ࡱ>  bjbjO O ~E-a-a&&D\\\!$\^<,:v,:,,,2B2B2Buwwwwww$T2B<2B2B2B,,f&H&H&H2Bl,,u&H2Bu&H&H ,),yV'Ca0rFN4))=$2B2B&H2B2B2B2B2B&H2B2B2B2B2B2B2B2B2B2B2B2B2B2B2B2B& F: Intensive/Training - Policy 4 Documentation of Program Eligibility 1. Purpose. To provide an easy reference for Title I WIA Program Eligibility Criteria for Registration along with Corresponding Act/Regulation Citations for adults, youth, and dislocated workers. Program Eligibility and Criteria for Registration for State Blue Collar and Skills Grant Programs is also provided. Information is provided on Definitions, Selective Service Registration, Poverty Income Guidelines, 70% of the Lower Living Standard Income Level, Acceptable Verification Sources, a Acceptable Eligibility Verification Listing, Statement of Family Size/Family Income, Self-Certification Requirements, and Telephone/Document Inspection Verification Requirements. 2. Reference. Public Law 105-220, dated August 7, 1998; WIA Final Regulations, dated August 11, 2000; Training and Employment Guidance Letter (TEGL) No. 14-00, Change 1, dated November 19, 2001; Federal Register, Vol. 78, No. 16, dated January 24, 2013; and Local Workforce Investment Area (LWIA) Plan Instructions. Delaware Blue Collar Jobs Act and, Division of Employment and Training (DET) / Delaware Workforce Investment Board (DWIB) Policy. 3. Discussion. Title I WIA, State Blue Collar, and Skills Grant Program Eligibility Criteria for Registration and Corresponding Act/Regulation Citations, WIA, State Blue Collar, and Skills Grant Eligibility Statement/Definitions, Selective Service Registration, WIA Definitions for Title I Eligibility, State Blue Collar and Skills Grant Definitions for Program Eligibility Poverty Guidelines and 70% of the Lower Living Standard Income Level, Composite of WIA Acceptable Verification, WIA, State Blue Collar, and Skills Grant Acceptable Eligibility Verification Listing, Statement of Family Size/Family Income, Self-Certification, and Telephone/ Document Inspection Verification Requirements. Action Required. Contractors and Case Managers are requested to copy this information and distribute to all staff that are involved in the enrollment of participants and collection of eligibility documentation. Attachments. ATTACHMENT A Title I WIA Program Eligibility Criteria for Registration and Corresponding Act/Regulation Citations. State Blue Collar and Skills Grant Eligibility Criteria for Registration and Corresponding Act / Policy Citations ATTACHMENT B WIA Eligibility Statement/Definitions Adult (18 or older) WIA Eligibility Statement/Definitions Youth (14 21) WIA Eligibility Statement/Definitions Dislocated Worker State Blue Collar Eligibility Statement / Definitions Youth (14-21) State Blue Collar Eligibility Statement / Definitions Adult (18 or older) Skills Grant Eligibility Statement / Definitions Adult (18 or older) ATTACHMENT C Selective Service Registration NOTE: For information on Selective Service regulations, please refer to the following: TEGL 11-11, Change 2 (dated May 16, 2012) Selective Service Registration Requirements for Employment and Training Administration Funded Programs Selective Service Telephone Verification No. (847) 688-6888 or toll-free: (888) 655-1825 TTY: (847) 688-2567 Hours of operation: 8:00 a.m. to 3:30 p.m., Central Time. Have your date of birth and social security number handy Internet Verification/Registration (HYPERLINK "http://www.sss.gov"www.sss.gov). ATTACHMENT D Definitions for Eligibility ATTACHMENT E 70% of the Lower Living Standard Income Level Self Sufficiency Income Guidelines ATTACHMENT F Composite of Acceptable Verification ATTACHMENT G Acceptable Eligibility Verification Listing WIA, Blue Collar, and Skills Grant General Eligibility Acceptable Verification Listing ATTACHMENT H Statement of Family Size/Family Income ATTACHMENT I Self-Certification ATTACHMENT J Telephone/Document Inspection Verification Requirements ATTACHMENT K Family Income Documentation Requirements/Worksheet Expiration Date This policy will be updated as necessary to reflect amendments to WIA, changes in federal regulations, and new USDOL policy directives. ELIGIBILITYADULT* (18 or Older)YOUTH* (14 21)DISLOCATED* WORKERGENERAL ELIGIBILITY All registered individuals must meet Citizenship/Eligible to Work, Selective Service (if applicable), Residency & Age.CITIZENSHIP OR ELIGIBLE TO WORKAct 188(a)(5)Act 188(a)(5)Act 188(a)(5)SELECTIVE SERVICE REGISTRANTAct 189(h)Act 189(h)Act 189(h)RESIDENCYDWIB PolicyDWIB PolicyDWIB PolicySOCIAL SECURITY NUMBERDWIB PolicyDWIB PolicyDWIB PolicyAGEAct 101(1) 20 CFR 663.110Act 101(13)(A) 20 CFR 664.200(a)20 CFR 663.110 ECONOMIC ELIGIBILITY Youth must meet the definition of Section 1 (Low Income) AND Section 2 (Barrier)LOW INCOME INDIVIDUAL [Act 101(25)] Any one of the following six elements: Cash public assistance Family income at or below the Poverty Line or 70% of the Lower Living Standard Income Level Receives Food Stamps or was determined eligible to receive in last six months Homeless per 103(a) & (c) of the McKinney Act Publicly supported foster child Individual with a disability whose own income is at or below the Poverty Line or 70% of the Lower Living Standard Income Level [20 CFR 664.250] Income based on Self Sufficiency Income found in Attachment E otherwise same as YouthAct 101(25) 20 CFR 664.200(b)BARRIERS is within one or more of the following categories: [Act 101(13)] Basic Skills Deficient [Act 101(4); 20 CFR 664.200(c)(1) and 20 CFR 664.205] School Dropout [Act 101(39); 20 CFR 664.200(c)(2)] Homeless, Runaway, or Foster Child [20 CFR 664.200(c)(3)] Pregnant or Parenting [20 CFR 664.200(c)(4)] Offender [20 CFR 664.200(c)(5)] Is an individual (including a youth with a disability) who requires additional assistance to complete an educational program, or to secure and hold employment [20 CFR 664.200(c)(6) and 20 CFR 664.210]Act 101(13)(c) 20 CFR 664.200(c)DISLOCATED WORKER ELIGIBILITYDISLOCATED WORKER [Act 101(9)] Any one of the five categories: Terminated/Laid Off; Eligible for UC and Unlikely to Return Permanent Closure/Substantial Layoff General Announcement of Closure Formerly Self-Employed/Currently Unemployed Displaced Homemaker [Act 101(10)] Act 101(9)(A); 20 CFR 663.115 Act 101(9)(B); 20 CFR 663.115 Act 101(9)(B); 20 CFR 663.115 Act 101(9)(C); 20 CFR 663.115 Act 101(9)(D); 20 CFR 663.120* Training funded with State Skills Grant or Blue Collar funds requires only general eligibility documentation. PURPOSE the Program Eligibility for Registration chart shows AT-A-GLANCE the Title I WIA eligibility criteria for the Adult (18 or older), Youth (1421), and Dislocated Worker programs. REGISTRATION the process for collecting information to support a determination of eligibility. [20 CFR 663.105 (Adult and Dislocated Worker); 20 CFR 664.215 (Youth)] DESCRIPTION: This chart is displayed as a four-column chart that consists of Eligibility, Adult (18 or older), Youth (1421), and Dislocated Worker programs. When an Act/Regulation Citation is listed in a specific column, the registered individual must meet the eligibility criteria if they are to receive staff-assisted core, intensive, and training services under WIA as an adult (18 or older) and/or dislocated worker. Likewise, a registered individual who is a youth must meet the youth eligibility criteria if they are to receive youth services. Blue Collar and State Skills Grant participants do not need to meet specific eligibility requirements unless specified in agreements/contracts. Participants are required at a minimum to document the General Eligibility Items. GENERAL INSTRUCTIONS: Eligibility column denotes the three areas for Eligibility (General, Economic, and Dislocated Worker). For General Eligibility Criteria, all registered individuals must meet the definition of Citizenship or Eligible to Work, Selective Service Registrant (if applicable), Residency, and Age. Adult (18 or older) column denotes the specific Act and Regulation Citation for eligibility under the Adult (18 or older) program. Registered adults (18 or older) must meet the definition of General Eligibility, which includes Citizenship or Eligible to Work, Selective Service Registrant (if applicable), Residency, and Age. Adults who receive services funded under Title I other than self-service or informational activities must be registered and determined eligible. [20 CFR 663.105(b)] Youth (1421) column denotes the specific Act and Regulation Citation for eligibility under the Youth (1421) program. Registered youth (1421) must meet the definition of General Eligibility, which includes Citizenship or Eligible to Work, Selective Service Registrant (if applicable), Residency, and Age, plus be a Low Income Individual and have one or more Barriers. If the youth does not meet the definition of low income and barriers, they must meet the definition of one or more of the categories listed under Exceptions. All youth participants must be registered. [20 CFR 664.215] Dislocated Worker column denotes the specific Act and Regulation Citation for eligibility under the Dislocated Worker program. Registered dislocated workers must meet the definition of General Eligibility, which includes Citizenship or Eligible to Work, Selective Service Registrant (if applicable), Residency, and any one of the five categories of Dislocated Worker. Dislocated workers who receive services funded under Title I other than self-service or informational activities must be registered and determined eligible. [20 CFR 663.105(b)] PARTICIPANT an individual who has registered under 20 CFR 663.105 or 20 CFR 664.215 and has been determined to be eligible to participate in and who is receiving services (except for follow-up services) under a program authorized by WIA Title I. Participation commences on the first day, following determination of eligibility, on which the individual begins receiving core, intensive, training, or other services provided under WIA Title I. [20 CFR 660.300] ACT AND/OR REGULATION CITATION Act 188(a)(5) Act 189(h) Act 101(1); 20 CFR 663.110 Act 134(d)(4)(E); 20 CFR 663.600 Delaware Workforce Investment Board (DWIB) PolicyWIA ELIGIBILITY STATEMENT ADULT (18 OR OLDER) An individual (18 or older) shall be eligible to participate in the WIA Title I Adult Program if such individual meets: General Eligibility consists of: Citizenship or Eligible to Work Selective Service Registrant (if applicable) Residency Age AND Unemployed, and, unable to obtain employment through core services, and, in need of more intensive services in order to obtain employment, and meets the definition of low-income individual, or Employed, but in need of intensive services in order to obtain or retain employment that allows for self-sufficiency. Self-sufficiency for WIA adult programs is a Total Family Income which exceeds 100% of the Lower Living Standard Income Level (LLSIL) NOTE: Priority shall be given to recipients of public assistance and other low-income individuals for intensive and training services. ADULT (18 or older) Individuals must meet General Eligibility, which consists of Citizenship or Eligible to Work, Age, Residency, and Selective Service Registration. Citizenship or Eligible to Work participation in programs and activities financially assisted in whole or part under WIA shall be open to citizens and nationals of the United States, lawfully admitted permanent resident immigrants, lawfully admitted refugees and parolees, and other individuals authorized by the Attorney General to work in the United States (applies to all programs under Title I). [Act 188(a)(5)] Selective Service Registrant the Secretary shall ensure that each individual participating in any program established under WIA, or receiving any assistance or benefit under WIA, has not violated Section 3 of the Military Selective Service Act (MSSA) (50 U.S.C. App. 453) by not presenting or submitting to registration as required pursuant to such section. The Director of the Selective Service System shall cooperate with the Secretary in carrying out this section. NOTE: Males born after December 31, 1959 must register with the selective service system within 30 days after their 18th birthday or at least before they reach the age of 26. [Act 189(h)] Procedures outlined in TEGL No. 11-11, Change 2 dated May 16, 2012 must be followed. Age the term adult means an individual who is age 18 or older. [Act 101(1) and 20 CFR 663.110]. Residency participation in a program administered by the DWIB / Delaware Department of Labor, Division of Employment and Training (DE DOL / DET) shall be open to all residents of Delaware. Residency is determined at time of application. Low Income Status employed but family income does not exceed 100% of the Lower Living Standard Income Level. ACT AND/OR REGULATION CITATION Act 188(a)(5) Act 189(h) Act 101(13)(A); 20 CFR 664.200(a) Act 101(25); 20 CFR 664.200(b) DWIB Policy Act 101(13)(c); 20 CFR 664.200(c) WIA ELIGIBILITY STATEMENT YOUTH (14 21) An individual who is not less than 14 and not more than 21 shall be eligible to participate in the WIA Title I Youth Program if such individual: Meets General Eligibility, which consists of providing a verification source for each applicable category: Citizenship or Eligible to Work Selective Service Registrant (if applicable) Residency Age AND Meets the definition and provides a verification source for one of the following Low-income categories: Cash Public Assistance Family Income at or below the Poverty Line or 70% of the Lower Living Standard Income Level (LLSIL) Receives Food Stamps or was determined eligible to receive in the last six months Homeless per 103(a) and 103(c) of the McKinney Act Publicly supported Foster Child Individual with a disability and own income at or below Poverty Line or 70% of the LLSIL AND Meets the definition and provides a verification source for one or more of the following Barrier categories: Basic Skills Deficient School Dropout Homeless, Runaway, or Foster Child Pregnant or Parenting Offender Is an individual (including a youth with a disability) who requires additional assistance to complete an educational program or to secure and hold employment YOUTH (14 21) Individuals must meet General Eligibility, which consists of Citizenship or Eligible to Work, Residency, Age, and Selective Service Registration. Citizenship or Eligible to Work participation in programs and activities financially assisted in whole or part under WIA shall be open to citizens and nationals of the United States, lawfully admitted permanent resident immigrants, lawfully admitted refugees and parolees, and other individuals authorized by the Attorney General to work in the United States (applies to all programs under Title I). [Act 188(a)(5)] Selective Service Registrant the Secretary shall ensure that each individual participating in any program established under WIA, or receiving any assistance or benefit under WIA, has not violated Section 3 of the Military Selective Service Act (MSSA) (50 U.S.C. App. 453) by not presenting or submitting to registration as required pursuant to such section. The Director of the Selective Service System shall cooperate with the Secretary in carrying out this section. Note: Males born after December 31, 1959 must register with the selective service system within 30 days after their 18th birthday or at least before they reach the age of 26. [Act 189(h)] Procedures outlined in TEGL No. 11-11, Change 2 dated May 16, 2012 must be followed. Age for youth is not less than age 14 and not more than age 21 [Act 101(13) and 20 CFR 664.200(a)] Residency participation in a program administered by the DWIB / Delaware Department of Labor, Division of Employment and Training (DE DOL / DET) shall be open to all residents of Delaware. Residency is determined at time of application. An exception to Delaware residency may be permissible if the youth is enrolled in a Delaware school and lives in a town split by state boundaries (for example Delmar and Marydel). Youth must meet the definition of one of the six Low-income categories AND must meet the definition of one of the six youth Barriers. Low-income Individual an individual who receives, or is a member of a family that receives cash payments under a Federal, State, or local income-based public assistance program; received an income, or is a member of a family that received a total family income, for the six-month period prior to application for the program involved (exclusive of unemployment compensation, child support payments, payments described in subparagraph (A), and old-age and survivors insurance benefits received under Section 202 of the Social Security Act (42 U.S.C. 402) that, in relation to family size, does not exceed the higher of (i) the poverty line, for an equivalent period; or YOUTH (14 21) (continued) (ii) 70 percent of the lower living standard income level for an equivalent period; is a member of a household that receives (or has been determined within the six month period prior to application for the program involved to be eligible to receive) food stamps pursuant to the Food Stamp Act of 1977 (7 U.S.C. 2011 et seq.); qualifies as a homeless individual, as defined in subsections (a) and (c) of Section 103 of the Stewart B. McKinney Homeless Assistance Act (42 U.S.C. 11302); is a foster child on behalf of whom State or local government payments are made; or in cases permitted by regulations promulgated by the Secretary of Labor, is an individual with a disability whose own income meets the requirements of a program described in subparagraph (A) or of subparagraph (B), but who is a member of a family whose income does not meet such requirements. BARRIERS A low-income youth (14 21) who has one or more of the following barriers: Deficient in Basic Literacy Skills an individual who Computes or solves problems, reads, writes, or speaks English at or below the 8th grade level on a generally accepted standardized test or a comparable score on a criterion-referenced test; or Is unable to compute or solve problems, read, write, or speak English at a level necessary to function on the job, in the individuals family or in society. School Dropout an individual who is no longer attending any school and who has not received a secondary school diploma or its recognized equivalent. Homeless, Runaway Youth, or Foster Child Homeless qualifies as a homeless individual that is an individual who lacks a fixed regular, adequate nighttime residence, and any adult or youth who has a primary nighttime residence that is a publicly or privately operated shelter for temporary accommodation; an institution providing a temporary residence for individuals intended to be institutionalized; or a public or private place not designed for or ordinarily used as a regular sleeping accommodation for human beings. The term does not include a person imprisoned or detained pursuant to an Act of Congress or State law (Section 103 of the Stewart B. McKinney Act); or is a runaway youth. Runaway Youth a youth (1418) who absents himself or herself from home or place of legal residence without the permission of parents or legal guardian. YOUTH (14 21) (continued) Foster Child a foster child is an individual on behalf of who State or local government payments are made. Pregnant or Parenting Youth an individual who is under 22 years of age and who is pregnant, or a youth (male or female) who is providing custodial care for one or more dependents under age 18. Offender any adult or juvenile who is or has been subject to any stage of the criminal justice process, for whom services under this Act may be beneficial; or who requires assistance in overcoming artificial barriers to employment resulting from a record of arrest or conviction. An individual (including youth with a disability) who requires additional assistance to complete an educational program, or to secure and hold employment definitions and eligibility verification requirements regarding the requires additional assistance to complete an educational program, or to secure and hold employment criterion must documented and rationale provided for each youth using this barrier for eligibility. ACT AND/OR REGULATION CITATION Act 188(a)(5) Act 189(h) 20 CFR 663.110 DWIB Policy Act 101(9)(A); 20 CFR 663.115 Act 101(9)(B); 20 CFR 663.115 Act 101(9)(B); 20 CFR 663.115 Act 101(9)(C); 20 CFR 663.115 Act 101(9)(D); 20 CFR 663.120 WIA ELIGIBILITY STATEMENT DISLOCATED WORKER An individual shall be eligible to participate in the WIA Title I Dislocated Worker Program if such individual: Meets General Eligibility, which consists of providing the appropriate verification to verify: Citizenship or Eligible to Work Selective Service Registrant (if applicable) Residency Age AND Meets the definition and provides the verification source for one of the following categories: Terminated/Laid Off; Eligible for UC and Unlikely to Return to Previous Industry or Occupation Permanent Closure/Substantial Layoff General Announcement of Closure Formerly Self-Employed/Currently Unemployed Displaced Homemaker DISLOCATED WORKER Individuals must meet General Eligibility, which consists of Citizenship or Eligible to Work, Residency, Age, and Selective Service Registration. Citizenship or Eligible to Work participation in programs and activities financially assisted in whole or part under WIA shall be open to citizens and nationals of the United States, lawfully admitted permanent resident immigrants, lawfully admitted refugees and parolees, and other individuals authorized by the Attorney General to work in the United States (applies to all programs under Title I). [Act 188(a)(5)] Selective Service Registrant the Secretary shall ensure that each individual participating in any program established under WIA, or receiving any assistance or benefit under WIA, has not violated Section 3 of the Military Selective Service Act (MSSA) (50 U.S.C. App. 453) by not presenting or submitting to registration as required pursuant to such section. The Director of the Selective Service System shall cooperate with the Secretary in carrying out this section. NOTE: Males born after December 31, 1959 must register with the selective service system within 30 days after their 18th birthday or at least before they reach the age of 26. [Act 189(h)] Procedures outlined in TEGL No. 11-11, Change 2 dated May 16, 2012 must be followed. Age to be eligible for the dislocated worker program, an individual must be 18 years of age or older. [20 CFR 663.110] Residency participation in a program administered by the DWIB / Delaware Department of Labor, Division of Employment and Training (DE DOL / DET) shall be open to all residents of Delaware. Residency is determined at the time of application. Unemployed unemployed and unable to obtain employment through core services and in need of more intensive services in order to obtain employment A dislocated worker must meet the definition of one of the five dislocated worker categories. A dislocated worker is an individual who has been: Terminated/Laid Off and Eligible for UC and Unlikely to Return has been terminated or laid off, or who has received a notice of termination or layoff, from employment and is eligible for or has exhausted entitlement to unemployment compensation; OR has been employed for a duration sufficient to demonstrate, to the appropriate entity at a one-stop center referred to in Section 134(c), attachment to the workforce, but is not eligible for unemployment compensation due to insufficient earnings or having performed services for an employer that was not covered under a State unemployment compensation law and is unlikely to return to a previous industry or occupation; Permanent Closure/Substantial Layoff has been terminated or laid off, or has received a notice of termination or layoff, from employment as a result of any permanent closure of, or any substantial layoff at, a plant, facility, or enterprise; General Announcement of Closure is employed at a facility at which the employer has made a general announcement that such facility will close within 180 days; or for purposes of eligibility to receive services other than training services described in Section 134(d)(4), intensive services described in Section 134(d)(3), or supportive services, is employed at a facility at which the employer has made a general announcement that such facility will close; Formerly Self-Employed/Currently Unemployed was self-employed (including employment as a farmer, a rancher, or a fisherman) but is unemployed as a result of general economic conditions in the community in which the individual resides or because of natural disasters; or Displaced Homemaker an individual who has been providing unpaid services to family members in the home and who has been dependent on the income of another family member but is no longer supported by that income; AND is unemployed or underemployed and is experiencing difficulty in obtaining or upgrading employment. Underemployment for WIA Displaced Homemaker programs shall be determined relative to a Total Family Income, which does not exceed 100% of the LLSIL. Additional Definition For the purpose of all dislocated worker categories except Displaced Homemaker the following definition of employed applies: Employed, but in need of intensive services in order to obtain or retain employment that allows for self sufficiency. Self-sufficiency for employed Dislocated Worker Program participants shall be determined by whether or not their current wage exceeds 90% of the layoff wage. ACT AND/ OR POLICY CITATION Delaware Blue Collar Jobs Act Delaware Workforce Investment Board (DWIB) Policy ELIGIBILITY STATEMENT An individual shall be eligible to participate in the State Blue Collar and Skills Grant Programs if such individual meets: General Eligibility consists of: Citizenship or Eligible to Work Selective Service Registrant (if applicable) Residency Age Individuals must meet General Eligibility, which consists of Citizenship or Eligible to Work, Residency, Age, and Selective Service Registration. Citizenship or Eligible to Work participation in programs and activities financially assisted in whole or part under DWIB / DE DOL / DET shall be open to citizens and nationals of the United States, lawfully admitted permanent resident immigrants, lawfully admitted refugees and parolees, and other individuals authorized by the Attorney General to work in the United States (applies to all programs under Blue Collar). Selective Service Registrant the Secretary shall ensure that each individual participating in any program established under DWIB / DE DOL / DET or receiving any assistance or benefit under Blue Collar, has not violated Section 3 of the Military Selective Service Act (MSSA) (50 U.S.C. App. 453) by not presenting or submitting to registration as required pursuant to such section. The Director of the Selective Service System shall cooperate with the Secretary in carrying out this section. Note: Males born after December 31, 1959 must register with the selective service system within 30 days after their 18th birthday or at least before they reach the age of 26. Age Not less than age 14 and not more than age 21 (Youth Programs) or any age beyond 14 (Adult Programs). Residency participation in a program administered by the DWIB / Delaware Department of Labor, Division of Employment and Training (DE DOL / DET) shall be open to all residents of Delaware. Residency is determined at time of application. An exception to Delaware residency may be permissible if the youth is enrolled in a Delaware school and lives in a town split by state boundaries (for example Delmar and Marydel). Additional exceptions to Delaware residency may be permissible if approved by DET/DWIB. SELECTIVE SERVICE REGISTRATION In accordance with Section 189(h) of the Workforce Investment Act, which states that the U.S. Secretary of Labor shall insure that each individual participating in any program established under this Act, has not violated Section 3 of the Military Selective Service Act (50 U.S.C. App. 453) by not presenting and submitting to registration as required pursuant to such section. WHO MUST REGISTER Almost all male U.S. Citizens and male immigrants living in the U.S., who are 18 through 25, are required to register with Selective Service. Its important to know that even though he is registered, a man will not automatically be inducted into the military. In a crisis requiring a draft, men would be called in sequence determined by random lottery number and year of birth. Then, they would be examined for mental, physical, and moral fitness by the military before being deferred or exempted from military service or inducted into the Armed Forces. A chart of who must register is available on page three of Attachment C. NON-CITIZENS Some non-citizens are required to register. Others are not. Non-citizens who are not required to register with Selective Service include men who are in the U.S. on student or visitor visas and men who are part of a diplomatic or trade mission and their families. Almost all other male non-citizens are required to register, including undocumented immigrants, legal permanent residents, and refugees. The general rule is that if a male non-citizen takes up residency in the U.S. before his 26th birthday, he must register with Selective Service. For a more detailed list of which non-citizens must register, see the Who Must Register for Selective Service Chart. DUAL NATIONALS Dual nationals of the U.S. and another country are required to register, regardless of where they live, because they are U.S. nationals. HOSPITALIZED OR INCARCERATED MEN Young men in hospitals, mental institutions, or prisons do not have to register while they are committed. However, they must register within 30 days after being released if they have not yet reached their 26th birthday. DISABLED MEN Disabled men who live at home must register with Selective Service if they can reasonably leave their homes and move about independently. A friend or relative may help a disabled man fill out the registration form if he cant do it himself. Men with disabilities that would disqualify them from military service still must register with Selective Service. Selective Service does not presently have authority to classify men, so even men with obvious handicaps must register now, and if needed, classifications would be determined later. FULL-TIME MILITARY EXEMPTED FROM REQUIREMENT Young men serving in the military on full-time active duty do not have to register. Those attending the service academies do not have to register. If a young man leaves the military before turning 26, he must register. NATIONAL GUARD AND RESERVES Members of the Reserve and National Guard not on full-time active duty must register. CONSCIENTIOUS OBJECTORS Men who would be classified as conscientious objectors if they were drafted must also register with Selective Service. If a draft begins and they are called, they would have the opportunity to file a claim for exemption from military service based upon their religious or moral objection to war. If a male is not required to register, his is still eligible for services. His qualifying reason for not registering (i.e. non-citizen takes up residency after his 26th birthday) must be documented. For information on selective service regulations, please refer to the following: TEGL 11-11, Change 2 (dated May 16, 2012) Selective Service Registration Requirements for Employment and Training Administration Funded Programs Selective Service Telephone Verification No. (847) 688-6888 or toll-free: (888) 655-1825 TTY: (847) 688-2567 Hours of operation: 8:00 a.m. to 3:30 p.m., Central Time. Have your date of birth and social security number handy Internet Verification/Registration (HYPERLINK "http://www.sss.gov"www.sss.gov). WHO MUST REGISTER FOR SELECTIVE SERVICE? With only a few exceptions, the registration requirement applies to all male U.S. citizens and male immigrants residing in the United States who are 18 through 25 years of age. CategoryYesNoAll male U.S. citizens born after December 31, 1959, who are 18 but not yet 26 years old, except as noted below:XMilitary Related Members of the Armed Forces on active duty (active duty for training does not constitute active duty for registration purposes)X*Cadets and Midshipmen at Service Academies or Coast Guard AcademyX*Cadets at the Merchant Marine AcademyXStudents in Officer Procurement Programs at the Citadel, North Georgia College and State University, Norwich University, Virginia Military Institute, Texas A&M University, Virginia Polytechnic Institute and State UniversityX*National Guardsmen or Reservists not on active dutyXDelayed Entry Program enlisteesXROTC StudentsXSeparatees from Active Military Service, separated for any reason before age 26 X*Men rejected for enlistment for any reason before age 26XCivil Air Patrol membersXImmigrants** Lawful non-immigrants on visas (e.g., diplomatic and consular personnel and families, foreign students, tourists with unexpired Forms I-94 or Border Crossing Documents DSP-150XPermanent resident immigrants (USCIS Form I-551)XSpecial agricultural workers XSeasonal agricultural workers (H-2A Visa) XRefugee, parolee, and asylee immigrantsXUndocumented immigrantsXDual national U.S. citizensXConfined Incarcerated, hospitalized, or institutionalized for medical reasonsX*Handicapped physically or mentally Able to function in public with or without assistanceX Continually confined to a residence, hospital, or institutionX* MUST register within 30 days of release unless already age 26 NOTE: To be fully exempt you must have been on active duty or confined continuously from age 18 to 25 ** Residents of Puerto Rico, Guam, Virgin Islands, and Northern Mariana Islands are U.S. citizens. Citizens of American Samoa are nationals and must register when they are habitual residents in the United States. Habitual residence is presumed whenever a national or a citizen of the Republic of the Marshall Islands or the Federated States of Micronesia resides in the United States for more than one year in any status, except as a student or employee of the government of his homeland. NOTE: Immigrants who did not enter the United States or maintained their lawful non-immigrant status by continually remaining on a valid visa until after they were 26 years old, were never required to register. Also, immigrants born before 1960, who did not enter the United States or maintained their lawful non-immigrant status by continually remaining on a valid visa until after March 29, 1975, were never required to register. Adult except in Sections 127 and 132, an adult is an individual with an age of 18 or older. [Act 101(1) and 20 CFR 663.110] Age the term adult means an individual who is age 18 or older [Act 101(1) and 20 CFR 663.110]; for youth age is not less than 14 and not more than 21 [Act 101(13) and 20 CFR 664.200(a)]. Basic Skills Deficient an individual who computes or solves problems, reads, writes, or speaks English at or below the 8th grade level on a generally accepted standardized test or a comparable score on a criterion-referenced test; or is unable to compute or solve problems, read, write, or speak English at a level necessary to function on the job, in the individuals family or in society. [Act 101(19); Act 203(12); and 20 CFR 664.205] Behind Grade Level individuals with educational attainment that is one or more grade levels below the grade level appropriate to the age of the individual. [Act 129(C)(5)] When determining the level of deficiency for a youth participant, it is essential to determine the grade level at which they should be functioning. In order to enter the first grade, a child must be six years old on or before September 1st. Cash Public Assistance an individual who is listed on the grant and/or is receiving assistance under any of the following programs at any time during participation. Temporary Assistance to Needy Families (TANF) General Assistance (GA) (State/local government) Refugee Cash Assistance (RCA) Supplemental Security Income (SSI-SSA Title XVI) Public assistance recipients may also include participants, who were referred by the TANF agency, participated in the TANF assessment program as a requirement prior to opening a TANF grant, and who received support services from the TANF agency. [Training and Employment Guidance Letter (TEGL) No. 14-00, Change 1, Attachment E] Citizenship/Eligible to Work participation in programs and activities financially assisted in whole or part under WIA shall be open to citizens and nationals of the United States, lawfully admitted permanent resident immigrants, lawfully admitted refugees and parolees, and other individuals authorized by the in the United States (applies to all programs under Title I Attorney General to work). [Act 188(a)(5)] Corroborative Witness a person who personally knows or can identify the WIA applicant and who is reasonably likely to be able to verify the applicants statement on the Statement of Family Size/Family Income Form. The witness signing the Statement of Family Size/Family Income Form may accomplish such verification. [See Attachment H of WIIN 3-99, Change 2] Dislocated Worker an individual who (i) has been terminated or laid off, or who has received a notice of termination or layoff from employment; (ii) (I) is eligible for or has exhausted entitlement to unemployment compensation; or (II) has been employed for a duration sufficient to demonstrate to the appropriate entity at a one-stop center, referred to in Section 134(c), attachment to the workforce, but is not eligible for unemployment compensation due to insufficient earnings or having performed services for an employer that was not covered under a State unemployment compensation law; AND (iii) is unlikely to return to a previous industry or occupation. (i) has been terminated or laid off, or has received a notice of termination or layoff from employment as a result of any permanent closure of, or any substantial layoff at, a plant, facility, or enterprise; (ii) is employed at a facility at which the employer has made a general announcement that such facility will close within 180 days; OR (iii) for purposes of eligibility to receive services other than training services described in Section 134(d)(4), intensive services described in Section 134(d)(3), or supportive services, is employed at a facility at which the employer has made a general announcement that such facility will close. was self-employed (including employment as a farmer, a rancher, or a fisherman), but is unemployed as a result of general economic conditions in the community in which the individual resides or because of natural disasters; OR is a displaced homemaker. [Act 101(9)] Displaced Homemaker an individual who has been providing unpaid services to family members in the home and who has been dependent on the income of another family member but is no longer supported by that income; AND is unemployed or underemployed and is experiencing difficulty in obtaining or upgrading employment. [Act 101(10)] Documentation to maintain physical evidence which is obtained during the verification process in participant files. Such evidence would be copies of documents, completed telephone/document inspection forms and signed self-certification statement. Eligible Youth an individual who is not less than age 14 and not more than age 21; is a low-income individual; and is an individual who has one or more of the following barriers: deficient in basic literacy skills; a school dropout; homeless, a runaway, or a foster child; pregnant or a parent; an offender; an individual (including a youth with a disability) who requires additional assistance to complete an educational program, or to secure and hold employment (see definition below). [Act 101(13)] A youth who requires additIonal assistance to complete school is defined by the Delaware Workforce Inverstment Board as: An individual whose educational level is two or more grade levels below the grade level appropriate to the age of the individual An individual identified as at risk in TEGL 03-04 & TEGL 28-05 not specifically identified in Section 101 (13) (c) including youth at risk of dropping out, dropouts, aging out of foster care, court involved youth, children of incarcerated parents, migrants, Indian and Native American youth and youth with disabilities. Emancipated Youth a youth who at time of eligibility determination was 19 or older and who was 19 or older on the previous January 1, except full time students. At time of eligibility determination was 18 or older and who was 18 or older on the previous January 1, except full time students, that on their tax return for the most recent year, claimed themselves. Other youth may be determined to be emancipated due to their family status, personal income and housing arrangements etc. (This is subject to a reasonable person test, requires documentation, and is solely the responsibility of the contractor (See definition of family for additional information)). Employed at Registration an employed individual is currently working as a paid employee or who works in his or her own businesses or profession or on his or her own farm, or works 15 hours or more per week as an unpaid worker on a farm or in an enterprise operated by a member of the family, or is one who is not working, but has a job or business from which he or she was temporarily absent because of illness, bad weather, vacation, labor-management dispute, or personal reasons, whether or not paid by the employer for time-off, and whether or not seeking another job. [Training and Employment Guidance Letter (TEGL) No. 14-00, Change 1, Attachment E] Exceptions/Youth Only up to five percent of youth participants served by youth programs in a local area may be individuals who do not meet the income criterion for eligible youth provided that they are within one or more of the following categories. (This is only available when it is specifically identified in the agreement / contract). School Dropout; Basic Skills Deficient; Are one or more grade levels below the grade level appropriate to the individuals age; Pregnant or Parenting Possess one or more disabilities, including learning disabilities; Homeless or Runaway; Offender; or Face Serious Barriers to employment as identified by the Local Board. [20 CFR 664.220 and Act 129(c)(2)(5)] Family two or more persons related by blood, marriage, or decree of court, who are living in a single residence, and are included in one or more of the following categories: A husband, wife, and dependent children. A parent or guardian and dependent children. A husband and wife. [Act 101(15)] A dependent child is defined as a child: Under age 19 at the end of the previous calendar year; or Under age 24 at the end of the previous calendar year and was a student. A dependent child was a student if he or she: Was enrolled as a full-time student at a school during any 5 months of the previous calendar year or took a full-time, on-farm training course during any 5 months of the previous calendar year. The course had to be given by a school or a state, county or local government agency. A school includes technical, trade and mechanical schools. It does not include on-the-job training courses or correspondence schools. Also, regardless of residence and/or citizenship, anyone claimed as a dependent on another persons Federal Income Tax return for the previous year shall be presumed to be part of the persons family for the current year. To negate this assumption, the person who was claimed as a dependent for income tax purposes would be required to provide information that demonstrates the individual is no longer financially dependent. In applying the definition of family, runaway youth, emancipated youth, and court adjudicated youth separated from the family through involuntary temporary residence elsewhere (e.g., institutionalized, incarcerated, or placed as a result of a court order) shall not be classified as dependent children. Individual with a disability and own income at or below the Poverty Line or 70% of the Lower Living Standard Income Level. [20 CFR 663.640 Adult; 20 CFR 664.250 Youth] Family Income for the purpose of determining WIA income eligibility. List the total income received by you and members of your family from (1) gross wages and salaries (before deductions); (2) net self-employment income (gross receipts minus operating expenses); and (3) other money income from sources such as net rents, social security, pensions, alimony, government and armed forces retirement payments, insurance policy annuities, and other sources of periodic income. Inclusions for Family Income Money wages and salaries before any deductions; WIA OJT wage payments to participants; Disaster Relief Employment Wages; Net receipts from non-farm self-employment (receipts from a persons own unincorporated business, professional enterprise, or partnership after deductions for business expense); Net receipts from farm self-employment (receipts from a farm which one operates as an owner, renter, or sharecropper, after deductions for farm operating expenses); Regular payments from social security, railroad retirement, strike benefits from union funds, workers compensation (public/private), and training stipends; Alimony; Military family allotments or other regular support from an absent family member or someone not living in the household; Pensions whether private government employee (including military retirement pay); Regular insurance or annuity payments; College or university grants, fellowships and assistantships; Dividends, interest, net rental income, net royalties, periodic receipts from estates or trust; Net gambling or lottery winnings; Net self-employment income (gross receipts minus operating expenses). Exclusions for Family Income Unemployment compensation; [Act 101(25)(B)] Child support payments; [Act 101(25)(B)] Cash welfare payments (including TANF, SSI, RCA, GA); [Act 101(25)(B)] Old Age and Survivors Insurance (OASI) benefits received under Section 202 of the Social Security Act (42 U.S.C. 402); [Act 101(25)(B)] Foster care payments; [Act 101(25)(B)] Needs-based scholarship assistance; Financial assistance under Title IV of the Higher Education Act, i.e., Pell Grants, Federal Supplemental Educational Opportunity Grants and Federal Work Study, PLUS, Stafford and Perkins loans like any other kind of loan are debt and not income; Income earned while the veteran was on active military duty and certain other veterans benefits, i.e., compensation for service-connected disability, compensation for service-connected death, vocational rehabilitation, and education assistance; Tax refunds, gifts, loans, lump-sum inheritances, one-time insurance payments, or compensation for injury; Any assets drawn down as withdrawals from a bank, the sale of property, a house or a car; IRA withdrawals; Capital gains; Non-cash benefits such as employer-paid fringe benefits, food or housing received in lieu of wages, Medicare, Medicaid, food stamps, school meals, and housing assistance; WIA payments to participants (except OJT wages) shall not be considered as income for the purposes of determining eligibility. NOTE: When a federal statute specifically provides that income or payments received under such statute shall be excluded in determining eligibility for the level of benefits received under any other federal statute, such income or payments shall be excluded in WIA eligibility determination. Follow-up Services (Adult and Dislocated Worker) follow-up services, including counseling regarding the workplace, for participants in workforce investment activities authorized under subtitle (B) of Title I of WIA who are placed in unsubsidized employment, for not less than 12 months after the first day of the employment, as appropriate. [20 CFR 662.240(b)(11)] Follow-up Services (Youth) follow-up services for youth may include: leadership development and supportive service activities listed in 20 CFR 664.420 and 20 CFR 664.440; regular contact with a youth participants employer, including assistance in addressing work-related problems that arise; assistance in securing better paying jobs, career development and further education; work-related peer support groups; adult mentoring; and tracking the progress of youth in employment after training. All youth participants must receive some form of follow-up services for a minimum duration of 12 months. Follow-up services may be provided beyond 12 months at the State or Local Boards discretion. The types of services provided and the duration of services must be determined based on the needs of the individual. The scope of these follow-up services may be less intensive for youth who have only participated in summer youth employment opportunities. [20 CFR 664.450] Food Stamps is a member of a household that receives (or has been determined within the 6-month period prior to application for the program involved to be eligible to receive) food stamps pursuant to the Food Stamp Act of 1977. [Act 101(25)(C)] Foster Child a foster child is an individual on behalf of whom state or local government payments are made. [Act 101(25)(E)] Homeless an individual who lacks a fixed regular, adequate night time residence; and any individual who has a primary night time residence that is: A publicly or privately operated shelter for temporary accommodation; An institution providing temporary residence for individuals intended to be institutionalized; or A public or private place not designated for or ordinarily used as a regular sleeping accommodation for human beings. The term homeless does not include a person imprisoned or detained pursuant to an Act of Congress or State law. [Section 103(a) and Section 103(c) of the Stewart B. McKinney Act] Individual with a Disability means an individual with any disability (as defined in Section 3 of the Americans with Disabilities Act of 1990 (42 U.S.C. 12102)). [Act 101(17)] Disability means, with respect to an individual, a physical or mental impairment that substantially limits one or more of the major life activities of such individual; a record of such an impairment; or being regarded as having such an impairment. (i) The phrase physical or mental impairment means any physiological disorder or condition, cosmetic disfigurement, or anatomical loss affecting one or more of the following body systems: neurological, musculoskeletal, special sense organs, respiratory (including speech organs), cardiovascular, reproductive, digestive, genitourinary, hemic and lymphatic, skin, and endocrine. any mental or psychological disorder such as mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities. The phrase physical or mental impairment includes, but is not limited to, such contagious and non-contagious diseases and conditions as orthopedic, visual, speech and hearing impairments, cerebral palsy, epilepsy, muscular dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, specific learning disabilities, HIV disease (whether symptomatic or asymptomatic), tuberculosis, drug addiction, and alcoholism. The phrase physical or mental impairment does not include homosexuality or bisexuality. The phrase major life activities means functions such as caring for ones self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working. The phrase has a record of such an impairment means has a history of, or has been misclassified as having, a mental or physical impairment that substantially limits one or more major life activities. The phrase is regarded as having an impairment means: has a physical or mental impairment that does not substantially limit major life activities but that is treated by the recipient as being such a limitation; has a physical or mental impairment that substantially limits major life activities only as a result of the attitudes of others toward such impairment; or has none of the impairments defined in paragraph (1) of this definition but is treated by the recipient as having such an impairment. [20 CFR 37.4] The following questions and answers are in regard to disabled individuals and can be found in 20 CFR 663.640 (Adult) and 20 CFR 664.250 (Youth) of the Final Rules. 20 CFR 663.640 May an individual with a disability whose family does not meet income eligibility criteria under the Act be eligible for priority as a low-income adult? Yes. Even if the family of an individual with a disability does not meet the income eligibility criteria, the individual with a disability is to be considered a low-income individual if the individuals own income: meets the income criteria established in WIA section 101(25)(B); or meets the income eligibility criteria for cash payments under any Federal, State or local public assistance program. (WIA section 101(25)(F)) 20 CFR 664.250 May a disabled youth whose family does not meet income eligibility criteria under the Act be eligible for youth services? Yes. Even if the family of a disabled youth does not meet the income eligibility criteria, the disabled youth may be considered a low-income individual if the youths own income: meets the income criteria established in WIA section 101(25)(B); or meets the income eligibility criteria for cash payments under any Federal, State or local public assistance program. (WIA section 101(25)(F)) Individual Service Strategy (ISS) The individual employment plan is an ongoing strategy jointly developed by the participant and the case manager that identifies the participants employment goals, the appropriate achievement objectives, and the appropriate combination of services for the participant to achieve the employment goals. [20 CFR 663.245] Individual Who Requires Additional Assistance Definitions and eligibility verification requirements regarding the requires additional assistance to complete an educational program, or to secure and hold employment criterion of 20 CFR 664.200(c)(6) must be specified in the agreement / contract. [20 CFR 664.210] Literacy An individuals ability to read, write, and speak in English, and to compute and solve problems at levels of proficiency necessary to function on the job, in the family of the individual, and in society. [Act 203(12); 20 CFR 660.300] Local Board A local workforce investment board established under WIA section 117 to set a policy for the local workforce investment system. [20 CFR 660.300] Lower Living Standard Income Level (LLSIL) The income level (adjusted for regional, metropolitan, urban, and rural differences and family size) determined annually by the Secretary of the U.S. Department of Labor based on the most recent lower living family budget issued by the Secretary. [See Attachment E of WIIN 3-99, Change 2] Low-income Individual An individual who receives, or is a member of a family that receives, cash payments under a Federal, State, or local income-based public assistance program; received an income, or is a member of a family that received a total family income, for the six month period prior to application for the program involved (exclusive of unemployment compensation, child support payments, payments described in subparagraph (A), and old-age and survivors insurance benefits received under Section 202 of the Social Security Act (42 U.S.C. 402)) that, in relation to family size, does not exceed the higher of the Poverty Line for an equivalent period; or 70 percent of the Lower Living Standard Income Level (LLSIL) for an equivalent period; is a member of a household that receives (or has been determined within the six month period prior to application for the program involved to be eligible to receive) food stamps pursuant to the Food Stamp Act of 1977 (7 U.S.C. 2011 et seq.); qualifies as a homeless individual, as defined in subsections (a) and (c) of Section 103 of the Stewart B. McKinney Homeless Assistance Act (42 U.S.C. 11302); is a foster child on behalf of whom State or local government payments are made; or in cases permitted by regulations promulgated by the Secretary of Labor, is an individual with a disability whose own income meets the requirements of a program described in subparagraph (A) or of subparagraph (B), but who is a member of a family whose income does not meet such requirements. [Act 101(25)] Not Employed at Registration An individual who does not meet the definition of employed or who, although employed, has received notice of termination of employment. [Training and Employment Guidance Letter (TEGL) No. 14-00, Change 1, Attachment E] Offender An individual who is or has been subject to any stage of the criminal justice process for whom services under WIA may be beneficial; or who requires assistance in overcoming artificial barriers to employment resulting from a record of arrest or conviction. [Act 101(27)] Out-of-School Youth An eligible youth, at the time of registration, who is a school dropout or who has received a secondary school diploma or its equivalent but is basic skills deficient, unemployed, or underemployed. [Act 101(33)] An individual who is out-of-school at any time, has not received a secondary school diploma or its recognized equivalent and then enrolled in an alternative school, may be considered an out-of-school youth. [20 CFR 664.310] Participant An individual who has registered under 20 CFR 663.105 or 20 CFR 664.215 and has been determined to be eligible to participate in and who is receiving services (except for follow-up services) under a program authorized by WIA Title I. Participation commences on the first day, following determination of eligibility, on which the individual begins receiving other core, intensive, training or other services provided under WIA Title I. [Act 101(34); 20 CFR 660.300] Pregnant or Parenting Youth An individual who is under 22 years of age and who is pregnant, or a youth (male or female) who is providing custodial care for one or more dependents under age 18. [Training and Employment Guidance Letter (TEGL) No. 14-00, Change 1, Attachment E] Poverty Guidelines are issued by the Department of Health and Human Services and are used for administrative purposes for instance, for determining whether a person or family is financially eligible for assistance or services under a particular Federal program. [Federal Register, Volume 78, Number 16, January 24, 2013, pp. 5182 5183; See Attachment E of WIIN 3-99, Change 2] Poverty Line The poverty line (as defined by the Office of Management and Budget, and revised annually in accordance with Section 673(2) of the Community Services Block Grant Act (42 U.S.C. 9902(2)) applicable to a family of the size involved. [Act 101(36)] Priority Policy (for intensive and training services) If funds are limited, priority shall be given to recipients of public assistance and other low-income individuals for intensive and training services. [20 CFR 663.600 and Act 134(d)(4)(E)] Funds allocated for dislocated workers, blue collar, or skills grant are not subject to this requirement. Public Assistance Federal, State, or local government cash payments for which eligibility is determined by a needs or income test. [Act 101(37)] Public Assistance Recipient A participant who is listed on the grant and/or is receiving assistance under any of the following programs at any time during participation. Temporary Assistance to Needy Families (TANF) General Assistance (GA) (State/local government) Refugee Cash Assistance (RCA) Supplemental Security Income (SSI-SSA Title XVI) Public assistance recipients may also include participants who were referred by the TANF agency, participated in the TANF assessment program as a requirement prior to opening a TANF grant, and who received support services from the TANF agency. [Training and Employment Guidance Letter (TEGL) No. 14-00, Change 1, Attachment E] Register The process for collecting information to determine an individuals eligibility for services under WIA Title I. Individuals may be registered in a variety of ways as described in 20 CFR 663.105 and 20 CFR 664.215. [20 CFR 660.300] Registration (Adults and Dislocated Workers) Registration is the process for collecting information to support a determination of eligibility. This information may be collected through methods that include electronic data transfer, personal interview, or an individuals application. Adults and dislocated workers who receive services funded under Title I other than self-service or informational activities must be registered and determined eligible. EO data must be collected on every individual who is interested in being considered for WIA Title I financially assisted aid, benefits, services, or training by a recipient, and who has signified that interest by submitting personal information in response to a request from the recipient. [20 CFR 663.105] Registration (Youth) All youth participants must be registered. Registration is the process of collecting information to support a determination of eligibility. EO data must be collected on individuals during the registration process. [20 CFR 664.215] Runaway Youth A youth (14 18) who absents himself or herself from home or place of legal residence without the permission of parents or legal guardian. School Dropout An individual who is no longer attending any school and who has not received a secondary school diploma or its recognized equivalent. [Act 101(39)] Selective Service Registrant The Secretary shall ensure that each individual participating in any program established under WIA, or receiving any assistance or benefit under WIA, has not violated Section 3 of the Military Selective Service Act (MSSA) (50 U.S.C. App. 453) by not presenting or submitting to registration as required pursuant to such section. The Director of the Selective Service System shall cooperate with the Secretary in carrying out this section. NOTE: Males born after December 31, 1959 must register with the selective service system within 30 days after their 18th birthday or at least before they reach the age of 26. [Act 189(h)] Procedures outlined in TEGL No. 11-11, Change 2 dated May 16, 2012 must be followed. [See Attachment C of WIIN 3-99, Change 2] Self-Certification An individuals signed attestation that the information he/she submits to demonstrate eligibility for a program under Title I of WIA is true and accurate. [20 CFR 660.300] Self-Sufficiency Local boards must set the criteria for determining whether employment leads to self-sufficiency. At a minimum, such criteria must provide that self-sufficiency means employment that pays at least the lower living standard income level, as defined in WIA Section 101(24). Self-sufficiency for a dislocated worker may be defined in a relation to a percentage of the layoff wage. The special needs of individuals with disabilities or other barriers to employment should be taken into account when setting criteria to determine self-sufficiency. Self-sufficiency may be defined differently for an adult and a dislocated worker. The self-sufficiency definition can be found in your Local Plan. [20 CFR 663.230] Supportive Services Services such as transportation, child care, dependent care, housing, and needs-related payments that are necessary to enable an individual to participate in activities authorized under this title, consistent with the provisions of this title. [Act 101(46); Also see Youth Supportive Services] Underemployed Occurs when an individual who is working part-time but desires full-time employment, or who is working in employment not commensurate with the individuals demonstrated level of educational attainment. [Training and Employment Guidance Letter (TEGL) No. 14-00, Change 1] Verification To confirm eligibility requirements through examination of official documents (e.g., birth certificates, public assistance records, or speaking with official representatives of cognizant agencies). Youth Leadership Development Opportunities Leadership development opportunities are opportunities that encourage responsibility, employability, and other positive social behaviors such as: Exposure to postsecondary educational opportunities; Community and service learning projects; Peer-centered activities, including peer mentoring and tutoring; Organizational and team work training, including team leadership training; Training in decision-making, including determining priorities; and Citizenship training, including life skills training such as parenting, work behavior training, and budgeting of resources. [20 CFR 664.420] Youth Supportive Services Supportive services for youth, as defined in WIA section 101(46), may include the following: Linkages to community services; Assistance with transportation; Assistance with child care and dependent care; Assistance with housing; Referrals to medical services; and Assistance with uniforms or other appropriate work attire and work-related tools, including such items as eyeglasses and protective eye gear. [20 CFR 664.440; Also see Supportive Services] INTRODUCTION The 70% of the Lower Living Standard Income Levels and Self Sufficiency Income Guidelines are updated each year, but not at the same time. When the 70% of the Lower Living Standard Income Level and Self Sufficiency Income charts are updated, they are sent out via e-mail. The most recent table at the time this guide was assembled can be found towards the back of the guide and is labeled Family Income Guidelines. Please note that we will not replace the pages that follow providing the income guidelines for the previous years. Instead, we will issue the updated income guidelines as a new page, which will allow you to keep a history of these guidelines. This table is annual income Example only-not current 70% of the LLSIL Guidelines or Poverty Guideline (whichever is higher)This table is annual incomeFamily SizeLow Income (Adult/Youth) Table at 70 PercentLow Income (Adult/Youth) Table at 85 PercentLow Income (Adult/Youth) Table at 100 Percent111,17013,56415,957215,13018,37221,614319,60623,80728,009424,20529,39234,579528,56834,69040,811633,44140,60747,773For families greater than 6, add this amount for each additional family member4,8735,9176,961Effective: July 11, 2012 Introduction All eligibility will be documented and verified. It is important to note that verification is far different than hard copy documentation. Verification means to confirm eligibility requirements through examination of official documents (e.g., birth certificates, public assistance records, or speaking with official representatives of cognizant agencies). Documentation means to maintain physical evidence, which is obtained during the verification process, in participant files. Such evidence would be copies of documents, completed telephone/document inspection forms, and signed self-certification statement. All registrants for intensive and training services must verify and document the General Eligibility criteria, which consist of citizenship or eligible to work, residency selective service registrant (if applicable), and age. Registrants to be served with WIA funds (Adult, Youth, Dislocated Workers will also verify and document all remaining eligibility requirements. GENERAL ELIGIBILITY Must meet all of the following:Citizenship/Alien Status Birth Date/Age Residency Selective Service Registrant YOUTH ECONOMIC ELIGIBILITY (Low Income) Must meet at least one of the following:Cash Public Assistance Individual/Family Income Individual Status/Family Size Food Stamps Homeless Supported Foster Child Individual with a Disability  DISLOCATED WORKER ELIGIBILITY Must meet at least one of the following:Terminated/Laid Off; Eligible for UC and Unlikely to Return Permanent Closure or Substantial Lay-Off General Announcement of Closure Formerly Self-Employed/Currently Unemployed Displaced Homemaker YOUTH BARRIERS Must meet one or more of the following:Basic Skills Deficient School Dropout Homeless, Runaway Youth, or Foster Child Pregnant or Parenting Offender Requires Additional Assistance to complete educational program or to secure and hold employment Individuals must meet the following General Eligibility Criteria, which consists of Citizenship or Eligible to Work, Age, Residency, and Selective Service Registration. Although an individuals Social Security Number is not considered General Eligibility Criteria, it must be verified. ELIGIBILITY CRITERIAACCEPTABLE VERIFICATIONYouthAdultDislocated WorkerSOCIAL SECURITY NUMBER Assignment of pseudo Social Security Number is forbidden by IRS regulations. NOTE: An unsigned social security card is valid, and a childs social security card is valid if signed by a parent. When the child reaches working age (14 or 15), the parent can apply for another card, which can then be signed by the child.DD-214, Report of Transfer or Discharge (if Social Security Number is listed) Employment Records IRS Form Letter 1722 Letter from Social Service Agency Drivers License (if Social Security Number is listed) Pay Stub Social Security Benefit Documents Social Security Card/Notice of Social Security Number Assignment W-2 Form U. C. Records (if Name and Social Security Number is shown) Self-Certification Form Telephone Verification Signed Documentation from School Officials OtherXXXCITIZENSHIP OR ELIGIBLE TO WORK State/Federal records of printout of a parent can be used as proof of citizenship of dependent children. If, on the verification source, the place of birth is not in the United States, additional verification may be needed. * From List B of the I-9 Form the Voter Registration Form cannot be used. NOTE: For individuals that applied for a Social Security Card after 1972 the Social Security Card only is acceptable documentation of citizenship / alien status. The Social Security Administration on 11-18-03 provided this information. Alien Registration Card Indicating Right to Work (INS Form I-151, I-551, I-94, I-688A I-197, I-179) Baptismal Certificate (if Place of Birth is shown) Birth Certificate DD-214, Report of Transfer or Discharge (if Place of Birth is shown) Food Stamp Record Foreign Passport Stamped Eligible to Work Hospital Record of Birth (if Place of Birth is shown) Hand Gun Permit Naturalization Certification Public Assistance Records U. S. Passport Social Security Card Native American Tribal Document One verification source from List A of the I-9 Form OR one verification source from List B AND one verification source from List C of the I-9 Form* Signed Documentation from School Officials Telephone Verification OtherXXX ELIGIBILITY CRITERIAACCEPTABLE VERIFICATIONYouthAdultDislocated WorkerAGE/BIRTHDATEBaptismal Record (if Date of Birth is shown) Birth Certificate DD-214, Report of Transfer or Discharge Paper Drivers License Federal, State or Local Government Identification Card Hospital Record of Birth (if Full Name is shown) Passport Public Assistance/Social Service Records School Records/Identification Card Work Permit Self-Certification Form Telephone Verification OtherXXXSELECTIVE SERVICE REGISTRANT Selective Service Advisory Opinion Letter Selective Service Registration Record (Form 3A) DD-214, Report of Transfer or Discharge Stamped Post Office Receipt of Registration Internet Verification/Registration (HYPERLINK "http://www.sss.gov"www.sss.gov) Selective Service Telephone Verification (847) 688-6888 OtherXXXResidencyDrivers License or State ID Utility Bill Lease or Landlord Statement Rent Receipt Voter Registration Card Letter from a State Social Service Agency Letter from a School / School District OtherXXX Must meet at least one of the following Economic Eligibility Criteria, which consists of Individual/Family Income, Individual Status/Family Size, Cash Public Assistance, Food Stamps, Homeless, Supported Foster Child, and Individuals with Disabilities ELIGIBILITY CRITERIAACCEPTABLE VERIFICATIONYouthAdultDislocated WorkerINDIVIDUAL/FAMILY INCOME Verification should be provided for each applicable income source. If the applicant is low-Income based on meeting the definition of TANF, Food Stamps, SSI, Homeless, or Foster Child, this must be verified. However, family size does not need to be verified, and family income does not need to be verified or recorded. Alimony Agreement Statement of Family Size/Family Income Award Letter from Veterans Administration Bank Statement (Direct Deposit) Compensation Award Letter Court Award Letter Employer Statement/Contact Farm or Business Financial Records Housing Authority Verification Pay Stubs Pension Statement Public Assistance Records Quarterly Estimated Tax for Self-employed Persons (Schedule C) Social Security Benefits UI Documents and/or Printout Self-Certification Form Telephone Verification OtherXNot applicable unless funds are limited and a priority policy is in place with the local board for intensive and/or training servicesINDIVIDUAL STATUS/FAMILY SIZE If the applicant is low-Income based on meeting the definition of TANF, Food Stamps, SSI, Homeless, or Foster Child to determine Low-Income Individual Family size; does not need to be verified, but the family for the individual needs to be established. Statement of Family Size/Family Income Birth Certificate Decree of Court Disabled (See Individuals with a Disability) Divorce Decree Landlord Statement Lease Marriage Certificate Medical Card Most Recent Tax Return supported by IRS Documents (e.g., Form Letter 1711) Public Assistance/Social Service Agency Records Public Housing Authority (if Resident of or on Waiting List) Written Statement from a Publicly supported 24-hour Care Facility or Institution (e.g., Mental, Prison) Self-Certification Form Telephone Verification OtherXNot applicable unless funds are limited and a priority policy is in place with the local board for intensive and/or training services CASH PUBLIC ASSISTANCE If the applicant is low-income based on meeting the definition of TANF, Food Stamps, SSI, Homeless, or Foster Child, this must be verified. However, family size does not need to be verified and family income does not need to be verified or recorded. Copy of Authorization to Receive Cash Public Assistance Copy of Public Assistance Check Medical Card Showing Cash Grant Status Public Assistance Identification Card Showing Cash Grant Status Public Assistance Records/Printout Refugee Assistance Records Self-Certification Form Telephone Verification OtherX FOOD STAMPS If the applicant is low-income based on meeting the definition of TANF, Food Stamps, SSI, Homeless, or Foster Child, this must be verified. However, family size does not need to be verified and family income does not need to be verified or recorded. Current Authorization to Obtain Food Stamps Current Food Stamp Recipient Food Stamp Card with Current Date Letter from Food Stamp Disbursing Agency Postmarked Food Stamp Mailer with Applicable Name and Address Public Assistance Records/Printout Self-Certification Form Telephone Verification OtherXHOMELESS If the applicant is low-income based on meeting the definition of TANF, Food Stamps, SSI, Homeless, or Foster Child, this must be verified. However, family size does not need to be verified and family income does not need to be verified or recorded.Written Statement from an Individual Providing Temporary Residence Written Statement from Shelter Written Statement from Social Service Agency Self-Certification Form Telephone Verification OtherX ELIGIBILITY CRITERIAACCEPTABLE VERIFICATIONYouthAdultDislocated WorkerSUPPORTED FOSTER CHILD If the applicant is low-income based on meeting the definition of TANF, Food Stamps, SSI, Homeless, or Foster Child, this must be verified. However, family size does not need to be verified and family income does not need to be verified or recorded.Court Contact Court Documentation Medical Card Verification of Payments made on Behalf of the Child Written Statement from State/Local Agency Self-Certification Form Telephone Verification OtherXINDIVIDUALS WITH DISABILITIES 20 CFR 663.640 May an individual with a disability whose family does not meet income eligibility criteria under the Act be eligible for priority as a low-income adult? Yes, even if the family of a disabled individual does not meet the income eligibility criteria, the disabled individual is to be considered a low-income individual if the individuals own income: Meets the income criteria established in WIA section 101(25)(B); or Meets the income eligibility criteria for cash payments under any Federal, State or local public assistance program. (WIA section 101(25)(F).)Letter from Drug or Alcohol Rehabilitation Agency Letter from Child Study Team stating Specific Disability Medical Records Observable Condition (Self-Certification Form Needed) Physicians Statement Psychiatrists Diagnosis Psychologists Diagnosis Rehabilitation Evaluation Sheltered Workshop Certification Social Service Records/Referral Social Security Administration Disability Records Veterans Administration Letter/Records Vocational Rehabilitation Letter Signed Documentation from School Official Workers Compensation Record Self-Certification Form Telephone Verification OtherXX Youth must be within one or more of the following Youth Barriers which consist of Basic Skills Deficient, Pregnant or Parenting, School Dropout, Offender, Homeless, Runaway Youth or Foster Child, and Requires Additional Assistance. ELIGIBILITY CRITERIAACCEPTABLE VERIFICATIONYouthAdultDislocated WorkerYOUTH BARRIERS BASIC SKILLS DEFICIENT Assessed by a Generally Accepted Standardized Test School Records Self-Certification Form Telephone Verification OtherXYOUTH BARRIERS PREGNANT OR PARENTING Birth Certificate Hospital Record of Birth Medical Card Physicians Note Referrals from Official Agencies School Program for Pregnant Teens School Records Statement from Social Service Agency Self-Certification Form Telephone Verification OtherXYOUTH BARRIERS SCHOOL DROPOUT Attendance Record Dropout Letter Self-Certification Form Telephone Verification OtherX ELIGIBILITY CRITERIAACCEPTABLE VERIFICATIONYouthAdultDislocated WorkerYOUTH BARRIERS OFFENDER Court Documents Halfway House Resident Letter of Parole Letter from Probation Officer Police Records Self-Certification Form Telephone Verification OtherXYOUTH BARRIERS HOMELESS, RUNAWAY YOUTH Written Statement from an Individual providing Temporary Residence Written Statement from Shelter Written Statement from Social Service Agency Self-Certification Form Telephone Verification Other OR FOSTER CHILD Court Contact Court Documentation Medical Card Verification of Payment made on Behalf of the Child Written Statement from State/Local Agency Self-Certification Form Telephone Verification OtherXYOUTH BARRIERS REQUIRES ADDITIONAL ASSISTANCE Self-Certification Form OtherX DISLOCATED WORKER the term dislocated worker means an individual who (a) has been terminated or laid off, or who has received a notice of termination or layoff, from employment; is eligible for or has exhausted entitlement to unemployment compensation; or has been employed for a duration sufficient to demonstrate, to the appropriate entity at a one-stop center, attachment to the workforce, but is not eligible for unemployment compensation due to insufficient earnings or having performed services for an employer that were not covered under a State unemployment compensation law; and is unlikely to return to a previous industry or occupation; (b) has been terminated or laid off, or has received a notice of termination or layoff, from employment as a result of any permanent closure of, or any substantial layoff at, a plant, facility, or enterprise; is employed at a facility at which the employer has made a general announcement that such facility will close within 180 days; or for purposes of eligibility to receive services other than training services, intensive services, or supportive services, is employed at a facility at which the employer has made a general announcement that such facility will close; (c) was self-employed (including employment as a farmer, a rancher, or a fisherman) but is unemployed as a result of general economic conditions in a community in which the individual resides or because of natural disasters; or (d) is a displaced homemaker. ELIGIBILITY CRITERIAACCEPTABLE VERIFICATIONYouthAdultDislocated WorkerDISLOCATED WORKERTERMINATED/LAID OFF/RECEIVED NOTICE OF TERMINATION OR LAYOFF Certification of Expected Separation Layoff Letter from Employer Verification from Prospective Employer Verification from Employment Agency Self-Certification Form Other AND ELIGIBLE FOR UI UI Documents and/or Printout E.S. Contact Profile Reemployment Program (PREP) Service Activity Plan Other AND UNLIKELY TO RETURN (Reemployment Opportunity is poor) Contact with Separating Employer Job Service Contact Layoff/Termination Notice Profile Reemployment Program (PREP) Service Activity Plan Statewide/Local Labor Market Information UC Printout listing Reason for Termination Self-Certification Form Telephone Verification OtherX ELIGIBILITY CRITERIAACCEPTABLE VERIFICATIONYouthAdultDislocated WorkerDISLOCATED WORKER PERMANENT CLOSURE OF PLANT/FACILITY/ ENTERPRISE OR SUBSTANTIAL LAYOFF Certification of Expected Separation Letter from Employer Media Announcement with Employment Verification Contact with Separating Employer Layoff Notice Public Notice as determined by the States Rapid Response Coordination Services UI Documents and/or Printout WARN Notice to Individual with Separating Employer WARN Notice to Labor Union which represents Worker Self-Certification Form Telephone Verification OtherXDISLOCATED WORKER GENERAL ANNOUNCEMENT OF CLOSURE Verification from Media Source Employer Verification Self-Certification Form Telephone Verification OtherX ELIGIBILITY CRITERIAACCEPTABLE VERIFICATIONYouthAdultDislocated WorkerDISLOCATED WORKER FORMERLY SELF-EMPLOYED/CURRENTLY UNEMPLOYED Business License/Permit IRS Forms Labor Market Information Unemployment Rate Approved Labor Market Analysis Business Ledgers Chapter 7 Bankruptcy published in Newspaper (Date must be shown) Chapter 11 Bankruptcy published in Newspaper (Date must be shown) Failure of Business Supplier Failure of Business Customer Depressed Prices or Market Federal/State Declaration of Disaster BWI Approved Disaster AND Permanent Dislocation Self-Certification Form Telephone Verification OtherX Displaced Homemaker an individual who has been providing unpaid services to family members in the home and who has been dependent on the income of another family member but is no longer supported by that income; AND is unemployed or underemployed and is experiencing difficulty in obtaining or upgrading employment. ELIGIBILITY CRITERIAACCEPTABLE VERIFICATIONYouthAdultDislocated WorkerDISLOCATED WORKER The term displaced homemaker means an individual who has been providing unpaid services to family members in the home and who has been dependent on the income of another family member but is no longer supported by that income; AND is unemployed or underemployed and is experiencing difficulty in obtaining or upgrading employment.DISPLACED HOMEMAKER IRS Forms Court Records Medical Records Bank/Financial Records Divorce Decree Spouse Death Certificate Spouse Disability check Self-Certification Form AND Employer Verification Job Search Verification Self-Certification Form Telephone Verification OtherX INSTRUCTIONS FOR COMPLETING WORKFORCE INVESTMENT ACT (WIA) STATEMENT OF FAMILY SIZE/FAMILY INCOME This form is required for the verification of income of all WIA participants. In cases where the recommended verification sources of Family Size verification are unavailable, then this form may also be used to document family size. For WIA program services, in extraordinary circumstances, this form may be also used to document income. The explanation of the extraordinary circumstances will be documented in the case file and the justification must be approved by supervision. The documentation will include the Self Attestation Statement described in attachment I. The purpose of this form is to verify the WIA applicants family size at time of registration and family income during the last six months (26 weeks) when necessary. This entails verifying the size and makeup of the applicants FAMILY. This form is only required when eligibility is based on FAMILY INCOME. The applicant should complete the Statement of Family Size/Family Income with the assistance of intake staff to ensure it is completed correctly. The applicant will then take the form to have it signed by a witness who can corroborate the given information. Family two or more persons related by blood, marriage, or decree of court, who are living in a single residence, and are included in one or more of the following categories: A husband, wife, and dependent children. A parent or guardian and dependent children. A husband and wife. A dependent child is defined as a child: Under age 19 at the end of the previous calendar year, or Under age 24 at the end of the previous calendar year and was a student. A dependent child was a student if he or she: Was enrolled as a full-time student at a school during any 5 months of the previous calendar year or took a full-time, on-farm training course during any 5 months of the previous calendar year. The course had to be given by a school or a state, county or local government agency. A school includes technical, trade, and mechanical schools. It does not include on-the-job training courses or correspondence schools. Also, regardless of residence and/or citizenship, anyone claimed as a dependent on another persons Federal Income Tax return for the previous year shall be presumed to be part of the persons family for the current year. To negate this assumption, the person who was claimed as a dependent for income tax purposes would be required to provide information that demonstrates the individual is no longer financially dependent. In applying the definition of family, runaway youth, emancipated youth, and court adjudicated youth separated from the family through involuntary temporary residence elsewhere (e.g., institutionalized, incarcerated, or placed as a result of a court order) shall not be classified as dependent children. An individual with a disability whose own income is at or below the Poverty Line or 70% of the Lower Living Standard Income Level may be treated as a family of 1. Family Income for the purpose of determining WIA income eligibility, list the total income received by you and members of your family from (1) gross wages and salaries (before deductions); (2) net self-employment income (gross receipts minus operating expenses); and (3) other money income from sources such as net rents, social security, pensions, alimony, government and armed forces retirement payments, insurance policy annuities, and other sources of periodic income. Inclusions for Family Income Money wages and salaries before any deductions; WIA OJT wage payments to participants; Disaster Relief Employment Wages; Net receipts from non-farm self-employment (receipts from a persons own unincorporated business, professional enterprise, or partnership after deductions for business expense); Net receipts from farm self-employment (receipts from a farm which one operates as an owner, renter, or sharecropper, after deductions for farm operating expenses); Regular payments from social security, railroad retirement, strike benefits from union funds, workers compensation (public/private), and training stipends; Alimony; Military family allotments or other regular support from an absent family member or someone not living in the household; Pensions whether private government employee (including military retirement pay); Regular insurance or annuity payments; College or university grants, fellowships and assistantships; Dividends, interest, net rental income, net royalties, periodic receipts from estates or trust; Net gambling or lottery winnings; Net self-employment income (gross receipts minus operating expenses). Exclusions for Family Income Unemployment compensation; Child support payments; Cash welfare payments (including TANF, SSI, RCA, GA); Old Age and Survivors Insurance (OASI) benefits received under Section 202 of the Social Security Act (42 U.S.C. 402); Foster care payments; Needs-based scholarship assistance; Financial assistance under Title IV of the Higher Education Act, i.e., Pell Grants, Federal Supplemental Educational Opportunity Grants and Federal Work Study, PLUS, Stafford, and Perkins loans like any other kind of loan are debt and not income; Income earned while the veteran was on active military duty and certain other veterans benefits, i.e., compensation for service-connected disability, compensation for service-connected death, vocational rehabilitation, and education assistance; Tax refunds, gifts, loans, lump-sum inheritances, one-time insurance payments, or compensation for injury; Any assets drawn down as withdrawals from a bank, the sale of property, a house or a car; IRA withdrawals; Capital gains; Non-cash benefits such as employer-paid fringe benefits, food or housing received in lieu of wages, Medicare, Medicaid, food stamps, school meals, and housing assistance; WIA payments to participants (except OJT wages) shall not be considered as income for the purposes of determining eligibility. NOTE: When a federal statute specifically provides that income or payments received under such statute shall be excluded in determining eligibility for the level of benefits received under any other federal statute, such income or payments shall be excluded in WIA eligibility determination. IDENTIFYING INFORMATION Please complete this block with the WIA applicants name, address, social security number, and application date. FAMILY MEMBERS NAME/RELATIONSHIP TO APPLICANT/FAMILY MEMBER INCOME List the names of all FAMILY MEMBERS (including applicant) living in the applicants residence on the date of registration. Indicate the relationship of each FAMILY MEMBER to the applicant. Indicate the income during the last six months (26 weeks) of each FAMILY MEMBER living in the applicants residence on the date of registration. Complete the block Total Number in Family. Complete the block Total Income (if applicable). NAME/LOCATION/REASON List the names of any FAMILY MEMBERS not currently residing in the applicants residence. This should include any FAMILY MEMBER who is not currently living in the residence but would be considered a part of the applicants family. These absences may be due to temporary and voluntary residence elsewhere (e.g., attending school or college, or visiting relatives). It would not include involuntary temporary residence elsewhere (e.g., incarceration, or placement as a result of a court order). Members of the Armed Forces on extended temporary assignment elsewhere are considered to be assigned involuntarily and would not be considered as part of the applicants FAMILY. Indicate the location of the absent family member. Indicate the reason for the absence. Include whether the absence is voluntary or involuntary and if it is temporary or permanent. The applicant must sign and date the form. A corroborating witness must sign and date the form attesting to the accuracy of the given information. The corroborating witness may live in or out of the residence, and may or may not be related to the applicant. The witness must have verifiable knowledge of the applicants FAMILY STATUS. The Family Income Worksheet will also be completed in support of this form in order to describe the method used to determine the income included on this form. WORKFORCE INVESTMENT ACT STATEMENT OF FAMILY SIZE/FAMILY INCOME IDENTIFYING INFORMATION Applicants Name Last First MI Address Social Security Number Application Date:  To be completed by WIA applicant with staff assistance For use in completing this form, the definitions of FAMILY and FAMILY INCOME can be found on the previous page. Please provide information regarding the applicants FAMILY as requested below. The Family Member Income column is only completed when documenting income due to extraordinary circumstances. FAMILY MEMBERS NAMERELATIONSHIP TO APPLICANTFAMILY MEMBER INCOME (Last Six Months)Total Number in Family:Total Income: If applicable, please complete the following information for FAMILY MEMBERS not currently residing in the applicants residence (see instructions). NAMELOCATIONREASON I attest to the best of my knowledge that the information above is true and correct.  Signature of Applicant Date CORROBORATING WITNESS I attest to the best of my knowledge that the information is true and correct. Name Signature Date Street Address City State Zip Telephone Number Relationship to WIA Applicant Self-Certification Requirements After review of the eligibility criteria, along with possible ways to verify the criteria, it was found that much of the verification was readily available through a number of agencies or sources. In some cases, definitive verification is required (e.g., eligibility to work (I-9 requirements under IRCA) and Selective Service Registration or exemption for males. WIIN 3-99, Change 2 allows for the use of Self-Certification to verify those items that in some cases are not verifiable or may cause undue hardship for individuals to obtain. A Self-Certification may be used after all practicable attempts to secure verification have failed. In order to utilize the Self-Certification as verification, the Self-Certification Form, or facsimile, must be utilized. Use of the Self-Certification Form is as follows: If an applicant states that he/she cannot provide evidence that no income was received during the past six months, and that he/she was unemployed for that period, the blank spaces following the words I certify, under penalty of law, that the following information is true must be completed. For example: Have received no income from any source during the past six months, I have been unemployed during that time, and have been supported by donations/contributions from relatives and friends. NOTE: When using the Self-Certification form, the Counselors Signature/Date found in the Certification block must be completed. The Reviewers Signature/Date is to be completed by the Case Manager/Contract Intake Staff Supervisor. IDENTIFYING INFORMATION Applicants Name Last First MI Address Social Security Number Application Date:  I HEREBY CERTIFY UNDER PENALTY OF LAW, THAT THE FOLLOWING INFORMATION IS TRUE.       I ATTEST THAT THE INFORMATION STATED ABOVE IS TRUE AND ACCURATE, AND UNDERSTAND THAT THE ABOVE INFORMATION, IF MISREPRESENTED, OR INCOMPLETE, MAY BE GROUNDS FOR IMMEDIATE TERMINATION AND/OR PENALTIES AS SPECIFIED BY LAW.  APPLICANTS SIGNATURE and DATE APPLICANTS PHONE NUMBER APPLICANTS ADDRESS SIGNATURE OF PARENT OR GUARDIAN (as needed) The above Self-Certification is being utilized for verification of the following eligibility criteria:   CERTIFICATIONI certify that the individual whose signature appears above provided the information recorded on this form. Counselors Signature/Date: Reviewers Signature/Date:  Telephone/Document Inspection Verification Requirements Introduction WIA eligibility criteria may be verified by telephone contacts with cognizant governmental or social service agencies, or by document inspection. The information obtained must be verified by recording the information on a standardized form such as the example contained on page two of Attachment J. Information recorded must be adequate to enable a monitor or auditor to trace back to the cognizant agency or the document used. Telephone verification must include the name of the agency representative providing the verification information. In some cases, the information provided by an agency through telephone contact may be sufficient to satisfy multiple WIA eligibility criteria. For example, verification that an applicant has been determined eligible to receive TANF can satisfy the requirement for Youth program eligibility. Verification of eligibility through document inspection is appropriate when documents cannot or may not be machine-copied. Agencies that may assist in verifying via telephone are as follows: Local Schools Social Security Administration Veterans Administration Medical and health facilities Vocational rehabilitation facilities Drug and alcohol rehabilitation facilities Housing authorities Homeless shelters Judicial agencies and institutions Other State and local government agencies When WIA eligibility verification is accomplished via telephone or document inspection, Local Workforce Investment Areas are required to use a standardized form, such as the example on page two for monitoring and audit purposes. WIA TELEPHONE VERIFICATION/DOCUMENT INSPECTION FORM IDENTIFYING INFORMATION Applicants Name Last First MI Social Security Number Date:  WIA ELIGIBILITY VERIFICATION BY TELEPHONE NAME AND/OR NUMBER OF DOCUMENT ELIGIBILITY ITEM(S) TO BE VERIFIED: INFORMATION VERIFIED: AGENCY PROVIDING VERIFICATION: AGENT VERIFYING ELIGIBILITY ITEM: DATE AND TIME OF VERIFICATION: TELEPHONE NUMBER OF AGENCY PROVIDING VERIFICATION:  WIA ELIGIBILITY VERIFICATION BY DOCUMENT INSPECTION NAME AND/OR NUMBER OF DOCUMENT ELIGIBILITY ITEM TO BE VERIFIED: INFORMATION VERIFIED: DOCUMENT TO BE INSPECTED: ORIGINAL SOURCE OF DOCUMENT: REASON FOR DOCUMENT INSPECTION:  REMOTE SITE ELIGIBILITY, NO COPIER AVAILA  ON SITE ELIGIBILITY, NO COPIER AVAILABLE.  DOCUMENT CANNOT BE COPIED. I ATTEST THAT THE INFORMATION RECORDED BY ME ON THIS DOCUMENT WAS OBTAINED THROUGH TELEPHONE CONTACT OR DOCUMENT INSPECTION ON THE ABOVE DATE. AS INDICATED BY THE AGENT, ALL INFORMATION WAS OBTAINED FROM DATA PREVIOUSLY DETERMINED AND RECORDED IN THE APPLICANTS RECORDS AT THE AGENCY PROVIDING THE ELIGIBILITY VERIFICATION. OR I ATTEST THAT THE DOCUMENT INSPECTION VERIFIED THE PRIMARY/SECONDARY ITEMS REQUIRED TO DETERMINE ELIGIBILITY FOR THE WIA PROGRAM. ELIGIBILITY SPECIALISTS SIGNATURE DATE Income Verification Methods Introduction When income is used to document low income status, the eligibility is based on the income of the family. Family income will be documented as described in Attachment G. The verification of income is accomplished through the combination of three forms as follows: Statement of Family Size/Family Income Family Income Worksheet Supporting Documentation The Family Income Worksheet is used to document family income for the family members entered on the Statement of Family Size/Family Income except in extraordinary circumstances (Attachment H). Family income is subject to the definitions of Family and Includable Family Income found in Attachment G A separate section of the Family Income Worksheet will be completed for each applicant and family member over 15 years of age. When the individual has no income, no income should be written on the Annualized Total line. For family members with wages/salary, the form will be completed as specified, identifying, the periods of work, and the amount of income for the period. For individuals with other includable income, the type of income and amount of income will be provided. Income is calculated for the six (6) month period prior to application. It is then doubled to obtain the individuals annual income. When this has been completed for all the family members, the individual family incomes are totaled to obtain the total annual family income. The total annual family income is then compared with the appropriate income table. The form will also be used to document excludable income when it assists in verifying the support of the family. APPLICANTS NAME:INCLUDABLE INCOME (Wages/Salary)EXCLUDABLE INCOMEFrom _______To ________$________ per wk X _______ wks = $________Supplemental Sec. Income:$________ per wk X ________ mos = $________From _______To ________$________ per wk X _______ wks = $________AFDC, GA, RA$________ per wk X ________ mos = $________From _______To ________$________ per wk X _______ wks = $________Food Stamps$________ per wk X ________ mos = $________Pension/Military Retirement$________ per mo X _______ mos = $________Unemployment Comp.$________ per wk X ________ wks = $________Soc. Sec. Dis. Income$________ per mo X _______ mos = $________Child Support$________ per wk X ________ wks = $________Workmans Compensation$________ per mo X _______ mos = $________Old Age & Survivors Income$________ per wk X ________ wks = $________Other, Specify:Other, Specify:$________ per wk X _______ mos = $________$________ per wk X ________ mos = $________$________ per wk X _______ mos = $________$________ per wk X ________ mos = $________6 MONTH TOTAL = $_______6 MONTH TOTAL = $________If there has been no income in the family during the income determination period, state how the applicant has been living during the last 6 months:X2ANNUALIZED TOTAL = $ ________ FAMILY MEMBERS NAME:RELATIONSHIP:AGE:INCLUDABLE INCOME (Wages/Salary)EXCLUDABLE INCOMEFrom _______To ________$________ per wk X _______ wks = $________Supplemental Sec. Income:$________ per wk X ________ mos = $________From _______To ________$________ per wk X _______ wks = $________AFDC, GA, RA$________ per wk X ________ mos = $________From _______To ________$________ per wk X _______ wks = $________Food Stamps$________ per wk X ________ mos = $________Pension/Military Retirement$________ per mo X _______ mos = $________Unemployment Comp.$________ per wk X ________ wks = $________Soc. Sec. Dis. Income$________ per mo X _______ mos = $________Child Support$________ per wk X ________ wks = $________Workmans Compensation$________ per mo X _______ mos = $________Old Age & Survivors Income$________ per wk X ________ wks = $________Other, Specify:Other, Specify:$________ per wk X _______ mos = $________$________ per wk X ________ mos = $________$________ per wk X _______ mos = $________$________ per wk X ________ mos = $________6 MONTH TOTAL = $________X2ANNUALIZED TOTAL = $_________     Revised 06/05/2013<> Page  PAGE \* MERGEFORMAT 1 ATTACHMENT A TITLE I WIA, STATE BLUE COLLAR AND SKILLS GRANT PROGRAM ELIGIBILITY CRITERIA FOR REGISTRATION AND CORRESPONDING ACT/REGULATION CITATIONS Revised 06/05/2013 Page  PAGE \* MERGEFORMAT 12 ATTACHMENT B ATTACHMENT B WORKFORCE INVESTMENT ACT ELIGIBILITY STATEMENT ATTACHMENT B ATTACHMENT B WORKFORCE INVESTMENT ACT ELIGIBILITY STATEMENT ATTACHMENT B ATTACHMENT B WORKFORCE INVESTMENT ACT ELIGIBILITY STATEMENT ATTACHMENT B BLUE COLLAR JOBS ACT AND STATE SKILLS GRANT ELIGIBILITY STATEMENT ATTACHMENT C Revised 06/05/2013 Page  PAGE \* MERGEFORMAT 4 ATTACHMENT C ATTACHMENT D DEFINITIONS FOR ELIGIBILITY Revised 06/05/2013 ATTACHMENT E ATTACHMENT F COMPOSITE OF ACCEPTABLE ELIGIBILITY VERIFICATION ATTACHMENT G WIA, BLUE COLLAR, AND SKILLS GRANT ACCEPTABLE ELIGIBILITY VERIFICATION GENERAL ELIGIBILITY CRITERIA ATTACHMENT G WIA ACCEPTABLE ELIGIBILITY VERIFICATION ECONOMIC ELIGIBILITY CRITERIA ATTACHMENT G WIA ACCEPTABLE ELIGIBILITY VERIFICATION YOUTH BARRIERS CRITERIA ATTACHMENT G WIA ACCEPTABLE ELIGIBILITY VERIFICATION DISLOCATED WORKER CRITERIA ATTACHMENT H ATTACHMENT I ATTACHMENT I SELF-CERTIFICATION FORM ATTACHMENT J ATTACHMENT K DELAWARE DEPARTMENT OF LABOR FAMILY INCOME WORK SHEETINCOME DETERMINATION PERIOD:FROM: ______________TO: ___________ BCDFGOP ]^_op345AееОееznhvhX>*CJaJhvhX>*CJ\aJhvhXCJKHaJh\lCJ\aJhvhXCJaJhvhXCJ\aJhvhvCJ\aJhvhv5>*CJ\aJhvhvCJaJhvhv5CJ\aJhXCJ\aJ h"1h"1 h"1h+%CD ^_45BCQRs  & F gd\l ! & F 8gd\l & F 8gd\l & F gd\l H07$8$H$^`007$8$H$^`0 0^`0gd+ABCPQRrs+,-9:;vw01|}KLͣͅynhvhvCJaJhvhXCJ\aJhvhvCJ\aJ"hvhX5CJOJQJ\aJ"hvhv5CJOJQJ\aJhvhv5CJaJhvhv5CJaJhvhXCJaJhvhv5CJ\aJhvhX5CJaJhvhX5CJ\aJ&,-:;w1}L  ^ `^ ! & F 8pgd\l & F @  gd\l  & F @ gd\l  & F  gd\l & F 8gd\l8^8  & F gd\lL  :;<HIJxy  abcuujjuj^jhvhv5CJaJhvhXCJaJhvhvCJ\aJhvhXCJ\aJhvhX5CJaJhvhvCJaJhvh?n5CJ\aJhvhv5CJ\aJhvhX5CJ\aJ h\lh\l>*B*CJaJphjh\lh\lCJUaJ h\lh\lh\lh\lCJaJ$L;<IJy & Fgdv & F gdv & F gdv8^88^8gd?n & Fgd?n^ & F* 8 1$^gd\l & F* 81$^gd\l bcpqC & Fgdv & Fgdv & F gdv^ & F gdv^$ & F ^a$gdv$ & F8^8a$gd?ncopqBDSyqf[P[hvhXCJaJhvhvCJaJhvh`.CJaJhvCJaJhvhvCJaJhvh?nCJaJhvhvCJaJhvhv5>*CJ\aJhvhv5CJaJhvhXCJaJhvhXCJ\aJhvhvCJ\aJhvhX5CJaJhvhX5CJ\aJhvhv5CJ\aJCD ' $$Ifa$$If 0^`0^gd?n & Fgd?n  &'(()34>?@IJUVabmnobƺƺƺƺƺƺƺƺƺƺƺƺƺƺƺƺƺƺƺƺƺƺhvhv5CJ\aJhvhXCJ\aJhvhvCJ\aJhvhvCJaJhvhX5CJaJhvhv5CJaJhvhXCJaJ>'(/)$Ifkd$$Ifl\#* (0+44 lap(yt?nwww $$Ifa$$Ifxkd$$Ifl4*+  0+44 laf4p yt?n)4?`ZQQQ $$Ifa$$Ifkd$$Ifl\#*0+44 layt?n?@JVbn`ZQQQ $$Ifa$$IfkdG$$Ifl\#*0+44 layt?nno`ZQQQ $$Ifa$$Ifkd$$Ifl\#*0+44 layt?n`ZQQQQQQ $$Ifa$$Ifkdu$$Ifl\#*0+44 layt?nc`Z$Ifkd$$Ifl\#*0+44 layt?nbcd{|#$qr@AOPQV  45hijz{ϴۨۨۨۨۨۨϴۨۨ۴ϴϴύۨhvhX6CJ\]aJhvh~#CJ\aJhvhXCJ\aJhvhX5CJaJhvhv56CJ]aJhvhv5CJaJhvhvCJ\aJhvhXCJaJhvhX5CJ\aJ7cd$rwmgZZZZZ & F$Ifgdv$If h$If^h & F$Ifgdvzkd$$Ifl4*+  0+44 laf4p yt?n QRSTUV$If $$Ifa$ $If^  /" & F$Ifgdvkde$$Ifl\#* \(0+44 lap(yt?n j' $$Ifa$ $If^ & F$Ifgdv$If h$If^h%&'345HISTUtu$ & ; < G H M \ ] k l { | ۦhvhX6CJ\]aJhvhXCJaJhvhXCJ\aJhvhv56CJ]aJhvhv5CJaJhvhvCJ\aJhvhX5CJaJA4/)$Ifkdg$$Ifl\#* \\(0+44 lap(yt?n45Uu% & wm`m`m`m`m & F$Ifgdv h$If^h & F$Ifgdvzkd[$$Ifl4*+  0+44 laf4p yt?n & I J K L M ] l | $$Ifa$$If & F$Ifgdv Y![!\!:8++ $0^`0a$kd $$Ifl\#* \\0+44 lapyt?n X!Y!Z![!a!h!i!"" 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