Work Opportunity Tax Credit

OMB 1205-0371

OMB 1205-0371

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

The latest form for Work Opportunity Tax Credit expires 2023-03-31 and can be found here.

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OMB Details

Work Opportunity Tax Credit (WOTC)

Federal Enterprise Architecture: Workforce Management - Training and Employment

Form ETA-9061Individual Characteristics Form (ICF) Work Opportunity Tax CreditFillable FileableForm and instruction
Form ETA-9065Agency Declaration of Verification Results (ADVR) WorksheetFillable FileableForm and instruction
Form ETA-9063Employer Certification Work Opportunity Tax CreditFillable FileableForm and instruction
Form ETA-9062Conditional Certification Work Opportunity Tax CreditFillable FileableForm and instruction
Form ETA-9061Individual Characteristics Form (ICF) Work Opportunity Tax CreditFillable FileableForm and instruction

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