The Self-Employment Assistance Program Individual Services Verification Form (ES 161 4) 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your name and the last four digits of your Social Security Number in the designated fields.
3. Fill in the School/Agency name and their phone number, ensuring all information is accurate for verification purposes.
4. Specify the workshop or class you attended, along with the dates of attendance and total number of hours completed.
5. Ensure that your instructor fills in their name/title and provides a signature to validate your attendance.
6. Finally, sign the form as a participant and include the date to confirm your attendance.

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