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Document Number: TRA-858-A
Description: This form is used by the claimant while collecting TRA payments; to verify attendance in approved training for the calendar week. The completed form must be submitted by the claimant to the local TRA coordinator to authorize TRA payment for the week.
Comments: The claimant fills in full name, social security number, telephone number, email address, complete street address, city, state, zip code, name of training institution (school), name of training program (course of study), unemployment insurance week number, beginning Sunday date and ending Saturday date.
Section A includes three parts. The claimant answers question one and provides an explanation if necessary. The claimant answers question two and obtains the required signature if necessary. Part three requires the claimant to list the names of all classes scheduled in the current semester, as well as the days of the week attended. An instructor signature or email is required to verify class attendance.
The claimant will receive instructions from their local TAA Coordinator if they are to complete section B.
Section C requires a claimant signature and date. The completed form must be submitted to the local TRA Coordinator for processing and to authorize payment for the week.
Content Contact: Gary Burtch
Document Attachment: TRA-858A (pdf/30 KB)
Directions for Completing Form TRA-858A (English Print Version)
Directions for Completing Form TRA-858A (Hmong Print Version)
Directions for Completing Form TRA-858A (Spanish Print Version)
***Should you require the necessary software to view the above attachment, please go to the DWD Viewers Download Page. Links to each specific vendor's site have been provided for you. Thank you.