Individual Characteristics

Work Opportunity Tax Credit (WOTC) and Welfare-to-Work (WtW) Tax Credit

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0371 can be found here:

Documents and Forms

Document Name Document Type
Form ETA 9061 Individual Characteristics Form and Instruction
ETA 9061 Individual Characteristics ETA Form 9061 (3-5-2012).doc Form and Instruction
ETA 9061 Spanish v Individual Characteristics, Spanish version ETA Form 9061 Spanish Version w-o Instrs (CO 3-6-2012).doc Form
1205-0371 Nov 2011 amendments TEGL.doc TEGL IC Document

Information Collection (IC) Details

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	ETA Form 9061 (3-5-2012).doc		Yes	Yes	Fillable Fileable Signable
Form	ETA 9061 Spanish version	Individual Characteristics, Spanish version	ETA Form 9061 Spanish Version w-o Instrs (CO 3-6-2012).doc		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title: DOL/ETA-15	FR Citation: 75 FR 6884

Number of Respondents: 990,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	990,000	990,000
Annual IC Time Burden (Hours)	326,700	326,700
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
TEGL	1205-0371 Nov 2011 amendments TEGL.doc	01/18/2012

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