CONNECTICUT DEPARTMENT OF LABOR – TRADE ADJUSTMENT ASSISTANCE (TAA)
TRAINING WAIVER REVIEW / Circle Month: / Jan. / Feb. / Mar. / Apr. / May / Jun. / Year
Health
/ Jul. / Aug. / Sep. / Oct. / Nov. / Dec.Name / SSN / Petition No.
To remain eligible for Trade Readjustment Allowances (TRA) after the applicable training enrollment or waiver deadline, a worker who has not completed Trade Act-approved training must either be enrolled in such training or covered by a waiver of the training requirement. For workers eligible under Trade Act petitions greater than70000, training waivers must be reviewed three months after issuance and every 30 days thereafter (review of waivers issued for retirement is optional). Workers covered under petitions less than 70000 are subject to monthly review in all cases. Waiver review considers whether the conditions existing at the time of waiver issuance continue to exist. In the event conditions have changed and training becomes feasible and appropriate, the waiver must be revoked. Failure to comply with the waiver review process will result in waiver revocation and may jeopardize your eligibility to receive TRA.
Directions:Complete and return this form on the first fifteenth of each month as directed by your Labor Department career development specialist. The form must be received within ten days of the due date.
Section One - Job Search Review
How many employers did you contact during the past month?0 1-5 6-11 12-15 16-19 20 or more
If you did not actively seek work during the past month, explain why and skip any remaining questions in this section that do not apply.
How did you find most job leads during the past month? Check all that apply.
Job/Career Fairs / Online Job Sites/Job Boards / CT Department of Labor Referral
Networking / Cold Contact/Direct Mail / College Career/Alumni Offices
Help Wanted Signs / Recruiters/Headhunters / Professional/Trade Organizations
Union Hiring Halls / Corporate Career Centers / Want Ads/Newspaper Websites
How did you seek work during the past month? Check what was most typical.
I made phone calls. / I submitted applications. / I inquired or applied in person.
I applied online. / I was interviewed. / I submitted copies of my resume.
I made inquiries asking if any jobs were available. / I applied for specific positions.
Other:
How many interviews did you have during the past month? 0 1 2 3 4 5 or more
Compared to prior months, is the number of interviews
increasing? decreasing? remaining steady?
Were any of your interviews “second” or “third” interviews? Yes No
If you have not yet been offered a job, what reason(s), if any, have employers given you for not being selected? What feedback have you received from employers about your qualifications? If you have been advised that you lack any particular qualification(s), please indicate.
If you know of anything else that may be preventing you from finding work, please indicate.
Are you running out of employers to contact for suitable job opportunities? Yes No
If you have started to seek work that is less desirable than your past job, indicate how these job opportunities compare. If necessary, provide additional details in the comments section on page two.
Lower Wages Lower Skill Fewer Fringe Benefits Less Desirable Shift Fewer Hours
Other:
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Section Two - Employment Status
I am currently unemployed. / I am working as previously reported.During the past month, I accepted work that is:
full-time part-time / and / temporary permanent.
Employer: / Start date:
Title: / Pay rate: $ / per
If not working, what is your chance of being offered a job during the next month?
Poor Fair Good Excellent
Do you request an in-person appointment with a career development specialist (if not already scheduled)? Yes No If yes, indicate any weekdays you are not available during the next month.
IMPORTANT: This monthly waiver review is conducted todetermine your ongoing eligibility for a Trade Act training waiver. Providing information here DOES NOT satisfy the reporting requirements of Unemployment Insurance (UI) or TRA claims in the case of questions about circumstances “not previously reported.” Information provided here about any job refusals or change in your employment or work availability status must also be given when answering similar questions on your weekly claims.
Section Three - Waiver Review
You received a training waiver based on being unable to participate in training for health reasons.Have conditions changed in any way?
Yes - I am now physically able to participate in training.
No - I am still unable to participate in training for health reasons.
If there has been a change in your ability to seek and accept work, explain below or attach a separate page.
If the health waiver category no longer applies or there has been a change in your circumstances:
Do you have an interest in training? Yes No If yes, what kind of training?
Note TRA
Deadline: / The following deadline applies only if you are covered under a petition number lower than 70000: In order to qualify for additional TRA if otherwise eligible, you must sign a bona fide application for training within 210 days of either the date of the Trade Act certification providing your eligibility or the date of your most recent qualifying separation, whichever is later. In Connecticut, a bona fide application for training is the JS-52/Trade Adjustment Assistance (TAA) Training Application and Proposal.
If you believe you may qualify for a training waiver based on one of the other five criteria, check the appropriate category and explain below.
Available to petition numbers less than 80000:
Recall Marketable Skills Retirement
Available to all petition numbers:
Enrollment Unavailable Training Not Available
I certify that the information I have provided is true and correct to the best of my knowledge and belief. I understand that the reporting of any job refusals or change in my employment or work availability status here DOES NOT relieve me of my obligation to fully disclose similar information requested of me during the filing of my weekly UI or TRA claims, unless expressly authorized by a Labor Department representative.
Signature / Date
Phone / Email / JS-55A4
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