<p>JS-55A5 (Rev 3-13) CONNECTICUT DEPARTMENT OF LABOR – TRADE ADJUSTMENT ASSISTANCE (TAA)</p><p>Jan. Feb. Mar. Apr. May Jun. TRAINING WAIVER REVIEW Circle Month: Enrollment Unavailable Jul. Aug. Sep. Oct. Nov. Dec. Year Name SSN Petition No. To remain eligible for Trade Readjustment Allowances (TRA) after the applicable training enrollment or waiver deadline, a worker who has not completed Trade Act-approved training must either be enrolled in such training or covered by a waiver of the training requirement. Training waivers must be reviewed three months after issuance and every 30 days thereafter (if subject to 2002 program rules, review must begin within 30 days of waiver issuance). Waiver review considers whether the conditions existing at the time of waiver issuance continue to exist. In the event conditions have changed and training becomes feasible and appropriate, the waiver must be revoked. Failure to comply with the waiver review process will result in waiver revocation and may jeopardize your eligibility to receive TRA. Directions: Complete and return this form on the first fifteenth of each month as directed by your Labor Department career development specialist. The form must be received within ten days of the due date. </p><p>Section One - Job Search Review How many employers did you contact during the past month? 0 1-5 6-11 12-15 16-19 20 or more If you did not actively seek work during the past month, explain why and skip any remaining questions in this section that do not apply. </p><p>How did you find most job leads during the past month? Check all that apply. Job/Career Fairs Online Job Sites/Job Boards CT Department of Labor Referral Networking Cold Contact/Direct Mail College Career/Alumni Offices Help Wanted Signs Recruiters/Headhunters Professional/Trade Organizations Union Hiring Halls Corporate Career Centers Want Ads/Newspaper Websites</p><p>How did you seek work during the past month? Check what was most typical. I made phone calls. I submitted applications. I inquired or applied in person. I applied online. I was interviewed. I submitted copies of my resume. I made inquiries asking if any jobs were available. I applied for specific positions. Other: </p><p>How many interviews did you have during the past month? 0 1 2 3 4 5 or more Compared to prior months, is the number of interviews increasing? decreasing? remaining steady? Were any of your interviews “second” or “third” interviews? Yes No </p><p>If you have not yet been offered a job, what reason(s), if any, have employers given you for not being selected? What feedback have you received from employers about your qualifications? If you have been advised that you lack any particular qualification(s), please indicate. </p><p>If you know of anything else that may be preventing you from finding work, please indicate. </p><p>Are you running out of employers to contact for suitable job opportunities? Yes No If you have started to seek work that is less desirable than your past job, indicate how these job opportunities compare. If necessary, provide additional details in the comments section on page two. Lower Wages Lower Skill Fewer Fringe Benefits Less Desirable Shift Fewer Hours Other: Page 1 of 2 Section Two - Employment Status I am currently unemployed. I am working as previously reported. During the past month, I accepted work that is: full-time part-time and temporary permanent.</p><p>Employer: Start date: </p><p>Title: Pay rate: $ per If not working, what is your chance of being offered a job during the next month? Poor Fair Good Excellent Do you request an in-person appointment with a career development specialist (if not already scheduled)? Yes No If yes, indicate any weekdays you are not available during the next month. </p><p>IMPORTANT: This monthly waiver review is conducted to determine your ongoing eligibility for a Trade Act training waiver. Providing information here DOES NOT satisfy the reporting requirements of Unemployment Insurance (UI) or TRA claims in the case of questions about circumstances “not previously reported.” Information provided here about any job refusals or change in your employment or work availability status must also be given when answering similar questions on your weekly claims. Section Three - Waiver Review You received a training waiver based on the delayed start to your approved training program. Is your training start date still valid? Yes - I will begin training on , as previously reported. No - My training start date has changed from to . No - I am unable or unwilling to begin training as planned. </p><p>If your scheduled training has been further delayed or cancelled, how and when were you notified? </p><p>What reason were you given for the change? </p><p>If you are unable to participate as scheduled for personal reasons, explain. </p><p>If other training providers or programs need to be considered, contact your Labor Department career development specialist as soon as possible or request an appointment in section two, above. If you have other particular training interests, please indicate. </p><p>If your circumstances have changed and you believe you may qualify for a training waiver for any other reason, check the appropriate category and explain below. </p><p>__ Health __ Training Not Available __ Marketable Skills* __ Retirement* __ Recall* </p><p>*Note: These waiver categories are NOT available to workers covered under 2011 program rules.</p><p>I certify that the information I have provided is true and correct to the best of my knowledge and belief. I understand that the reporting of any job refusals or change in my employment or work availability status here DOES NOT relieve me of my obligation to fully disclose similar information requested of me during the filing of my weekly UI or TRA claims, unless expressly authorized by a Labor Department representative. </p><p>Signature Date Phone Email JS-55A5</p><p>Page 2 of 2</p>