| Date Of Certification: | ||
| Last Day Of Work: | ||
| Waiver Deadline: | ||
| First Week Payable For TRA: | ||
| Enrollment Deadline: | ||
| Basic TRA Eligibility Period End Date: | ||
| Full Weekly UI Benefit Rate: | $ | x 8 = $ |
| Last Day Of Eligibility To Begin ATAA: | ||
| First Month Of HCTC Eligibility: | ||
| TAA Coordinator: | ||
| TRA Coordinator: | ||