Work Opportunity Tax Credit

ICR 201912-1205-010

OMB: 1205-0371

Federal Form Document

ICR Details
1205-0371 201912-1205-010
Active 201611-1205-003
Work Opportunity Tax Credit
Revision of a currently approved collection   No
Approved with change 03/03/2020
Retrieve Notice of Action (NOA) 01/31/2020
  Inventory as of this Action Requested Previously Approved
03/31/2023 36 Months From Approved 03/31/2020
13,527,028 0 5,840,620
4,454,205 0 1,960,777
0 0 0

The Work Opportunity Tax Credit (WOTC) is a Federal tax credit available to employers for hiring individuals from certain target groups who have consistently faced significant barrier to employment. This submission includes seven WOTC program forms as follows: • ETA Form 9175, Revised November 2016 – Self-Attestation Form (SAF) for the Long-Term Unemployment Recipient • ETA Form 9058 - Report 1, Revised November 2016 - Certification Workload and Characteristics of Certified Individuals • ETA Form 9061, Revised November 2016 - Individual Characteristics Form • ETA Form 9062, Revised April 2016 - Conditional Certification • ETA Form 9063, Revised April 2016 - Employer Certification • ETA Form 9065, Revised April 2016 - Agency Declaration of Verification Results Worksheet

PL: Pub.L. 101 - 508 11405(c) Name of Law: Omnibus Budget Reconciliation Act of 1989
   PL: Pub.L. 97 - 34 261(f)(2) Name of Law: Economic Recovery Act of 1981
   PL: Pub.L. 97 - 248 233(e) Name of Law: Tax Equity and Fiscal Responsibility Act of 1982
   PL: Pub.L. 98 - 369 1041(b) Name of Law: Tax Equity and Fiscal Responsibility Act of 1982
   PL: Pub.L. 99 - 514 1701(d) Name of Law: Tax Equity and Fiscal Responsibility Act of 1982
   PL: Pub.L. 104 - 188 2242 Name of Law: Small Business Job Protection Act of 1996
   PL: Pub.L. 113 - 114 1755 Name of Law: Protecting Americans from Tax Hikes Act of 2015
   US Code: 26 USC 2242 Name of Law: Small Business Job Protection Act of 1996

Not associated with rulemaking

  84 FR 56204 10/21/2019
85 FR 5254 01/29/2020

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 13,527,028 5,840,620 0 208 7,686,200 0
Annual Time Burden (Hours) 4,454,205 1,960,777 0 208 2,493,220 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Miscellaneous Actions
Miscellaneous Actions
The burden hours significantly increased for this burden statement reporting due to incorporating the WOTC denial rate which has not been factored in historically. DOL/ETA believes this more accurately reflects the full total number of respondents.

Maya Kelley 202 693-2805 [email protected]


On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

© 2024 | Privacy Policy