Reconciliation of Trade Out-of-Area Job Search Allowance Instructions

A separate form should be completed for each Out-of-Area Job Search to be made by the customer.

Customer Information

This form is a combined form to be used for TAA and TGAAA and TAARA Programs.
Check the appropriate Trade Program petition requirements that apply for this individual.
1. / LWIA #/ETC / Enter the LWIA # & ETC where the customer is being served.
2. / Customer SSN / Enter customer's Social Security Number.
3. / Reconciliation Date / Enter the date of reconciliation.
4. / Name / Enter the customer's last name, first name and middle initial.
5. / Street Address (Residence)
/ Enter the customer's current street address of residence.
6. / City / Enter the customer's city of residence.
7. / State / Enter the customer's state of residence.
8. / Zip / Enter customer's corresponding five or nine digit zip code.
Trade Out-of-Area Job Search Information
9. / Trade Petition Number / Enter the 5 digit (and letter if applicable) Petition Number from the certified petition covering the worker group from which the customer was laid off.
10. / Interview Date / Enter the date of customer's interview.
11. / Name of Company / Enter the name of the company interviewing the customer.
12. / Title Applied For / Enter the job title for which customer has interviewed.
13. / Contact Name / Enter the name of contact at interviewing company.
14. / Phone Number / Enter phone number for contact provided in #13. Include relevant extensions.
15. / Street Address / Enter the street address of the location of the interview. A PO Box may also be entered but a street address must be entered.
16. / City / Enter the city of the location of the interview.
17. / State / Enter the State of the location of the interview.
18. / Zip / Enter the five or nine digit zip code of location of the interview.
Trade Out-of-Area Job Search Payment Eligibility
19.-21. / Yes – No / Respond to each question with a Yes or No selection. In order to pay the actual, items #19-21 must be answered Yes.
19. / Job Search Completed / Check Yes or No to indicate whether the Trade Out-of-Area Job Search was completed. A job search is deemed to be completed when the customer either secures employment or has contacted each employer approved by the LWIA on the corresponding Commerce/Trade Form #012.
20. / Job Search Completed Within 30 days / Check Yes or No to indicate whether the Out-of-Area Job Search was completed within a reasonable period not exceeding 30 days after the day on which the job search began.
21.
22. / Verification of Employer Contacts
Travel for Out-of-Area
Relocation More than
12 hours / Check Yes or No to indicate whether verification has been received for all employers included in a job search. The LWIA shall verify contacts with employers certified by the customer. The LWIA will utilize Commerce/Trade Form #012b to verify contact by the customer.
Travel Associated with the Out-of-Area Relocation was for more than 12 hours. If No, the customer is not eligible for Subsistence Assistance. Do not complete Items #33 - #37 below.
23. / Approved/Denied / Indicate Approval or Denial as appropriate. In order to pay the actual amount, all above criteria must be answered Yes. If approval is denied for reason other than those discussed in items #19-21, describe the reason. If approval is denied for any reason, skip to Item #45.
Trade Out-of-Area Job Search Allowance Reconciliation
24. / Previous Allowance Payments / Indicate previous Allowance Payments in items #24a-d. Indicate the sum of these payments in item #24e.
25. / Available Allowance Calculation / Indicate sum of previous allowance payments (item #24e) in item #25b. Subtract this amount from Maximum Job Search Allowance (#25a - #25b) and enter difference in item #25c.
Note: The maximum allowable Out-of-Area Job Search Allowance is $1,250 for TAA and TAARA and $1,500 for TGAAA. The customer may conduct multiple Job Searches to reach the full benefit amount. The customer is only eligible to receive an Out-of-Area Job Search Allowance up to the total of Item #25c. If the total in #25c is $0, the customer is not eligible to receive further Out-of-Area Job Search Allowances. Skip to Item #45.
Trade Actual Out-of-Area Job Search Allowance
This is the actual payment calculation of the Out-of-Area Job Search based on actual receipts – documentation is required.
Transportation Request:
26. / Date / Indicate the date of out-of-area job search event.
27. / Departed From / Indicate the place and time of customer departure.
28. / Arrived At / Indicate the place and time of customer arrival.
29. / Transportation / Calculate the auto reimbursement compensation by multiplying miles driven and the current mileage rate. For current mileage rate, go to www.gsa.gov. To calculate other mode, enter the cost of round trip travel by the most economical public transportation the customer reasonably can be expected to take from the customer’s residence to the area of job search. The customer must provide receipts if public transportation was used in lieu of auto reimbursement. Indicate the most cost effective mode of transportation. *Note: If applicable. Describe here the Other Mode of Transportation and "Other" Travel Expenses anticipated to be incurred.
30. / Other Travel Expenses / Indicate the sum total of all other applicable travel expenses such as tolls, parking, etc.
31. / Line Totals / Provide the sum total of items #29 (most cost effective mode) and #30 for each line.
32. / Total / Provide the sum total of all prior line totals from Item #31.
GSA M&IE Schedule
When Travel Is: / The Allowance Is:
More than 12 Hours, but Less than 24 Hours / 75% of the Applicable M&IE Rate
24 Hours or More: / The Day of Departure / 75% of the Applicable M&IE Rate
Full Day(s) in Travel / 100% of the Applicable M&IE Rate
The Last Day of Travel / 75% of the Applicable M&IE Rate
33. / Date / Indicate the applicable date of each event requiring subsistence assistance.
34. / Lodging and Meals Expense / Actual travel expense: The customer will provide receipts from the lodging entity and meals. Record these amounts in columns #34a and #34b along with a sum total in column #34c. (Note: the amount in #34c is the customer’s actual travel expense and will be compared to the GSA Per Diem Rate.)
35. / GSA Per Diem Rate / GSA Per Diem Rate: go to www.gsa.gov to obtain current maximum per diem rate. Record this amount in column #35a. Record 50% of this amount in column #35b.
36. / Most Cost Effective / Enter the most cost effective method from Items #34c or #35b in Item #36 for each date travelled.
37. / Total Most Cost Effective / Enter the sum total of the Most Cost Effective from Item #36.
38. / Lodging Information / Provide name, address, city, state, zip, phone & ext., and fax of the lodging facility used for actual travel expense. Include any relevant additional lodging information on a separate sheet.
39. / Subtotal Out-of-Area Job Search Expense / Add items #32 & #37 to calculate a subtotal Out-of-Area Job Search Expenses.
40. / Allowable Out-of-Area Job Search Expenses / Calculate the total Out-of-Area Job Search Expense Amount by multiplying Item #39 by 90% for TAA and TAARA or 100% for TGAAA. A customer is only allowed 90% of the Subtotal Out-of-Area Job Search expenses for TAA and TAARA or 100% for TGAAA.
41. / Requested Out-of-Area Job Search Allowance / Calculate the Requested Out-of-Area Job Search Allowance Amount by entering the lesser of Items #25c or #40.
42. / Advanced Payment / Check yes or no to indicate if customer was provided an advance payment of their out-of-area job search allowance.
43. / Advanced Payment Amount
/ If yes to #42, indicate amount of the advanced payment. This should match Item #44 from Commerce/Trade Form #012.
44. / Difference Owed to Customer
/ Calculate the amount owed to the customer by deducting the amount advanced Item #43 from Item #41.
45. / Customer Acknowledgment / Customer must acknowledge awareness of either eligibility or ineligibility for Out-of-Area job search assistance. Check box as appropriate for customer.
46. / Customer Signature / Customer must sign and date this form.
47. / Career Planner Signature / Career planner must sign and date this form.
48. / LWIA Director Signature / LWIA Director or designee must sign and date this form.

NOTE: THE LWIA CAREER PLANNER SHALL NOT RELEASE REIMBURSEMENT PAYMENT UNTIL THEY HAVE RECEIVED A COPY OF THE LETTER/FORM (Commerce/Trade Form #012b, #012c OR #012d) FROM THE INTERVIEWING COMPANY(S) OR THE LWIA REPRESENTATIVE VERIFYING THE CUSTOMER HAS COMPLETED ALL JOB SEARCHES.

January 20, 2016 Page 4 of 4 Instructions: Commerce/Trade Form #012a