Pay File Checklist

Supportive Services

• Books 
• Car repairs
• CDL License/Permit Reimbursement
• Background Check/Fingerprinting
• Exam Fee
• GED Testing
• Healthcare License
• Health Special Fees: (exam/test fees & Insurance fee)
• Housing
• Mileage
• Needs Related Payment
• Supplies
• Tools
• Uniforms or Work Attire
• Utilities
• Parking Pass
• Bus Pass
• Vehicle Insurance (liability)
• Driver’s License/State ID (Youth only)
• Child Care
• Medical (Referrals to Healthcare)
• OJT
• Work Experience
• Tuition & Fees
• Incentives
• Additional Information

Books

• ITA Voucher (Per Deb when reviewing a case with me, Books should not be a part of the ITA and should ALWAYS be a supportive service) or Customer Assistance Request form (CAR) – MUST INCLUDE ALL REQUIRED SIGNATURES- ALL SECTIONS COMPLETED
• Coordination of Assistance form (each term)
• Book expense estimate) REQUIRED books only – from book vendor
• School document with training dates and course numbers (ex. Schedule, statement from school).
• Receipt/Invoice to show that purchase has been made.
  • Receipt must be signed by participant OR documentation from participant must be obtained verifying those books were received. This would include electronic books (email, written, or self-attestation).
• Invoice from training provider must be included if applicable

Career Planner Actions not included in pay file packet but MUST be completed

• If class is dropped need to attempt to get book/funds back and case note as well as upload the demand letter in NEworks funds if the book is an eBook, the book itself if not)

Car repairs

• Customer Assistance Request form (CAR) – – MUST INCLUDE ALL REQUIRED SIGNATURES- ALL SECTIONS COMPLETED
• Coordination of Assistance
• Copy of Nebraska registration with participants name (Not expired) Ensure vehicle on registration matches vehicle listed on insurance
• Copy of Insurance with Participants name (Not expired) Ensure vehicle on insurance matches vehicle on registration
• Copy of Nebraska driver’s license (Not expired)
• Two car repair estimates (if the vehicle is not drivable can one estimate, but need self-attestation including information regarding the situation)
• KBB- private party sell documentation (cost of repairs cannot exceed 80% of private sale vehicle value)
• Receipt/Invoice to verify repairs were paid for
  • Receipt must be signed by participant OR documentation from participant must be obtained verifying that vehicle was repaired. (Email, written, or self-attestation).

Career Planner Actions not included in pay file packet but MUST be completed

• Must obtain W-9

CDL License/Permit Reimbursement

• Customer Assistance Request form (CAR) – MUST INCLUDE ALL REQUIRED SIGNATURES- ALL SECTIONS COMPLETED
• Coordination of Assistance
• License/Permit expense estimate
• Receipt/Invoice to verify CDL License/Permit was purchased
  • Receipt must be signed by participant OR documentation from participant must be obtained verifying that CDL License/Permit was purchased (email, written, or self-attestation)

Career Planner Actions not included in pay file packet but MUST be completed

• Obtain a copy of CDL License/Permit. Case note and upload document in NEworks

Background Check/Fingerprinting

• Customer Assistance Request form (CAR) – MUST INCLUDE ALL REQUIRED SIGNATURES- ALL SECTIONS COMPLETED
• Coordination of Assistance
• Background check/fingerprinting expense estimate (including what type of background check needs to be completed)
• Document showing it is required for training and/or Work Based Learning (WBL) worksite (not OJT)
• Receipt/Invoice to verify services were paid for
  • Receipt must be signed by participant OR documentation from participant must be obtained verifying those services were paid for. (Email, written, or self-attestation).

Career Planner Actions not included in pay file packet but MUST be completed

• Results will be case noted and uploaded into NEworks

Exam Fee

• Customer Assistance Request form (CAR) – MUST INCLUDE ALL REQUIRED SIGNATURES- ALL SECTIONS COMPLETED
• Coordination of Assistance (each term)
• Document showing requirement for class/employer
• Exam Fee expense estimate documentation
• Receipt/Invoice to verify services were paid for
  • Receipt must be signed by participant OR documentation from participant must be obtained verifying those services were paid for. (Email, written, or self-attestation).

Career Planner Actions not included in pay file packet but MUST be completed

• Exam results will be obtained, case noted and uploaded into NEworks
• Enter EFL Gain and/or MSG if applicable

GED Testing

• Customer Assistance Request form (CAR) – MUST INCLUDE ALL REQUIRED SIGNATURES- ALL SECTIONS COMPLETED
• Coordination of Assistance (each term)
• GED Testing expense estimate
• Receipt/Invoice to verify services were paid for
  • Receipt must be signed by participant OR documentation from participant must be obtained verifying those services were paid for. (Email, written, or self-attestation).

Career Planner Actions not included in pay file packet but MUST be completed

• Exam results will be obtained, case noted and uploaded into NEworks
• Enter EFL Gain and/or MSG if applicable

Healthcare License

• Customer Assistance Request form (CAR) – MUST INCLUDE ALL REQUIRED SIGNATURES- ALL SECTIONS COMPLETED
• License expense estimate (copy of application, blank copy is acceptable)
• Receipt/Invoice to verify services were paid for
  o Receipt must be signed by participant OR documentation from participant must be obtained verifying those services were paid for. (Email, written, or self-attestation).

Career Planner Actions not included in pay file packet but MUST be completed

• Copy of License will be obtained, case noted and uploaded into NEworks
• Enter EFL Gain and/or MSG if applicable

Health Special Fees: (exam/test fees & Insurance fee)

• ITA Voucher or Customer Assistance Request form (CAR) – MUST INCLUDE ALL REQUIRED SIGNATURES- ALL SECTIONS COMPLETED
• Coordination of Assistance (each term)
• Document showing requirement for class
• Fee Expense Estimate
• Receipt/Invoice to verify services were paid for showing a breakdown of fees
  • Receipt must be signed by participant OR documentation from participant must be obtained verifying those services were paid for. (Email, written, or self-attestation).

Housing

• Customer Assistance Request form (CAR) – MUST INCLUDE ALL REQUIRED SIGNATURES- ALL SECTIONS COMPLETED
• Coordination of Assistance
• Lease / rental agreement with monthly rent amount (if mortgage, include mortgage payment statement or document showing the monthly mortgage due date and payment amount.) *Do not include the entire mortgage purchase agreement *Lease/rental agreement/mortgage needs to include participant’s name
• Rent cannot be paid in advance unless documented thoroughly why
• Receipt/Invoice to verify services were paid for showing a breakdown of fees
  • Receipt must be signed by participant OR documentation from participant must be obtained verifying those services were paid for. (Email, written, or self-attestation)

Career Planner Actions not included in pay file packet but MUST be completed

• Must case note how this expense will be covered by the participant moving forward

Mileage

• Customer Assistance Request form (CAR) – MUST INCLUDE ALL REQUIRED SIGNATURES- ALL SECTIONS COMPLETED
• Coordination of Assistance (must be completed each term)
• Mileage Pre-Authorization form
  • Class or work schedule with participant’s name verifying days they will travel
  • Google Maps directions page showing mileage (including specific address)
  • Copy of Nebraska registration with participants name (Not expired) Ensure vehicle on registration matches vehicle listed on insurance.
• Copy of Insurance with Participants name (Not expired) Ensure vehicle on insurance matches vehicle on registration
• Copy of Nebraska driver’s license (Not expired) Completed WIOA Motor Vehicle Mileage Log Form (Signed and dated)
• Attendance sheets completed with required signatures verifying attendance

Career Planner Actions not included in pay file packet but MUST be completed

• Complete W-9 with participant and send to Project Accountant prior to first payment authorization

Needs Related Payment

• Customer Assistance Request form (CAR) – MUST INCLUDE ALL REQUIRED SIGNATURES-ALL SECTIONS COMPLETED
• Coordination of Assistance
• Need Related Payment Worksheet
• Verification showing participant is ineligible for OR has exhausted UI benefits (for Adults & DW)

Career Planner Actions not included in pay file packet but MUST be completed

• Complete W-9 with participant and send to Project Accountant prior to first payment authorization

Supplies

• ITA Voucher or Customer Assistance Request form(CAR) – MUST INCLUDE ALL REQUIRED SIGNATURES-ALL SECTIONS COMPLETED
• Coordination of Assistance (each term)
• List of required supplies (from school/employer)
• Supply expense estimate
  • Match up items on the invoice/receipt with the items on the list of required supplies
• Receipt/Invoice to verify services were paid for showing a breakdown of fees
  • Receipt must be signed by participant OR documentation from participant must be obtained verifying those services were paid for. (Email, written, or self-attestation).

Tools

• ITA Voucher or Customer Assistance Request form (CAR) – MUST INCLUDE ALL REQUIRED SIGNATURES-ALL SECTIONS COMPLETED
• Coordination of Assistance (each term)
• List of required tools (from school/employer)
• Tools expense estimates
  • Match up items on the invoice/receipt with the items on the list of required tools
• Receipt/Invoice to verify services were paid for showing a breakdown of fees
  • Receipt must be signed by participant OR documentation from participant must be obtained verifying those services were paid for. (Email, written, or self-attestation).

Uniforms or Work Attire

• Customer Assistance Request form (CAR) – MUST INCLUDE ALL REQUIRED SIGNATURES-ALL SECTIONS COMPLETED
• Coordination of Assistance
• List of required work attire (from school/employer)
• Clothing Expense Estimate
  • Match up items on the invoice/receipt with the items on the list of required clothing
• Receipt/Invoice to verify services were paid for showing a breakdown of fees
  • Receipt must be signed by participant OR documentation from participant must be obtained verifying those services were paid for. (Email, written, or self-attestation).

Utilities

• Customer Assistance Request form (CAR) – MUST INCLUDE ALL REQUIRED SIGNATURES-ALL SECTIONS COMPLETED
• Coordination of Assistance
• Utilities statement
  • Cannot pay late fees
• Receipt/Invoice to verify services were paid for showing a breakdown of fees
  • Receipt must be signed by participant OR documentation from participant must be obtained verifying those services were paid for. (Email, written, or self-attestation).

Career Planner Actions not included in pay file packet but MUST be completed

• Must case note how this expense will be covered by the participant moving forward
• Must obtain W-9

Parking Pass

• Customer Assistance Request form (CAR) – MUST INCLUDE ALL REQUIRED SIGNATURES-ALL SECTIONS COMPLETED
  • Include date range that service will cover
• Coordination of Assistance
• Parking pass copies (receipt) with customers signature, SID#, and date

Career Planner Actions not included in pay file packet but MUST be completed

• CP must enter a case note that indicates why the number of parking passes were issued and explain first hour free in the determination

Bus Pass

• Customer Assistance Request form (CAR) – MUST INCLUDE ALL REQUIRED SIGNATURES-ALL SECTIONS COMPLETED
• Coordination of Assistance
• Copy of front and back of bus pass with signature from participant, SID#, and date

Vehicle Insurance (liability)

• Customer Assistance Request form (CAR) – MUST INCLUDE ALL REQUIRED SIGNATURES-ALL SECTIONS COMPLETED
• Coordination of Assistance
• Invoice/billing statement or quote if it is a new provider
  • Estimated expense must detail liability insurance and its specific cost
• Copy of Nebraska registration with participants name (Not expired)
• Copy of Nebraska driver’s license (Not expired)
• Receipt/Invoice to verify services were paid for showing a breakdown of fees
  • Receipt must be signed by participant OR documentation from participant must be obtained verifying those services were paid for. (Email, written, or self-attestation).

Career Planner Actions not included in payfile packet but MUST be completed

• Must case note how this expense will be covered by the participant moving forward
• Must also obtain W-9

Driver’s License/State ID (Youth only)

• Customer Assistance Request form (CAR) – MUST INCLUDE ALL REQUIRED SIGNATURES-ALL SECTIONS COMPLETED
• Coordination of Assistance
• ID/License Expense Estimate
• Receipt/Invoice to verify services were paid for showing a breakdown of fees
  • Receipt must be signed by participant OR documentation from participant must be obtained verifying those services were paid for. (Email, written, or self-attestation).

Career Planner Actions not included in pay file packet but MUST be completed

• CP must obtain a copy of Driver’s license/State ID and upload into NEworks

Child Care

• Customer Assistance Request form (CAR) – MUST INCLUDE ALL REQUIRED SIGNATURES-ALL SECTIONS COMPLETED
• Coordination of Assistance
• Documentation of DHHS licensed facility/provider
• Log designed by vendor (includes participant name, # of children and the charge rate; hourly, daily, etc.)
• Participant schedule (class or work)
• Log of when child was present at facility
  • Ensure times in childcare match participant schedule
• Receipt/Invoice to verify services were paid for showing a breakdown of fees
  • Receipt must be signed by participant OR documentation from participant must be obtained verifying those services were paid for. (Email, written, or self-attestation).
  • Invoice/receipt should include the name of the daycare, participant’s name, date, and payment amount.

Career Planner Actions not included in pay file packet but MUST be completed

• Must obtain W-9

Medical (Referrals to Healthcare)

• Customer Assistance Request form (CAR) – MUST INCLUDE ALL REQUIRED SIGNATURES-ALL SECTIONS COMPLETED
• Coordination of Assistance
• Document showing requirement for class/employer
  • Should not cover any long-term medical care expenses
• Receipt/Invoice to verify services were paid for showing a breakdown of fees
  • Receipt must be signed by participant OR documentation from participant must be obtained verifying those services were paid for. (Email, written, or self-attestation).

Career Planner Actions not included in pay file packet but MUST be completed

• Must obtain W-9

OJT

• Paystub verifying hours worked OR Payroll documents signed by participant OR Email acknowledgement or self-attestation signed by participant verifying hours worked
• Employer Request for Reimbursement Form
• OJT Contract

WEX Coordinator Actions not included in pay file packet but MUST be completed

• Enter hours into OJT Tracker and case note remaining hours
• Monthly site visit should be case noted as well
• Progress case noted

Work Experience

• Work Site Agreement
  • Beginning and ending dates
  • Number of allowed hours
  • Dated and signed prior to begin date
• Time sheet
  • Submitted by participant and approved by supervisor

WEX Coordinator Actions not included in pay file packet but MUST be completed

• Enter hours into WEX Tracker and case note remaining hours.
• Monthly site visit should be case noted as well
• Progress case noted

Tuition & Fees

• ITA Voucher or Customer Assistance Request form (CAR) – MUST INCLUDE ALL REQUIRED SIGNATURES-ALL SECTIONS COMPLETED
• Coordination of Assistance (each term)
• School document with training dates and course numbers
• FAFSA documentation if applicable
• Student financial statement or breakdown of costs from training provider
• Unofficial transcript if applicable
  • We cannot pay for the same course twice and student must be making satisfactory progress per policy
• FINAL invoice with requested payment amount

Career Planner Actions not included in pay file packet but MUST be completed

• Please see ITA Procedure Guide and follow accordingly

Incentives

• Customer Assistance Form (CAR) MUST INCLUDE ALL REQUIRED SIGNATURES-ALL SECTIONS COMPLETED
  • Must identify credential type on the form
    • Credential
    • GPA
    • WBL
• If credential or GPA Cop of Credential or transcript
• If WBL-Summary of all hours worked and a referral letter from employer
  • Must be on company letterhead
  • Must include begin and end dates of WBL
  • Must include Supervisor signature and date
  • Must include participant signature and date

All Services must include the following Career Planner Actions but are not included in the pay file checklist

• Enter a case note when completing every service listed above
  • Clearly case note anything that is out of the ordinary with the case
• Ensure that appropriate activities are open and correctly entered in NEworks

Note: This documentation is also sent to the PA.