Immediately preceding the qualified employee's commencement of employment with the taxpayer, was a person eligible to be a voluntary or mandatory registrant under the Greater Avenues for Independence Act of 1985 (GAIN) provided for pursuant to Article 3.2 (commencing with Section 11320) of Chapter 2 of Part 3 of Division 9 of the Welfare and Institutions Code, or its successor.

Immediately preceding the qualified employee's commencement of employment with the taxpayer, was a person eligible for services under the federal Job Training Partnership Act (29 U.S.C. Sec. 1501 et seq.), or its successor, who is receiving, or is eligible to receive, subsidized employment, training, or services funded by the federal Job Training Partnership Act, or its successor.

Immediately preceding the qualified employee's commencement of employment with the taxpayer, was a member of a targeted group, as defined in Section 51(d) of the Internal Revenue Code, or its successor.( i.e. Targeted Jobs Tax Credit and its successors, Welfare to Work and Work Opportunity Tax Credits)

Immediately preceding the qualified employee's commencement of employment with the taxpayer, was an economically disadvantaged individual 14 years of age or older.

1. Official ID card or other documentation issued by federal-state-local government showing employee age or date of birth and indicating they are 14 yrs of age or older

2. Documentation that immediately preceding the employee hire date they were a disadvantaged individual or economically disadvantaged youth as defined in subdivision 8461(d)

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Has been terminated or laid off or who has received a notice of termination or layoff from employment, is eligible for or has exhausted entitlement to unemployment insurance benefits, and is unlikely to return to his or her previous industry or occupation.

III. E1: Dislocated: Layoff (Con’t)

Section A

1. Copy of termination notice
2. Employer or union representative letter identifying employee's termination date
3. Photocopy of printed media article or announcement describing layoff along with a copy of employee's last payroll check prior to hire by the Applicant
4. Separation or termination report signed by employer
5. Documentation showing that the employee is eligible for or has exhausted entitlement to unemployment insurance benefits as specified in subdivision (c) (2)

Section B

1. Unemployment insurance records
2. Statement by an unemployment insurance representative

Section C

1. Screen print of CA EDD Labor Market Division screens that indicates limited opportunities for employment in the same or similar occupation
2. Doctor's statement indicating employee's inability to return to
3. previous industry/occupation due to physical limitations
4. Vocational rehabilitation counselor's statement indicating the employee's inability to return to previous industry/occupation due to physical limitations
5. Other third party documentation that demonstrates the unavailability of similar employment in the employee's previous industry or profession

Has been terminated or has received a notice of termination of employment as a result of any permanent closure or any substantial layoff at a plant, facility, or enterprise, including an individual who has not received written notification but whose employer has made a public announcement of the closure or layoff.

Section A

1. Bankruptcy documents, if declared under Ch. 7, Title 11 U.S.C., Notice of Foreclosure or a similar document provided by a financial institution when such document clearly shows that a foreclosure of mass layoff will occur as a result of its issuance
2. Copy of a printed media article/annoucement, including the name and date of the publication, describing the closure/mass layoff.
3. Statement from the employer or the union representative
4. Statement from the employer's bank official, attorney, supplier or accountant
5. WARN (Worker Adjustment and Retraining Notification Act) notice

Section B

1. Notice of termination or layoff or other company documentation of employee's termination
2. Employer or union representative letter identifying the employee's termination
3. Separation or Termination Report, or equivalent, signed by the employee's former employer
4. Evidence that the employee is or was employed by the plant, facility, or enterprise identified in subdivision (d)(1)
5. WARN (Worker Adjustment and Retraining Notification Act) notice

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Is long-term unemployed and has limited opportunities for employment or reemployment in same or a similar occupation in the area in which the individual resides, including an individual 55 years of age or older who may have substantial barriers to employment by reason of age

III.E3: Long-term unemployment/similar occupation (Con’t)

Section A

1. Proof of receipt of unemployment benefits for at least 15 weeks prior to commencement of employment or proof that unemployment benefits were exhausted.
2. Unemployment insurance verification benefits record
3. Unemployment insurance award letter with the claim history
4. Workers Investment Act Displaced Worker Unit verification
5. Statement by an unemployment insurance representative
6. Documentation that qualifies the employee as a dislocated worker under subdivision (c) or as a dislocated worker due to a plant, facility, or enterprise closure under subdivision (d) showing long-term unemployment for at least 15 weeks prior to commencement of employment

Section B

1. A screen print from the California Employment Development Department Labor Market Information Division screens that indicates limited opportunities for employment or reemployment in the same or similar occupation
2. Statement from a doctor indicating employees inability to return to previous industry/occupation due to physical limitations
3. Statement from a vocational rehabilitation counselor indicating employees inability to return to previous industry/occupation due to physical limitations
4. Other third party documentation that demonstrates the unavailability of similar employment in the employee's previous industry or profession

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Was self-employed (including farmers and ranchers) and is unemployed as a result of general economic conditions in the community in which he or she resides or because of natural disasters.

III.E4: Self-Employed individual unemployed due to economic conditions or natural disasters (Con’t)

1. Bankruptcy documents listing both the names of the business and the employee's name
2. Business license or permit listing the employee's name
3. Copy of articles of incorporation or documentation of dissolution for the business listing the employee as an owner
4. Prior year's income tax return
5. Other documentation sufficient to demonstrate that the employee was previously self-employed and was unemployed prior to the commencement of employment due to economic conditions in the community or due to natural disaster

Was a civilian employee of the Department of Defense employed at a military installation being closed or realigned under the Defense Base Closure and Realignment Act of 1990.

Section A

1. Employee's termination notice

Section B

1. Copy of media article or announcement describing the layoff or closure
2. Employer or union representative letter describing the layoff or closure

Was a civilian employee of the Department of Defense employed at a military installation being closed or realigned under the Defense Base Closure and Realignment Act of 1990.

1. Report of separation or discharge from the armed services of the National Guard
2. Veteran's Administration documentation
3. Verification by State Veterans Agency

Is a seasonal or migrant worker who experiences chronic seasonal unemployment and underemployment in the agriculture industry, aggravated by continual advancements in technology and mechanization.

1. Documentation of employee's migrant employment in a season occupation
2. Employer or union representative letter describing seasonal layoff in employee's seasonal occupation
3. Copies of termination notices identifying employer and employee
4. Copies of employee's pay stubs identifying seasonal employer

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Has been terminated or laid off, or has received a notice of termination or layoff, as a consequence of compliance with the Clean

Air Act.

III.E8: Layoff due to Clean Air Act (Con’t)

Section A

1. Employee's termination notice

Section B

1. Copy of media article or announcement describing the reason for the layoff
2. Employer or union representative letter stating that compliance with the Clean Air Act was the reason for the layoff

Immediately preceding the qualified employee's commencement of employment with the taxpayer, was a disabled individual who is eligible for or enrolled in, or has completed a state rehabilitation plan

Section A

1. Physician Statement
2. Rehabilitation Plan
3. Vocational Rehabilitation Letter
4. Verification by state or federal rehabilitation counselor
5. Letter from a state drug or alcohol rehabilitation agency
6. Medical records
7. Social Security Administration disability records
8. Social Service records/referral

Section B

1. DD-214 Defense Department Report of Separation showing the employee is a service-connected disabled veteran
2. Veteran's Administration documentation showing the employee is a service-connected disabled veteran
3. Verification by State Veterans Agency

Immediately preceding the qualified employee's commencement of employment with the taxpayer, was a service-connected disabled veteran, veteran of the Vietnam era, or veteran who is recently separated from military service.

1. DD-214, Defense Department Report of Separation
2. Veterans Administration Documentation
3. Verification by State Veterans Agency

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Immediately preceding the qualified employee's commencement of employment with the taxpayer, was an ex-offender. An individual shall be treated as convicted if he or she was placed on probation by a state court without a finding of guilt.

III.H: Ex-Offender (Con’t)

1. Court Documents
2. Letter of Parole
3. Letter from Probation Officer
4. Police Records
5. A copy of a background check report or independent court records report showing the employee as the ex-offender as defined in subdivision 8461(e), signed by a background checking business or independent court records business, licensed and/or certified if required by California or federal law
6. Other government documentation verifying ex-offender status, such as a letter from the Board of Prison Terms or a letter from the Governor's Office

Immediately preceding the qualified employee's commencement of employment with the taxpayer, was a person eligible for or a recipient of any of the following:

(aa) Federal Suppl Security Income benefits

(bb) Aid to Families with Dependent Children

(cc) Food stamps

(dd) State and local general assistance

1. Public Assistance Award Letter
2. Benefit Printout
3. Current Food Stamp ID Card or Award Letter
4. Social Security Insurance Award Letter or Check Stub
5. Refugee Cash Assistance (RCA)
6. Verification by Department of Social Services
7. Written statement from county welfare office or telephone verification by zone manager
8. Public assistance records/printout

Immediately preceding the qualified employee's commencement of employment with the taxpayer was a member of a federally recognized Indian tribe, band, or other group of Native American descent.

1. Native American Tribal Record Document
2. Certified Degree of Indian Blood (CDIB) Card Issued by Bureau of Indian Affairs
3. Documentation that the employee is a Native Samoan, Native Hawaiian or a member of another group of Native American descent

Immediately preceding the qualified employee's commencement of employment with the taxpayer, was a resident of a targeted employment area (as defined in Section 7072 of the Government Code).

Section A

1. TEA Street Range Listing

Section B

1. Federal Form W-4 completed at the time of hire
2. Federal Form I-9, U.S. Department of Justice, Immigration and Naturalization Service
3. Driver's license or state ID card
4. Landlord statement
5. Lease or rental agreement
6. Utility bill