Scsep Third Party Attestation Forms - U.s. Department Of Labor printable pdf download

Scsep Third Party Attestation Forms - U.s. Department Of Labor

SCSEP DATA VALIDATION

THIRD-PARTY ATTESTATION OMNIBUS SIGNATURE FORM

Instructions for SCSEP program personnel

The forms below are to be used by SCSEP program personnel to allow third parties who have a

relationship with a SCSEP applicant or participant to attest to information related to data elements that

are validated by the SCSEP program. There is a separate form for each of the 14 data elements that

accept signed third-party attestation as a form of source documentation. This enables SCSEP personnel

to print out only the form(s) that are needed in a given situation.

The information attested to by third parties should amount to more than what the applicant or participant

told the third party. On each form, then, the attester will be asked to provide specific information about

his or her relationship to the applicant/participant, as well as an explanation of how he or she is in a

knowledgeable position to attest to the facts cited.

NOTE 1: SCSEP program personnel should be aware that participants who are able to present

documentation that can be used to validate any of the data elements listed below have no need to rely on

third parties to attest to the specific facts or use the relevant attestation form for that element. Official

source documentation is, by itself, sufficient to validate any individual piece of information below.

Similarly, case notes and self-attestation may be used to validate the information for certain elements.

Please refer to the DV handbook for exact instructions on when these other forms of validation are

acceptable.

NOTE 2: The following data elements accept third-party attestation:

P8 – Homeless

P11 – Number in family (Signed third party attestation, as opposed to a medical professional, is not

acceptable in establishing family-of-one is due to disability.)

P13 – Employed prior to participation

P14 – Total Includable Family Income (12 Month or 6 Month Annualized)

P22 – Limited English proficiency?

P24 – Low literacy skills?

P27 – At Risk of Homelessness

P44 – Recertification - Number in family

P45 – Recertification: Total Includable Family Income (12 month or 6 month annualized)

E6 – If exit is not due to unsubsidized employment, other reason for exit

U28c – Any wages for the first quarter after exit quarter?

U29c – Any wages for the second quarter after exit quarter?

U29e – Any wages for the third quarter after exit quarter?

U30c – Any wages for the fourth quarter after exit quarter?

For U28c, U29c, U29e, and U30c, signed third party attestation is acceptable only if the

employer of the participant has not provided information on wages after reasonable efforts

(e.g. 3 attempts) were made by the sub-grantee to obtain this information.

SCSEP Third Party Attestation Forms

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Scsep Third Party Attestation Forms - U.s. Department Of Labor