Individual Characteristics

Work Opportunity Tax Credit

OMB: 1205-0371

IC ID: 184551

Information Collection (IC) Details

View Information Collection (IC)

Individual Characteristics
 
No Modified
 
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-9061 Individual Characteristics Form (ICF) ETA Form 9061 - Individual Characteristics Form [clean edit].docx Yes Yes Fillable Fileable
Form ETA-9062 Conditional Certification Form (CC) ETA Form 9062 - Conditional Certification [clean edit].docx Yes Yes Fillable Fileable
Form ETA-9198 Employer Representative Declaration ETA Form 9198 - Employer Representative Declaration Form .docx Yes Yes Fillable Fileable
Form ETA-9061 Individual Characteristics Form (Spanish) ETA Form 9061 - Individual Characteristics Form [clean edit] (1).docx Yes Yes Fillable Fileable

Workforce Management Training and Employment

DOL/ETA-15  75 FR 6884

9,185,562 0
   
Individuals or Households
 
   50 %

  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 9,185,562 0 3,554,796 0 0 5,630,766
Annual IC Time Burden (Hours) 3,031,235 0 1,173,082 0 0 1,858,153
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
ETA 9061 - Tracked Changes ETA Form 9061 - redline draft.docx 02/14/2023
ETA-9062 Tracked Changes ETA Form 9062 - redline draft.docx 02/14/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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