Information Collection

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

IC 18507 under ICR 201808-1545-015 · 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⚠️ Notice: This information collection may be referencing outdated material.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 8850 Pre-Screening Notice and Certification Request for the Work Opportunity and Welfare-to-Work Credits	Form
Instructions for Form 8850.pdf	Instruction
8850 Pre-Screening Notice and Certification Request for the W Fom 8850.pdf	Form
2018 Burden (Form 8850).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.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	8850	Pre-Screening Notice and Certification Request for the Work Opportunity Credit	Fom 8850.pdf		Yes	Yes	Fillable Fileable
Instruction			Instructions for Form 8850.pdf		Yes	No	Paper 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	Previously Approved
Annual Number of Responses for this IC	440,000	440,000
Annual IC Time Burden (Hours)	3,242,800	3,242,800
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Burden	2018 Burden (Form 8850).pdf	08/17/2018

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