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⚠️ Notice: This information collection may be referencing outdated material.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 Spanish v Individual Characteristics Form
TEGL-Non Subs Changes per PL 112-240 3 4 2013.doc Other-TEGL
ETA 9061 Spanish v Individual Characteristics, Spanish version ETA Form 9061 Spanish Version w-o Instrs (CO 3-6-2012).doc Form
ETA 9061 Individual Characteristics Form ETA Form 9061 3 4 2013.doc Form and Instruction
ETA Form 9061 (Exp 6-2015) 3 4 2013.doc ETA 9061 IC Document
ETA Form 9061 Fnl Spanish Version w-o Instrs Reauth PL 112-240 (CO-Rev. Feb. 2013).doc ETA 9061 Spanish version 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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
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
Form and Instruction	ETA 9061	Individual Characteristics Form	ETA Form 9061 3 4 2013.doc	Yes	Yes	Fillable Fileable Signable
Other-TEGL			TEGL-Non Subs Changes per PL 112-240 3 4 2013.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
ETA 9061	ETA Form 9061 (Exp 6-2015) 3 4 2013.doc	03/04/2013
ETA 9061 Spanish version	ETA Form 9061 Fnl Spanish Version w-o Instrs Reauth PL 112-240 (CO-Rev. Feb. 2013).doc	03/13/2013

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