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Individual Characteristics
Work Opportunity Tax Credit and Welfare-to-Work Tax Credit
OMB: 1205-0371
IC ID: 184551
OMB.report
DOL/ETA
OMB 1205-0371
ICR 201111-1205-010
IC 184551
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0371 can be found here:
2024-02-15 - No material or nonsubstantive change to a currently approved collection
2023-03-13 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form ETA-9061
Individual Characteristics
Form and Instruction
ETA Form 9061 Spanish Version.doc
Other-Spanish-language Guidance
ETA-9061 Individual Characteristics Form
ETA Form 9061.doc
Form and Instruction
1205-0371 Nov 2011 amendments TEGL.doc
TEGL for November 2011 Amendments
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Individual Characteristics
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
ETA-9061
Individual Characteristics Form
ETA Form 9061.doc
Yes
Yes
Fillable Fileable
Other-Spanish-language Guidance
ETA Form 9061 Spanish Version.doc
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Training and Employment
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
990,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
990,000
0
0
0
0
990,000
Annual IC Time Burden (Hours)
326,700
0
0
0
0
326,700
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
TEGL for November 2011 Amendments
1205-0371 Nov 2011 amendments TEGL.doc
11/30/2011
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.