WOTC Self-Attestation Form (ETA-9154)

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

OMB: 1205-0371

IC ID: 190816

Information Collection (IC) Details

View Information Collection (IC)

WOTC Self-Attestation Form (ETA-9154)
 
No Removed
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form ETA 9154 Youth Self Attestation Youth attachment I.doc Yes No Printable Only
Form ETA 9154, Spanish Version Youth Self Attestation, Spanish Version Youth Attachment II.doc Yes No Printable Only

Workforce Management Training and Employment

 

53 0
   
State, Local, and Tribal Governments
 
   90 %

  Approved 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 0 0 -106,000 0 0 106,000
Annual IC Time Burden (Hours) 0 0 -34,980 0 0 34,980
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
TEGL Change 3 Guidance TEGL 5-19-10.doc with highlights.doc 05/20/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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