Form 9058 - Tracked Changes
ETA Form 9058 - redline edits.rtf
Work Opportunity Tax Credit
Form 9058 - Tracked Changes
OMB: 1205-0371
U.S. Department of Labor
Employment and Training Administration
Certification Workload and Characteristics of Certified
Individuals
Work Opportunity Tax Credit - Report No. 1
OMB Control No. 1205-0371 Expiration Date: March 31, 2023U.S. Department of Labor
Employment and Training Administration
Certification Workload and Characteristics of Certified Individuals
Work Opportunity Tax Credit - Report No. 1
Instructions
for
Preparing
ETA
Form
9058,
Report
1
–“Certification
Workload
and
Characteristics
of
Certified
Individuals,”
Work
Opportunity
Tax
Credit
Report
Instructions for Preparing “Certification Workload and Characteristics of Certified Individuals,” ETA Form 9058, Report 1 – Work Opportunity Tax Credit
Introduction. Part I. of this report clarifies and simplifies data reported on certifications issued and provides state workforce agencies’ (SWAs) workload numbers during each reporting quarter. Part II., continues to collect data on selected characteristics of certified individuals.
Form Updates. The Protecting Americans from Tax Hikes Act of 2015 introduced a new WOTC target group, the Long-term Unemployment Recipient (LTUR), see Box 10SWAs will report on two new metrics in the EBSS tax credit reporting system: 1) Out-of-state certification requests received during the reporting period (quarter); and 2) Reason for issuing Denial notifications. See Part I. Certification Workload, Item C, and Item F.
Background. The purpose of ETA Form 9058 is to provide SWAs with a standardized e- reporting format, which accurately reflects program activity levels and outcomes under the Work Opportunity Tax Credit (WOTC). It is important for SWAs to maintain programmatic reporting procedures that account for each tax certification request (IRS Form 8850) received and its subsequent outcome (issuance of a tax certification or denial). A properly completed ETA Form 9058 accurately reflects program use and the level of any programmatic backlog that may exist. To ensure that the WOTC Program can be evaluated accurately at the national level, it is critical that all SWAs report in a standardized manner using the web-based Enterprise Business Service System (EBSS) Tax Credit Reporting System (TCRS).
INSTRUCTIONS FOR COMPLETING THIS FORM:
State. Enter the name of the state of the state workforce agency (SWA) submitting WOTC Report – 1, ETA Form 9058.
Quarter Ending Period. Enter ending date of the fiscal year reporting quarter for the reported applicable program data (i.e. QE 6/30/22).
Part I. "“Certification Workload.” SWAs must identify from Part I, Item F on the previous reporting quarter's ETA Form 9058 the number of requests (IRS Form 8850s) determined to be incomplete or Needing Actionthe reporting status for each certification request (IRS Form 8850) included in the SWA’s total workload. This includes any requests (IRS Form 8850s) that the SWA interacted with during the applicable quarter ending. Use the reporting status options for requests, as defined below:
Number of Requests Incomplete. Enter the total number of requests (IRS Form 8850s) received by the SWA prior to the beginning of the current report period, but for which no applicant eligibility determination action (excluding the 48-hourinitial review) was taken. Note: TThis total is to be entered intovalue is auto-populated with the value entered for Part I, Item (AG) of the previous quarter ending’s report on ETA Form 9058.
Number of Requests Needing Action. Enter the total number of requests (IRS Form 8850s) received by the SWA prior to the beginning of the current report period, but for which no review nor eligibility determination was rendered. Note: and This total is to beauto-populated with the value entered into for Part I, , Item (B) of recently revisedof the previous quarter ending’s report on ETA Form 9058.
Number of New Requests. Enter the total number of new requests (IRS Form 8850s) received by the SWA during the current reporting quarter. Note: Some states SWAs may have received targeted group eligibility verification requests (IRS Form 8850s) from other SWAs for individuals who reside (and possibly receive public welfare benefits) in their state, although the employer’s business (per IRS Form 8850) is located in another state. These requests are referred to as “Out of State” (OOS) certification requests. SWAs should record the number of “out-of-state” certification requests received in Part I, Item (C2). that were not previously recorded and/or reported on any prior quarterly report ETA 9058 for various reasons. It is Important for the SWAs to report all certification requests (IRS Form 8850s) received. Therefore, any requests that were received outside of the current reporting quarter, which have , which has not been previously been recorded/ reported on a prior ETA Form 9058, should be included with in the count for the n‘Number of New Rrequests’ for the applicable quarter ending report for when the certification request is initially reviewed by the SWAreceived during the current reporting period. That total should be entered as the number of "New Requests". This total (new requests and previously uncounted requests) is toshould be entered into Part I, Item (C) of ETA Form 9058.
Total Requests to Be be Processed. Enter the sum of Items (A, ) + (B) & + (C). This total represents the number of requests (IRS Form 8850s) received by the SWA, which are available to be processed as of the quarter ending date. Note: This total is auto-tabulated based on the completion formula: Item (A +B + C) = Item D. This value total is to be entered under Part I, Item (D) of ETA Form 9058. Note. A denial is a certification request (IRS Form 8850) determined by the SWA to be ineligible for the WOTC.
Number of Requests Certified. Enter the total number of WOTC Employer Ccertifications (ETA Form 9063) issued by the SWA during the current report period. Note: This value must match the value entered for Part II, Items I)11, J)24, and K)7.
Number of Requests Denied. Enter the total number of requests (IRS Form 8850s) Ddenied by the SWA during the current report period. Provide the number of Denials for the the twoF1, F2, and F3 categoriesies defined below.
Note. : A denial Denial is a request (IRS Form 8850) determined by the SWA to be ineligible for the WOTCby the SWA.
F1. Enter the total number of Ddenials issued due to “failure to meet IRS Form 8850 timely -filing requirements.”
F2. Enter the total number of Ddenials issued that diddue to “applicant does not meet targeted group(s) eligibility requirements.”
F3. Enter the total number of Denials issued due to “ineligible rehires” (applicant previously worked for the employer seeking WOTC certification.
Number of Requests Incomplete. Enter the total number of requests (IRS Form 8850s) received and reviewed by the SWA during the current report period, but for which the SWA could neither approve certify nor deny by the end of the report period, due to such things as, but not limited to, : the need for additional eligibilitymissing supporting documentation (for which the SWA has made a formal request to the employer to obtain), authorized tax consultant, or other third party entit;y, missing or incomplete ETA Form 9061/9062; SWA processing delays due to automated system malfunctions not submitted, etc.
Note. : This number value will also beauto-populate as the value entered in Part 1I, Item (A). of the subsequent quarterly quarter ending report, report ETA Form 9058.
(H) Number of Requests Needing Action. Enter the number of requests (IRS Form 8850s) received by the SWA during the current report period, but for which no review and/or processing action has yet been taken to determine applicant eligibility. This total represents the SWA’s existing “backlog” of pending requests and is auto-tabulated based on the following completion formula: Item H = Item D – (Item E + F + G). Note: This value will auto-populate as the value entered in Part I, Item (B) of the subsequent quarter ending report, ETA Form 9058. Enter the number of requests (IRS Form 8850s) received by the SWA during the current report period, but for which no review and/or action has yet been taken to determine applicant eligibility.
Note. This value will also be entered in Part I, Item B. of the subsequent quarterly report ETA Form 9058. Part I, Item H is the sum of Item D, minus Item E, minus Item F, minus Item G.
Part I. Completion Formulas:
Item (A +B + C) = Item D; same as: Items (A+B+C) = Item D
and
Item D – (E + F + G) = Item H; Same as: same asItems (A+B+C) = D: and Items (D-E-F-G) = Item H
Part II. "Characteristics of Certified Individuals by Tax Credit." SWAs must identify the individual characteristics (of the new hire/ applicant) for each Certification issued by the SWA during the current report period. Note: This pPart IIart is divided into three subsections: (Section (I), Section (J), and Section (K).
Section (I) reflects the number of requests (IRS Form 8850s) certified by the SWA during the current report period by WOTC targeted groups. Section (J) reflects the number of requests (IRS Form 8850s) certified by the SWA during the current report period by (applicant) occupation. Section (K) reflects the number of requests (IRS Form 8850s) certified by the SWA during the current report period by (applicant) starting hourly wage.
Section (I).
Section I, Column (a). Enter the total number of Certifications issued by the SWA, by targeted group, during the current report period, which resulted from the issuance of a conditional certification i.e., ETA Form 9062.
Section I, Column (b). Enter the total number of Certifications issued by the SWA, by target ed group, during the current report period.
Section I, Line #1. Enter the total number of Certifications issued by the SWA during the current report period, for the Qualified IV-A (TANF) Recipients.
Section I, Line #2Ba. Enter the total number of Certifications issued by the SWA during the current report period, for Veterans receiving SNAP benefits.
Section I, Line #2Bb. Enter the total number of Certifications issued by the SWA during the current report period, for Disabled Veterans receiving compensation for a service-connected disability.
Section I, Line #2Bc. Enter the total number of Certifications issued by the SWA during the current report period, for Disabled Veterans unemployed for 6 months.
Section I, Line #2Bd. Enter the total number of Certifications issued by the SWA during the current report period, for Veterans unemployed for at least 4 weeks but less than 6 months.
Section I, Line #2Be. Enter the total number of Certifications issued by the SWA during the current report period, for Veterans unemployed for at least 6 months.
Section I, Line #3. Enter the total number of Certifications issued by the SWA during the current report period for Ex-felons.
Section I, Line #4. Enter the total number of Certifications issued by the SWA during the current report period for Summer Youth Employees.
Section I, Line #5. Enter the total number of Certifications issued by the SWA during the current report period for Designated Community Residents (DCRs).
Section I, Line #6a. Enter the total number of Certifications issued by the SWA during the current report period for Vocational Rehabilitation (VR) Referrals.
Section I, Line #6b. Enter the total number of Certifications issued by the SWA during the current report period for “Ticket Holders” (authorized under the Social Security Administration’s ‘Ticket to Work’ Program).
Section I, Line #7. Enter the total number of Certifications issued by the SWA during the current report period for SNAP (formerly known as Food Stamps) recipients.
Section I, Line #8. Enter the total number of Certifications issued by the SWA during the current report period, for SSI recipients.
Section I, Line #9. Enter the total number of Certifications issued by the SWA during the current report period for Long-term Family Assistance (TANF) Recipients.
Section I, Line #10. Enter the total number of Certifications issued by the SWA during the current report period, for Long-term Unemployment Recipients (LTURs).
Section I, Line #11. Enter the sums of columns (a) and (b) for the current reporting quarter as TOTAL (For Qtr.) Note: The quarterly totals for Column I. “By WOTC Targeted Group” (Line#11); Column J. “By Occupation” (Line#27); and Column K. “B y S t a r t i n g H our l y W a ge” (Li ne#7 ), must all equal the same value. Note: For the first quarter ending report (ETA Form 9058) of the federal fiscal year (October 1 - December 31), the values for Section I, Line #11 (For Qtr) and Line #12 (YTD) should be the same. Also, the total (For Qtr.) of Part II, Section I, Line #12, columns (a) & (b) should equal the total entered in Part I. Item E. “Certified Requests.”
Section
I,
Line #12.
After
Quarter 1, for all subsequent quarters, enter the cumulative fiscal
Year-to-Date
(YTD)
totals
of
columns
(a)
and
(b).
R
em i n d er:
For
the first quarterly report of the fiscal year (October 1-
December
31),
the
totals
of
Section
I,
Line
#11
and
Line
#12
should
be
the
same
value.
Section J.
Section J, Column (a). Enter the total number of WOTC Certifications issued by the SWA during the current report period, By Occupation. Note: The total for Section J, Column (a), Line #27 is the sum of the column and must equal the total for Section I, Columns (a) & (b), Line # 11.
The occupational data reported in Section J, Boxes 1-23, derive from the job titles reported on ETA Forms 9061// 9062. To prepare this report, SWAs must use the O*NET job families of occupations (standard occupation classifications) and their two-digit corresponding codes, as illustrated in the following table.
-
O*NET SOC JOB FAMILIES
OCCUPATION NAME CODE
Management Occupations
11
Business & Financial Operations
13
Computer & Mathematical Occupations
15
Architecture & Engineering
17
Life, Physical & Social Sciences
19
Community & Social Services
21
Legal Occupations
23
Education, Training, & Library
25
Arts, Design, Entertainment, Sports and Media Occupations
27
Healthcare Practitioner & Technical
29
Healthcare Support Occupations
31
Protective Service Occupations
33
Food Preparation & Serving Related
35
Bldg. & Grounds Cleaning & Maintenance
37
Personal Care & Service
39
Sales & Related Occupations
41
Office & Administrative Support
43
Farming, Fishing, Forestry
45
Construction & Extraction
47
Installation, Maintenance & Repair
49
Production Occupations
51
Transportation & Material Moving
53
Military Specific Occupations
55
Section K.
Section K, Column (a). Enter the total number of Certifications issued by the SWA during the current report period, “By Starting Hourly Wage.” Note: The TOTAL (For Qtr) for Section K, Column (a), Line #6, is the sum for that quarter, and must be equal to the total for Section I, Column (b), Line #11, “Number of Certified Individuals.” *Federal Minimum Wage information is located at https://www.dol.gov/general/topic/wages/minimumwage.
Convert annual earnings to hourly wages as follows:
-
Unit of Time
Calculated Hourly Wage
Day
Amount divided by 8
W eek
Amount divided by 40
Month
Amount divided by 172
Name and Title of Certifying Official. Enter the name and title of the authorized signatory official.
Signature. Enter the signature of the authorized signatory official.
Date.
Enter the date of signature.
Page
1
of
5
ETA
Form
9058
(Rev.
Feb
2023)
| File Type | text/rtf |
| File Title | Certification Workload and Characteristics of Certified Individuals - ETA Form 9058 (Rev. November 2016) |
| Author | Deloris Norris |
| Last Modified By | Nshom, Yufanyi - ETA |
| File Modified | 2023-02-03 |
| File Created | 2021-04-30 |
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