WOTC Questionnaire

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Warning! DO NOT CHANGE the structure of the tables below. Do not change the table ID or add, delete, or rearrange the columns.

Original Field Names

Info. The following is a list of fields where the field label will appear when the toggle button is clicked. These are the original field names from the web form. We are retaining the original form names to avoid any future issues.

EMPLOYERUUID

applicant_id

Email Address

FName

LName

PhoneNumber

Applicant Address

Applicant City

Applicant State1

Applicant Zip

County

Date of Birth NEW

Your SSN

IDtype

Applicant State

Govt_id

Question1

q3a

Recipient_name3

Recipient_address3

q3acaseid

q3b

q3vetrancomp

q3c

q3vetranDischarged

Discharge Papers

q4b

Recipient_name4

Recipient_address_4

q4CaseID

q5a

5agencyContactname

5ContactPhoneNumber

q5b

q6a

q6b

q6c

Recipient_name_6

Recipient_address_6

q6caseID

Conviction_date

Conviction_release_date

Fed_state

7correctionsID

7NameofFacility

7City

7State

7dateProbationbegan

7ParoleOfficeName

7ParolePhoneName

Felony Records

8SSIContactName

8SSIContactPhoneNumber

q9a

COMPLETEPDF

Renamed Fields on API

Info. We understand that the API call and the original fields have different names. The table below will help you map the API object keys to the field names, allowing the toggle button to display the API object keys instead of the original field names.

EMPLOYERUUID	employerUUID
applicant_id	ApplicantID
Email Address	emailAddress
FName	FName
Mi	Mi
LName	LName
PhoneNumber	PhoneNumber
Applicant Address	Applicant Address
Applicant City	Applicant City
Applicant State1	Applicant State
Applicant Zip	Applicant Zip
County	County
Date of Birth NEW	DOB
Your SSN	SSN
IDtype	IDtype
Applicant State	Applicant State ID Issued
Govt_id	Identification Number
Question1	q1
q2	q2
q3	q3
q3a	q3a
Recipient_name3	q3a Recipient Name
Recipient_address3	q3a Recipient Address
q3acaseid	q3a Recipient CaseID
q3b	q3b
q3vetrancomp	q3b Veteran Comp
q3vetranDischarged	q3b Veteran Discharged
q3c	q3c
q3vetranDischarged	q3 Discharge Papers
Discharge Papers	q3 Discharge Papers_filename
q4	q4
q4b	q4b
Recipient_name4	q4b Recipient Name
Recipient_address_4	q4b Recipient CityState
q4CaseID	q4b CaseID
q5	q5
q5a	q5a
5agencyContactname	q5b Agency Contact Name
5ContactPhoneNumber	q5b Contact Phone Number
q5b	q5b
q6	q6
q6a	q6a
q6b	q6b
q6c	q6c
Recipient_name_6	q6c Recipient Name
Recipient_address_6	q6c Recipient CityState
q6caseID	q6c CaseID
q7	q7
Conviction_date	q7 Conviction Date
Conviction_release_date	q7 Conviction Release Date
Fed_state	q7 Federal or State
7correctionsID	q7 Corrections ID
7NameofFacility	q7 Facility Name
7City	q7 City
7State	7State
7dateProbationbegan	q7 Date Probation Began
7ParoleOfficeName	q7 Parole Office Name
7ParolePhoneName	q7 Parole Phone Number
Felony Records	q7 Felony Records
Felony Records	q7 Felony Records_filename
q8	q8
8SSIContactName	q8 Contact Name
8SSIContactPhoneNumber	q8 Contact Phone Number
q9a	q9
COMPLETEPDF	COMPLETEPDF
COMPLETEPDF	COMPLETEPDF_filename

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Kentucky Unemployment Tax Credit Program Application
You are eligible to for the Kentucky Unemployment Tax Credit Program. Please complete the following questions and submit the form to continue.

Were you a resident of Kentucky on the hire date?

YesYes	Yes
NoNo	No

Hire Date

Hire Date mm

Hire Date dd

Hire Date yy

Start to Work Date

Start Date mm

Start Date dd

Start Date yy

Your Address on the date you were hired:

Address

City

State

Zip/Postal Code

Were you actively seeking work during the 60 days prior to the hire date above?

YesYes	Yes
NoNo	No

Were you readily available to accept full-time employment during the 60 days prior to the hire date above?

YesYes	Yes
NoNo	No

Do you have an employment history?

YesYes	Yes
NoNo	No

Employment History

Previous Employment Details #1

Employer Name

Employer Telephone Number

Employer Address

Employer City

Employer State

Employer Zip

Employment Start Date

Employment End Date

Average Hours Worked Per Week

Average Hours Worked Per Month

Employer Address_1

Employer_1_phone_area

Employer_1_phone_first3

Employer_1_phone_last4

Employer_1_employed_mm

Employer_1_employed_dd

Employer_1_employed_yy

Employer_1_employed_to_mm

Employer_1_employed_to_dd

Employer_1_employed_to_yy

Previous Employment Details #2

Employer Name

Employer Address

Employer City

Employer State

Employer Zip

Employer Telephone Number

Employment Start Date

Employment End Date

Average Hours Worked Per Week

Average Hours Worked Per Month

Employer Address_2

Employer_2_phone_area

Employer_2_phone_first3

Employer_2_phone_last4

Employer_2_employed_mm

Employer_2_employed_dd

Employer_2_employed_yy

Employer_2_employed_to_mm

Employer_2_employed_to_dd

Employer_2_employed_to_yy

Previous Employment Details #3

Employer Name

Employer Address

Employer City

Employer State

Employer Zip

Employer Telephone Number

Employment Start Date

Employment End Date

Average Hours Worked Per Week

Average Hours Worked Per Month

Employer Address_3

Employer_3_phone_area

Employer_3_phone_first4

Employer_3_phone_last4

Employer_3_employed_mm

Employer_3_employed_dd

Employer_3_employed_yy

Employer_3_employed_to_mm

Employer_3_employed_to_dd

Employer_3_employed_to_yy

Continue Back

includeKTC

PDF File

Drivers LicenseDrivers License	Drivers License
State IDState ID	State ID
Birth CertificateBirth Certificate	Birth Certificate
US PassportUS Passport	US Passport
Federal/State Gov IDFederal/State Gov ID	Federal/State Gov ID

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Original Field Names

Renamed Fields on API