Driver’s License Utility Bill Lease Food Stamp Award Letter Public Assistance Records

Birth Certificate Driver’s License Passport Federal State or Local Govt ID Card

Birth Certificate United States Passport Alien Registration Card Indication Right to Work Naturalization Certification Documentation Specified on the I-9 Form

DD-214 Military Document ID or other DD form for spouse

Note: if unemployed please record 0.00

Employment Separation Notice Warn Notice or Letter of Authorization from the state WIOA Admin Department Documentation of General Announcement of Company Closure

Unemployment Eligibility from CONNECT

Death Certificate Divorce Decree or Legal Separation Court Records for Divorce

Current Authorization to obtain Food Stamps Public Assistance Records-Printout

Public Assistance Records-Printout

1 2 3 4 5 6 7 8 9 10 11 12 (Total number of people in your family = all those living in a household related by blood, marriage or court decree)
Adult Family Definition

Birth Certificate
Marriage Certificate
Decree of Court
Public Assistance-Social Service Agency Records
Most Recent Tax Return Supported by IRS Documents
Landlord Statement
Lease
Public Housing Authority

Below or Equal to $15,060 $15,061 - $20,440 $20,441 - $26,622 $26,623 - $32,867 $32,868 - $38,791 $38,792 - $45,368 $45,369 - $51,945 $51,946 - $58,522 More then $58,522 Use the past six months of income multiplied by two. (family income = all those living in a household related by blood, marriage or court decree)

Please list all types of income you are receiving
Family Includable & Excludable Income

Wages and salaries before any deductions
Net receipts from self-employment
Pension or retirement income
Unemployment compensation
Child support
Social security benefits
Strike benefits from union funds
Net rental income
Interest, dividends, royalties
Periodic receipts from estates, trusts
Alimony
Educational Assistance and training stipends
Other support from an absent family member not living in the household
Other miscellaneous sources of revenue considered as reportable income by the IRS

Select Type of Job Accountants and Auditors Administrative Services Managers Aircraft Mechanics and Service Technicians Airline Pilots, Copilots, and Flight Engineers Architects, Except Landscape and Naval Architectural and Civil Drafters Architectural and Engineering Managers Art Directors Audio and Video Technicians Automotive Body and Related Repairers Automotive Service Technicians and Mechanics Biological Technicians Bookkeeping, Accounting, and Auditing Clerks Bus and Truck Mechanics and Diesel Engine Specialists Business Operations Specialists, All Other Career/Technical Education Teachers, Secondary School Carpenters Chefs and Head Cooks Chemical Technicians Chemists Child, Family, and School Social Workers Civil Engineers Claims Adjusters, Examiners, and Investigators Clinical Laboratory Technologists and Technicians Coaches and Scouts Commercial Pilots Community and Social Service Specialists, All Other Community Health Workers Compensation, Benefits, and Job Analysis Specialists Compliance Officers Computer and Information Systems Managers Computer Network Architects Computer Network Support Specialists Computer Numerically Controlled Tool Operators Computer Occupations, All Other Computer Systems Analysts Computer User Support Specialists Construction and Building Inspectors Construction Managers Cost Estimators Data Scientists Dental Assistants Dental Hygienists Diagnostic Medical Sonographers Directors, Religious Activities and Education Electrical Engineers Electrical Power-Line Installers and Repairers Electricians Electronics Engineers, Except Computer Elementary School Teachers, Except Special Education Engineering Technologists and Technicians, Except Drafters, All Other Engineers, All Other Environmental Scientists and Specialists, Including Health Facilities Managers Farmers, Ranchers, and Other Agricultural Managers Financial and Investment Analysts Financial Examiners Financial Managers Financial Specialists, All Other Firefighters First-Line Supervisors of Construction Trades and Extraction Workers First-Line Supervisors of Entertainment and Recreation Workers, Except Gambling Services First-Line Supervisors of Landscaping, Lawn Service, and Groundskeeping Workers First-Line Supervisors of Mechanics, Installers, and Repairers First-Line Supervisors of Non-Retail Sales Workers First-Line Supervisors of Office and Administrative Support Workers First-Line Supervisors of Personal Service Workers First-Line Supervisors of Police and Detectives First-Line Supervisors of Production and Operating Workers First-Line Supervisors of Retail Sales Workers First-Line Supervisors of Transportation and Material Moving Workers, Except Aircraft Cargo Handling Supervisor Food Service Managers Fundraisers General and Operations Managers Graphic Designers Health Education Specialists Health Information Technologists and Medical Registrars Health Specialties Teachers, Postsecondary Health Technologists and Technicians, All Other Heating, Air Conditioning, and Refrigeration Mechanics and Installers Heavy and Tractor-Trailer Truck Drivers Human Resources Managers Human Resources Specialists Industrial Engineering Technologists and Technicians Industrial Engineers Industrial Machinery Mechanics Information Security Analysts Inspectors, Testers, Sorters, Samplers, and Weighers Insurance Sales Agents Interior Designers Interpreters and Translators Kindergarten Teachers, Except Special Education Licensed Practical and Licensed Vocational Nurses Life, Physical, and Social Science Technicians, All Other Loan Officers Lodging Managers Logisticians Machinists Management Analysts Managers, All Other Market Research Analysts and Marketing Specialists Marketing Managers Massage Therapists Mechanical Engineers Medical and Health Services Managers Medical Assistants Medical Equipment Repairers Medical Records Specialists Medical Scientists, Except Epidemiologists Medical Secretaries and Administrative Assistants Meeting, Convention, and Event Planners Mental Health and Substance Abuse Social Workers Middle School Teachers, Except Special and Career/Technical Education Mobile Heavy Equipment Mechanics, Except Engines Motorboat Mechanics and Service Technicians Musicians and Singers Natural Sciences Managers Network and Computer Systems Administrators Occupational Health and Safety Specialists Occupational Therapy Assistants Operations Research Analysts Ophthalmic Medical Technicians Opticians, Dispensing Paralegals and Legal Assistants Payroll and Timekeeping Clerks Personal Financial Advisors Pharmacy Technicians Phlebotomists Physical Therapist Assistants Plumbers, Pipefitters, and Steamfitters Producers and Directors Production, Planning, and Expediting Clerks Project Management Specialists Property Appraisers and Assessors Property, Real Estate, and Community Association Managers Public Relations Specialists Purchasing Managers Radiologic Technologists and Technicians Real Estate Brokers Real Estate Sales Agents Registered Nurses Religious Workers, All Other Respiratory Therapists Sales Managers Sales Representatives of Services, Except Advertising, Insurance, Financial Services, and Travel Sales Representatives, Wholesale and Manufacturing, Except Technical and Scientific Products Sales Representatives, Wholesale and Manufacturing, Technical and Scientific Products Secondary School Teachers, Except Special and Career/Technical Education Securities, Commodities, and Financial Services Sales Agents Security and Fire Alarm Systems Installers Social and Community Service Managers Social Workers, All Other Software Developers Software Quality Assurance Analysts and Testers Special Education Teachers, Secondary School Special Effects Artists and Animators Substance Abuse, Behavioral Disorder, and Mental Health Counselors Surgical Technologists Surveying and Mapping Technicians Teachers and Instructors, All Other Telecommunications Equipment Installers and Repairers, Except Line Installers Telecommunications Line Installers and Repairers Training and Development Specialists Transportation, Storage, and Distribution Managers Veterinary Technologists and Technicians Web and Digital Interface Designers Web Developers Welders, Cutters, Solderers, and Brazers Writers and Authors

Select Type of Job Accountants and Auditors Administrative Services Managers Aircraft Mechanics and Service Technicians Airline Pilots, Copilots, and Flight Engineers Architects, Except Landscape and Naval Architectural and Civil Drafters Architectural and Engineering Managers Art Directors Audio and Video Technicians Automotive Body and Related Repairers Automotive Service Technicians and Mechanics Biological Technicians Bookkeeping, Accounting, and Auditing Clerks Bus and Truck Mechanics and Diesel Engine Specialists Business Operations Specialists, All Other Career/Technical Education Teachers, Secondary School Carpenters Chefs and Head Cooks Chemical Technicians Chemists Child, Family, and School Social Workers Civil Engineers Claims Adjusters, Examiners, and Investigators Clinical Laboratory Technologists and Technicians Coaches and Scouts Commercial Pilots Community and Social Service Specialists, All Other Community Health Workers Compensation, Benefits, and Job Analysis Specialists Compliance Officers Computer and Information Systems Managers Computer Network Architects Computer Network Support Specialists Computer Numerically Controlled Tool Operators Computer Occupations, All Other Computer Systems Analysts Computer User Support Specialists Construction and Building Inspectors Construction Managers Cost Estimators Data Scientists Dental Assistants Dental Hygienists Diagnostic Medical Sonographers Directors, Religious Activities and Education Electrical Engineers Electrical Power-Line Installers and Repairers Electricians Electronics Engineers, Except Computer Elementary School Teachers, Except Special Education Engineering Technologists and Technicians, Except Drafters, All Other Engineers, All Other Environmental Scientists and Specialists, Including Health Facilities Managers Farmers, Ranchers, and Other Agricultural Managers Financial and Investment Analysts Financial Examiners Financial Managers Financial Specialists, All Other Firefighters First-Line Supervisors of Construction Trades and Extraction Workers First-Line Supervisors of Entertainment and Recreation Workers, Except Gambling Services First-Line Supervisors of Landscaping, Lawn Service, and Groundskeeping Workers First-Line Supervisors of Mechanics, Installers, and Repairers First-Line Supervisors of Non-Retail Sales Workers First-Line Supervisors of Office and Administrative Support Workers First-Line Supervisors of Personal Service Workers First-Line Supervisors of Police and Detectives First-Line Supervisors of Production and Operating Workers First-Line Supervisors of Retail Sales Workers First-Line Supervisors of Transportation and Material Moving Workers, Except Aircraft Cargo Handling Supervisor Food Service Managers Fundraisers General and Operations Managers Graphic Designers Health Education Specialists Health Information Technologists and Medical Registrars Health Specialties Teachers, Postsecondary Health Technologists and Technicians, All Other Heating, Air Conditioning, and Refrigeration Mechanics and Installers Heavy and Tractor-Trailer Truck Drivers Human Resources Managers Human Resources Specialists Industrial Engineering Technologists and Technicians Industrial Engineers Industrial Machinery Mechanics Information Security Analysts Inspectors, Testers, Sorters, Samplers, and Weighers Insurance Sales Agents Interior Designers Interpreters and Translators Kindergarten Teachers, Except Special Education Licensed Practical and Licensed Vocational Nurses Life, Physical, and Social Science Technicians, All Other Loan Officers Lodging Managers Logisticians Machinists Management Analysts Managers, All Other Market Research Analysts and Marketing Specialists Marketing Managers Massage Therapists Mechanical Engineers Medical and Health Services Managers Medical Assistants Medical Equipment Repairers Medical Records Specialists Medical Scientists, Except Epidemiologists Medical Secretaries and Administrative Assistants Meeting, Convention, and Event Planners Mental Health and Substance Abuse Social Workers Middle School Teachers, Except Special and Career/Technical Education Mobile Heavy Equipment Mechanics, Except Engines Motorboat Mechanics and Service Technicians Musicians and Singers Natural Sciences Managers Network and Computer Systems Administrators Occupational Health and Safety Specialists Occupational Therapy Assistants Operations Research Analysts Ophthalmic Medical Technicians Opticians, Dispensing Paralegals and Legal Assistants Payroll and Timekeeping Clerks Personal Financial Advisors Pharmacy Technicians Phlebotomists Physical Therapist Assistants Plumbers, Pipefitters, and Steamfitters Producers and Directors Production, Planning, and Expediting Clerks Project Management Specialists Property Appraisers and Assessors Property, Real Estate, and Community Association Managers Public Relations Specialists Purchasing Managers Radiologic Technologists and Technicians Real Estate Brokers Real Estate Sales Agents Registered Nurses Religious Workers, All Other Respiratory Therapists Sales Managers Sales Representatives of Services, Except Advertising, Insurance, Financial Services, and Travel Sales Representatives, Wholesale and Manufacturing, Except Technical and Scientific Products Sales Representatives, Wholesale and Manufacturing, Technical and Scientific Products Secondary School Teachers, Except Special and Career/Technical Education Securities, Commodities, and Financial Services Sales Agents Security and Fire Alarm Systems Installers Social and Community Service Managers Social Workers, All Other Software Developers Software Quality Assurance Analysts and Testers Special Education Teachers, Secondary School Special Effects Artists and Animators Substance Abuse, Behavioral Disorder, and Mental Health Counselors Surgical Technologists Surveying and Mapping Technicians Teachers and Instructors, All Other Telecommunications Equipment Installers and Repairers, Except Line Installers Telecommunications Line Installers and Repairers Training and Development Specialists Transportation, Storage, and Distribution Managers Veterinary Technologists and Technicians Web and Digital Interface Designers Web Developers Welders, Cutters, Solderers, and Brazers Writers and Authors