 months) SSI (receives or has received in past 6 months) Other Public Assistance Homeless Free or Reduced-Price School Lunch Foster Care/Former Foster Care Youth Individuals with Disabilities Individuals who are Basic Skills Deficient Child Care Assistance (receives or has received in past 6 months) CHIPS (receives or has received in past 6 months) Medicaid (receives or has received in past 6 months) Public Housing (receives or has received in past 6 months) Section 8 (receives or has received in past 6 months) WIC (receives or has received in past 6 months) DISLOCATED WORKER ELIGIBILITY BASIC: BASIC: 18 years of age or older 18 years of age or older Citizen or noncitizen authorized to work in the US Citizen or noncitizen authorized to work in the US Meet Selective Service registration requirements Meet Selective Service registration requirements (if born on or after 1/1/60) (if born on or after 1/1/60) Meet the definition of a Dislocated Worker at WIOA 3(15) CATEGORY I Priority Group 1 - Considered Low-Income - no additional income documentation required Priority Group 2 - Must document both Income & Family Size Priority Group 3 - Must document both Income & Family Size Board Priority Groups: Spouse of a Dislocated Worker Dependent Child of a Dislocated Worker Terminated/Laid Off / Received Notice of Termination / Layoff Eligible for, or has exhausted UI Can show attachment to workforce but ineligible for UI due to insufficient earnings or worked for employer not covered under state UI Law Expedited - trade & UI claimants who have been profiled likely to exhaust Separating military service members discharged > discharged under conditions other than dishonorable (voluntarily/involuntarily) or > non-retirees and Must be unlikely to return to his/her previous industry/occupation CATEGORY II Permanent closure of plant/facility/layoff or Substantial Layoff Notified of planned closure w/in 180 days or General announcement of closure with no date given or greater than 180 days CATEGORY III Previously self-employed (incl. farmer, rancher, fisherman, indecent contractors, consultants) and Presently unemployed because of general economic conditions in residing community or Permanently dislocated because of natural disaster CATEGORY IV Displaced Homemaker - Providing unpaid services to family members in the home or Unemployed or underemployed/experiencing difficulty in obtaining/upgrading employment and Dependent on the income of another family member but no longer supported by that income or Dependent spouse of member of the Armed Forces on active duty whose family income is significantly reduced because of: >deployment >call to order to active duty >permanent change of station >service-connected death or disability of military spouse CATEGORY V Spouse of a member of the Armed Forces on active duty and who has experienced a loss of employment as a direct result of relocation to accommodate a permanent change in duty station of such member or Spouse of a member of the Armed Forces on active duty and who is unemployed or underemployed and experiencing difficulty finding or upgrading employment.

20 AGES AGES BASIC: 18 years of age or older BASIC: 18 years of age or older Citizen or noncitizen authorized to work in the US Citizen or noncitizen authorized to work in the US Meet Selective Service registration requirements Meet Selective Service registration requirements CATEGORY 1 (must meet 1; if not, go to Category 2) CATEGORY 2 (must meet 1; if not, go to Category 3) CATEGORY 3 complete only if youth does not meet 1 or 2 Criteria OUT-OF-SCHOOL YOUTH Not Attending Any School AND any 1 of Category 1 criteria School Dropout Within the age of compulsory school attendance (16-18) but has not attended school for at least the most recent calendar quarter of the most recent school year Offender Homeless Pregnant Youth Parenting Youth Foster Care / Former Foster Care Youth Individuals with Disabilities High School Diploma / GED AND BSD OR ELL AND Low Income / Family Size Calculation Basic Skills Deficient English Language Learner LOW INCOME - MUST MEET 1 FOR CATEGORY 2 TANF SNAP SSI Other Public Assistance Individual/Family Income Individual Status/Family Size CATEGORY 3 - MANAGEMENT APPROVAL REQUIRED Additional Assistance Needed Needs Additional Educational Assistance Needs Additional Employment Assistance Individual/Family Income Individual Status/Family Size WIOA YOUTH ELIGIBILITY CATEGORY 1 (must meet 1; if not, go to Category 2) CATEGORY 3 (Must meet 1 from Category 3 & 1 from Category 4) CATEGORY 4 (Complete only if youth does not meet Criteria in Category 1 or 2) TANF SNAP IN-SCHOOL YOUTH Must meet 1 of Category 1 OR all of Category 2 AND 1 of Category 3 CATEGORY 2 (Both Income/Family Size must be documented) SSI Other Public Assistance Homeless Free or Reduced-Price Lunch Foster Care / Former Foster Care Youth Foster Care / Former Foster Care Youth Individuals with Disabilities LOW INCOME Individual/Family Income Individual Status/Family Size Offender Homeless Pregnant Youth Parenting Youth Foster Care / Former Foster Care Youth Individuals with Disabilities Basic Skills Deficient Additional Assistance Needed Needs Additional Educational Assistance Needs Additional Employment Assistance Individual/Family Income Individual Status/Family Size