| Sex 
 |  | 
		
			| Age/Date of Birth3 | OR 
					Driver's licenseBaptismal recordBirth Certificate (vital record, do not copy) DD-214Military report of Transfer or Discharge paperFederal, state, or local ID card (Do not copy state ID card)PassportHospital record of birthPublic assistance/social service recordsSchool records or ID cardsWork permitFamily BibleCross-match with state agency recordsJustice system recordsSelective Service registrationSigned letter from a parent or guardianMedical records | 
		
			| Ethnicity: Hispanic/Latino |  | 
		
			| Race 
 |  | 
		
			| Limited English Language Proficiency 
 |  | 
		
			| Limited English Reading Ability (if Limited English Language Proficient)
 |  | 
		
			| Limited English Speaking Ability (if Limited English Language Proficient)
 |  | 
		
			| Primary Language (if Limited English Language Proficient)
 |  | 
		
			| Eligible Veteran Status4 | Source documentation beyond Self-Attestation for this element is only required at the point in which a decision is made to enroll a covered person over a non-covered person and commit financial resources, which does not include staff time.OR 
					Form DD-214 showing the military service member's discharge that is anything other than dishonorableCross-match with Department of Defense recordsCross-match with Veterans Service DatabaseLetter from the Veterans AdministrationNGB-22 documenting Title 10 federal active-duty service | 
		
			| Current Education Status (School Status at Program Entry)5 | 
					Self-AttestationOR
Cross-match with Postsecondary Education DatabaseCopy of educational institution enrollment recordApplicable records from educational institution (GED certificate, diploma, attendance record, transcripts, report card, or school documentation)Electronic recordsVerbal VerificationCase notes | 
		
			| Current Highest School Grade Completed | 
					Self-AttestationOR
Applicable records from education institution (GED certificate, diploma, attendance record, transcripts, drop out letter, school documentation)Signed WIOA intake application or registration formElectronic RecordsCase notes | 
		
			| Single Parent6 | OR 
					
					TANF Single Parent Eligibility VerificationNeeds AssessmentIntake Application or Enrollment FormIndividual Service Strategy or Employment PlanCase notes | 
		
			| Current Employment Status |  | 
		
			| Current Unemployment Insurance Programs (UI)7 | 
					ORSelf-attestation, only if customer was not referred by RESEA 
					Cross-match to state UI databaseCross-match to state MIS database (Verification of Re-employment Services and Eligibility Assessment (RESEA)-funded services from the ASSET Manage Services tab) Referral transmittal by RESEA or WPRS | 
		
			| Pell Grant Recipient 
 | 
					Self-AttestationOR
FAFSA/Financial Aid RecordsAward Letter | 
		
			| Active Duty Military Spouse |  | 
		
			| Foster Care (Foster Care Youth Status at Program Entry)8 | 
					Self-attestationOR
Written Confirmation from Social Services Agency Foster Care Agency Referral TransmittalSigned WIOA intake application or registration form Needs AssessmentSigned Individual Employment PlanVerbal Verification from cognizant agency or official (school counselor, social worker, court, etc.)Case Notes | 
		
			| Family Income at or Below the Current Federal Poverty Guidelines or 70% of the Lower Living Standard Income Level (LLSIL) Guidelines9 
 Family size must be correctly determined and documented in order to correctly establish a low-income determination.
 
 NOTE: Information used to establish Family size is different from the information used to establish a household composition for the purposes of determining Economic Self-Sufficiency.
 
 NOTE: Family size is determined as of the date of eligibility determination. Family members who may have comprised part of the family during the past six months but no longer meet the definition of family should not be counted.
 
 See Income Guidance for included and excluded income types and the time span for calculating income.
 | 
					NOTE: The career planner must document the participant's income, even if the income was $0 for the past six months.Self-attestationOR
Award letter from Veterans AdministrationBank statementsPay stubsCompensation award letterCourt award letterPension statementEmployer statement/contactFamily or business financial recordsHousing authority verificationQuarterly estimated tax for self-employed personsSocial Security benefitsUI claim documentsCopy of authorization to receive cash public assistanceCopy of public assistance checkPublic assistance eligibility verificationCross-match with Refugee Assistance recordsCross-match with public assistance recordsCross-match with UI wage recordsLocal Income Determination Form | 
		
			| Unemployed Greater Than or Equal to 27 Consecutive Weeks (Long-term unemployed)10 | 
					Self-AttestationOR
Public assistance recordsRefugee assistance recordsCross-match with public assistance databaseCross-match to state UI database | 
		
			| FoodShare / (Supplemental Nutrition Assistance Program (SNAP))11 | 
					NOTE: The following are not acceptable forms of documentation:FoodShare/SNAP eligibility verificationCopy of Authorization to Receive Foodshare/SNAPReceipt of FoodShare/SNAP purchase showing balance from point of sale and date of purchaseReferral Transmittal from Foodshare/SNAPCross-Match with Foodshare/SNAP Public Assistance RecordVerbal Verification from appropriate Human Services agencyPrintout from www.access.wisconsin.gov showing benefits statement 
					A copy of the participant's FoodShare (Quest) cardScreen prints from CARES | 
		
			| Temporary Assistance for Needy Families (TANF) / Wisconsin Works (W-2)12 | 
					NOTE: It is not allowable to use screen prints from CARES to document TANF/W-2.TANF/W-2 Eligibility VerificationTANF/W-2 Period of Benefit Receipt VerificationReferral Transmittal from TANF/W-2Cross-Match with TANF/W-2 Public Assistance RecordsVerbal Verification from appropriate Human Services agency | 
		
			| Exhausting TANF/Wisconsin Works (W-2) within 2 years13 | 
					NOTE: It is not allowable to use screen prints from CARES to document TANF/W-2.TANF/W-2 Eligibility VerificationTANF/W-2 Period of Benefit Receipt VerificationReferral Transmittal from TANF/W-2Cross-Match with TANF/W-2 Public Assistance RecordsVerbal verification from appropriate Human Services agency | 
		
			| Other Income-Based Public Assistance (Other Public Assistance Recipient)14 | 
					NOTE: Career planners may not use screen prints from CARES to document public assistance.Copy of Authorization to Receive Cash Public AssistanceCopy of Public Assistance CheckMedical Card Showing Cash Grant StatusPublic Assistance Eligibility VerificationVerbal verification from appropriate social services agency | 
		
			| Offender or Ex-Offender (Ex-Offender Status at Program Entry)15 NOTE: Does not include speeding tickets or traffic court.
 | 
					Self-AttestationOR
Documentation from juvenile or adult criminal justice system (https://wcca.wicourts.gov)Written Statement or Referral Document from a Court or Probation Officer Referral Transmittal from a Reintegration Agency Signed WIOA intake application or registration formNeeds Assessment Signed Individual Employment PlanFederal Bonding Program ApplicationVerbal verification with court or probation representativeCase Notes | 
		
			| Incarcerated at Program Entry (if Offender or Ex-Offender)
 | 
					Self-AttestationOR
Verbal or written verification from justice system | 
		
			| Eligible Migrant and Seasonal Farmworker Status16 | OR 
					Cross-Match with Public Assistance RecordsCross-Match with State MISEmployment recordsCase notes | 
		
			| Individual with a disability17 | 
					NOTE: Case notes and other documentation related to this element must be maintained in compliance with Section 5.718 of this policy manual.Self-AttestationOR
School 504 records provided by studentAssessment test resultsSchool Individualized Education Program (IEP) record | 
		
			| Basic Skills Deficient19 | 
					Basic Skills Screening Tool (DETW-18156-E)OR
Assessment test resultsApplicable records from education institution (transcripts, academic assessments, or other school documentation)Case notes | 
		
			| English Language Learner20 | 
					Self-AttestationOR
Basic Skills Screening Tool (DETW-18156-E)Assessment test resultsApplicable records from education institution (transcripts, or other school documentation) Signed WIOA intake application or registration formSigned Individual Employment PlanCase notes | 
		
			| Cultural Barriers |  | 
		
			| Supplemental Security Income (SSI)/Social Security Disability Insurance (SSDI)21 | 
					SSI/SSDI Receipt of Benefits VerificationReferral Transmittal from Social Security Administration (SSA)SSI/SSDI Eligibility VerificationCross-Match with SSA DatabaseVerbal Verification from Social Security Administration | 
		
			| Homeless(Homeless participant, Homeless Children and Youths, or Runaway Youth at Program Entry)22 | 
					Self-attestationOR
Signed WIOA intake application or registration formWritten Statement or Referral Transmittal from a Shelter or Social Service AgencyNeeds AssessmentSigned Individual Employment PlanA letter from caseworker or support providerVerbal or written verification from social service agencyCase Notes | 
		
			| Qualifying Employer Name | 
					Self-attestationOR
Verification from employerRapid Response listNotice of layoff (Including a WARN Notice)Public announcement of layoffUI documentation | 
		
			| Qualifying Dislocation Date (Actual Dislocation Date)23 | 
					Self-attestationOR
Verification from Employer Rapid Response ListNotice of layoff (Including a WARN Notice)Public Announcement with Follow-Up Cross-Match with UI Database | 
		
			| Rapid Response Participation24 | OR 
					Cross-matchRapid Response listCase notes |