Attachment A

Form 1

Name: Date: _____ /_____ /_____

□Pre-test□Post-test

Basic Skills Goal

Learning Objective 3: Basic Life Skills (Allocates Resources)

BASIC LIFE SKILLS ASSESSMENTLIFE SKILLS

Fill in the blanks.

  1. What is the purpose of a W-4 form?

______

  1. Use the attached mock paycheck to identify and define the following items: net pay, gross pay, and standard payroll deductions.

Amount of itemDefinition of item

Net Pay:______

Gross Pay: ______

Standard ______

Payroll Deductions

What is FICA/Medicare tax money used for?

  1. Determine the total hours worked and total gross earnings for the following work schedule: Hourly wage is $6.25; Work schedule is Monday 3:30-7:00 pm, Wednesday 4:00-6:00 pm, Friday 6:00-10:00 pm, Saturday 1:45-6:15.

Total Hours:______

Gross Pay:______

  1. List two examples of employee fringe benefits that are required by federal law, and two (2) employee fringe benefits that are normally offered by employers, but are not required.

RequiredNot Required

1) ______1) ______

2) ______2) ______

  1. Which of the following is a better “paying” job? Explain you choice.

a) ______A job that pays $5.50 and offers paid sick leave, vacation leave and insurance.

b) ______A job that pays $6.25 and offers no fringe benefits.

______

  1. List three items of information that you should know before opening a bank account.

1)______2) ______3) ______

  1. List three items of information (other than name, address, telephone number) that is required by a bank to open a Checking or Savings account.

1)______2) ______3) ______

  1. Joe is trying to decide if he wants to put his money in a savings account. Give three reasons for keeping a savings account that you could tell Joe.

1) ______

2) ______

3) ______

  1. List two different types of credit.

1) ______2) ______

  1. Mickey is a college student and she just received a letter from a bank offering her a first credit card. What are three dangers of buying on credit that Mickey should be aware of?

1) ______

2) ______

3) ______

  1. List two positive things about using credit properly.

1) ______

2) ______

  1. Lena is buying a car. What are three things that could happen if she does not make her car payments on time?

1) ______

2) ______

3) ______

  1. List three reasons for keeping a personal budget.

1) ______

2) ______

3) ______

  1. Ted spent a long time planning his budget. List four smart shopping rules that could help him live within his budget.

1) ______

2) ______

3) ______

4)______

  1. Which is the better buy?

a)______8 oz jar of peanut butter @) $2.89

b)______12 oz jar of peanut butter @ $3.29

  1. Complete the mock blank check below. Make a payment to Safeway for groceries purchased in the amount of $47.28.

My Name03856

My Address

My Town, CA 96000Date

Pay to the order of

Dollars

My Bank

My Town

Memo

1012 2597 468239 4872: 3364

  1. List three services that the federal government spends your tax money on.

1)______2) ______3) ______

  1. What are the three basic components of a loan?

1)______2) ______3) ______

  1. Below is a list of loan sources (ways or places you can borrow money). Write high in the blank next to the sources that charge high interest rates. Write low in the blank next to the sources that charge low interest rates.

______1) banks______4) loan companies

______2) pawnshops______5) credit cards

______3) credit unions______6) borrowing on life insurance policies

  1. When looking for an apartment what are three items of information you should consider?

1) ______

2) ______

3) ______

  1. What are three things to check when buying a used car?

1)______2) ______3) ______

  1. List four expenses associated with buying and owning a car.

1) ______2) ______

3) ______4) ______

  1. Complete the following.

The emergency number for police or fire is_____.

The number for information is ____.

The cost to make a local call on a public pay phone is ____.

  1. Where are the following listings located in a telephone book?

Residential: ______

Government: ______

Business:______

  1. When taking a phone message what six items of information should be included?

1) ______2) ______

3) ______4) ______

5) ______6) ______

Total Possible Points: 25

Pre-test score______(a pre-test score of 19 points or less is required for deficiency)

Post-test score______(a post-test gain of 5 points or more, relative to the pre-test score, is

required for skill attainment)

Skill Attained: Yes____ No____

______/____/____

Staff SignatureTitle Date

I certify that this assessment has been discussed with me.

______/____/____

Participant Signature Date

WORKSHEET(For Question #2)
Joe’s Grill – Payroll Check Number: 06599
Employee: TRACY D. WORKER Social Security: 444-99-7777
EARNINGS
Hours / Wage / Gross / YTD
40 / 6.75 / 275.00 / 2146.00
TAXES
FIT / FICA / MC / SWT - CA / SDI
15.13 / 19.25 / 1.38 / 3.69 / 2.48
Pay Period: 4/15/01 – 4/30/01 Date: 5/10/01
Gross Pay: $275.00 Deductions: $41.93 Net Pay: $233.07
------
Joe’s Grill – Payroll Check Number: 06599
555 Main Street
Anytown, CA 96000
Payee: Date: Amount:
TRACY D. WORKER 05/10/01 $233.07
Two hundred thirty three and 07/100*********************************************** Dollars
0099: 22553: 366: 4411 ______
Authorized Signature

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