Information Collection

Pre-Screening Notice and Certification Request for the Work Opportunity and Welfare-to-Work Credits

IC 18507 under ICR 201111-1545-031 · OMB 1545-1500.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-1500 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form 8850 Pre-Screening Notice and Certification Request for the Work Opportunity and Welfare-to-Work Credits Pre-Screening Notice and Certification Request for the Work Opportunity and Welfare-to-Work Credits	Form
Form Form 8850 Pre-Screening Notice and Certification Request for the Work Opportunity and Welfare-to-Work Credit Pre-Screening Notice and Certification Request for the Work Opportunity and Welfare-to-Work Credits	Form
Form 8850 Inst.pdf	Instruction
Form 8850 Inst. (2011 Draft).pdf	Instruction
Form 8850 Pre-Screening Notice and Certification Request for the W Form 8850.pdf	Form
Form 8850 Pre-Screening Notice and Certification Request for the W Form 8850 (2011 Draft).pdf	Form
(2011) Burden.PDF Burden	IC Document

IC Title:

Pre-Screening Notice and Certification Request for the Work Opportunity and Welfare-to-Work Credits

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:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Form 8850	Yes	Yes	Fillable Fileable
Instruction		Yes	No	Printable Only
Form	Form 8850	Yes	Yes	Fillable Fileable
Instruction		Yes	No	Printable Only

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 440,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 30 %

table that charts list of burden
	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	440,000	80,000	-80,000	440,000
Annual IC Time Burden (Hours)	3,335,200	1,860,400	-606,400	2,081,200
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Burden		12/15/2011

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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