De 8309 Form – Fill Out and Use This PDF

The DE 8309 form is an Application for Trade Adjustment Assistance (TAA) designed to aid workers who have lost their jobs or are suffering from a substantial reduction in hours and wages as a result of increased foreign competition. This form ensures that affected individuals can apply for federal support to obtain the necessary skills, resources, and support to re-enter the workforce. For anyone undergoing such transitions, successfully completing and submitting this form is a crucial step toward securing assistance.

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De 8309 Form PDF Details

The Application for Trade Adjustment Assistance (TAA), known as the DE 8309 form, serves as a critical resource for workers impacted by global trade dynamics who are seeking assistance and reemployment services. Managed by the California Employment Development Department, this form facilitates access to benefits provided under the TAA program, designed to aid workers who have lost their jobs or experienced significant work and wage reductions due to increased imports or shifts in production to foreign countries. Comprising sections that range from personal worker information to employment details, reasons for separation from affected employment, other eligibility information, and certification by the worker, the DE 8309 form demands comprehensive data to ensure accurate assessment and approval of TAA benefits. It also includes sections for department and field office use to document TAA certification information and to address incumbent worker requests for pre-separation training. Completing and mailing this form to the designated Special Claims Office is a foundational step for affected workers in California to leverage support and training opportunities, aiding their transition into new employment roles in the face of global trade changes.

Question	Answer
Form Name	De 8309 Form
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	Trabajador, SECCIN, BENEFICIOS, Afectado

Form Preview Example

APPLICATION FOR TRADE ADJUSTMENT ASSISTANCE (TAA)

Complete all items in Sections A through D Mail to: SPECIAL CLAIMS OFFICE TRA STATE OF CALIFORNIA

EMPLOYMENT DEVELOPMENT DEPARTMENT PO BOX 419076

RANCHO CORDOVA, CA 95741-9076

SECTION A: Worker Information

SECTION E: Department Use -TAA Certification Information

Petition No: __________________	Impact Date: ________________
Certification Date: _____________	Termination Date: _____________

Social Security Number

Name (First)

(MI)

(Last)

Birthdate

Your Mailing Address

Apt.

City

State

Zip

Phone Number Where		Female	Male
You Can be Reached (	)

SECTION B: Employment Information

Name of Affected Employer		Subdivision or Department		Type of Work You Did

Employer’s Mailing Address		City		State	Zip

Date of First Separation from Affected Employment		Reason for Separation

Dates of Subsequent Separations		Reasons for Separations
1.		1.

SECTION C: Other Eligibility Information		Yes	No	Explain All “Yes” Answers
1.	Have you worked for any employer since your			Employer Name
	separation from the Employer shown in B above?
	Date Began Work			Address

	Date of Separation			Reason for Separation

2.	Have you filed an application for TAA prior to this			State Where Filed	Date Filed
	application?

3.	Have you filed a claim for Unemployment Insurance			Paying State
	benefits since your separation from the affected			____________________________________________________
	employer?			Name of Program

4.	How did you learn of the certification?

SECTION D: Worker’s Certification

I have answered these questions for the purpose of applying for TAA benefits, knowing that the law provides penalties for making false statements.

Signature of Worker: ____________________________________

Date Signed: ____________________________

SECTION F: Department Use - Field Office TAA specialists - Document Incumbent Worker requests for TAA pre-separation training. Worker must complete Section A – D, excluding separation information.

Documentation Supporting Worker Threatened With Layoff/Termination From Affected Employment

Identified From Employer List

Notice From Employer

Other

(Attach Letter From TAA Unit, Central Office)

(Attach Layoff Notice or Signed Statement)

(Attach Supporting Document)

Employer Contact Name

Employer Contact Phone Number

Employer Contact Fax Number

Date of Initial Contact (On or After Cert Date)

Expected Separation Date

No Documentation to Support Worker is Threatened With Separation

Worker Determined Incumbent

(Complete DE 8320 IW, Including Section E. Provide Copy to Worker)

(Complete DE 8320 IW and DE 2403T)

Interviewer Signature:

Date Signed:

F.O. #

DE 8309 Rev. 6 (8-09) (INTERNET)

Page 1 of 2

SOLICITUD DE BENEFICIOS PARA ASISTENCIA PARA AJUSTE DEL COMERCIO (TAA)

Complete todos los incisos en las secciones de A a la D

Envíe a: SPECIAL CLAIMS OFFICE TRA STATE OF CALIFORNIA

EMPLOYMENT DEVELOPMENT DEPARTMENT PO BOX 419076

RANCHO CORDOVA, CA 95741-9076

SECCIÓN A: Información sobre el Trabajador

SECTION E: Department Use -TAA Certification Information

Petition No: __________________	Impact Date: ________________
Certification Date: _____________	Termination Date: _____________

Número de Seguro Social

Nombre (Primero)

(Segundo)

(Apellidos)

Fecha de Nacimiento

Su Dirección Postal

Apto.

Ciudad

Estado

Código Postal

Número de Teléfono Donde Podamos		Mujer	Hombre
Comunicarnos con Ud. (	)

SECCIÓN B: Información sobre el Empleo

Nombre del Empleador Afectado		Subdivisión o Departamento		Clase de Trabajo que Ud. Hacia

Dirección Postal del Empleador		Ciudad		Estado	Código Postal

Fecha de la Primera Separación de Empleo Afectado		Razón de la Separación
Después de la Fecha de Impacto

Fechas de las Separaciones Posteriores		Razones de las Separaciónes
1.		1.

SECCIÓN C: Otra Información para Determinar Elegibilidad		Sí	No	Explique Todas las Respuestas que contestó “Sí”
1.	¿Ha trabajado para algún empleador desde su separación			Nombre del Empleador
	del Empleador indicado en B anteriormente?

	Fecha en que Empezó a Trabajar			Dirección

	Fecha de la Separación			Razón de la Separación

2.	¿Ha presentado una solicitud para TAA antes de esta			Estado donde la Presentó	Fecha en que la Presentó
	solicitud?

3.	¿Ha presentado una solicitud de beneficios del Seguro			Estado que le Paga Beneficios
	de Desempleo desde su separación del empleador			____________________________________________________
	afectado?			Nombre del Programa

4.	¿Cómo se enteró de la certificación?

SECCIÓN D: CERTIFICACIÓN DEL TRABAJADOR

He contestado estas preguntas con el propósito de solicitar para beneficios de TAA con pleno conocimiento de que la ley provee sanciones por hacer declaraciones falsas.

Firma del Trabajador: ____________________________________

Fecha en que se Firmó: ____________________________

SECTION F: Department Use - Field Office TAA specialists - Document Incumbent Worker requests for TAA pre-separation training. Worker must complete Section A – D, excluding separation information.

Documentation Supporting Worker Threatened With Layoff/Termination From Affected Employment

Identified From Employer List

(Attach Letter From TAA Unit, Central Office)

Notice From Employer

(Attach Layoff Notice or Signed Statement)

Other

(Attach Supporting Document)

Employer Contact Name	Employer Contact Phone Number	Employer Contact Fax Number

Date of Initial Contact (On or After Cert Date)	Expected Separation Date

No Documentation to Support Worker is Threatened With Separation (Complete DE 8320 IW, Including Section E. Provide Copy to Worker)

Worker Determined Incumbent (Complete DE 8320 IW and DE 2403T)

Interviewer Signature:		Date Signed:	F.O. #

DE 8309 Rev. 6 (8-09) (INTERNET)	Page 2 of 2			MIC 38/CU

How to Edit De 8309 Form Online for Free

Informacin can be filled out online easily. Simply make use of FormsPal PDF editor to do the job in a timely fashion. Our tool is continually developing to deliver the very best user experience possible, and that is thanks to our resolve for continuous enhancement and listening closely to customer comments. Here is what you would have to do to get started:

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2. Once this array of fields is finished, it is time to put in the essential details in Date of Separation Have you filed, application, Have you filed a claim for, benefits since your separation, How did you learn of the, SECTION D Workers Certification, I have answered these questions, Signature of Worker, Date Signed, SECTION F Department Use Field, Documentation Supporting Worker, Identified From Employer List, Notice From Employer Attach Layoff, Other Attach Supporting Document, and Employer Contact Name so you can proceed further.

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De 8309 Form – Fill Out and Use This PDF

De 8309 Form PDF Details

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