Qualified Long-term Unemployment Recipient (LTUR)

Work Opportunity Tax Credit

OMB: 1205-0371

IC ID: 221431

Information Collection (IC) Details

View Information Collection (IC)

Qualified Long-term Unemployment Recipient (LTUR)
 
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-9175 LONG-TERM UNEMPLOYMENT RECIPIENT SELF-ATTESTATION FORM Work Opportunity Tax Credit (WOTC) Program ETA_Form_9175_LTUR_Self-Attestation_Form.pdf Yes Yes Fillable Fileable

Workforce Management Training and Employment

 

233,160 0
   
Private Sector Businesses or other for-profits, Farms, Not-for-profit institutions
 
   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 233,160 0 0 0 0 233,160
Annual IC Time Burden (Hours) 39,637 0 0 0 0 39,637
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
ETA-9175-Tracked Changes ETA Form 9175 - LTUR Self Attestation Form redline Edits.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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