Items 16 – 22 Submit the bottom portion of the ETA Form instead of Form , State agency use only-ETA Form , Conditional Certification Form. Federal Forms and Information. ETA Form – Individual Characteristics Form – Work Opportunity Tax Credit; ETA Form – Conditional Certification. April – Individual Characteristics Form; ETA Form , Rev. April – Conditional Certification; ETA Form , Rev. April – Employer Certification.

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We use your feedback to help us improve this site but we are not able to respond directly. The Work Opportunity Tax Credit WOTC era a Federal tax credit incentive that employers may receive for hiring individuals from certain target groups who have consistently faced significant barriers gorm employment. The employer makes sure the individual has signed the form. If you need to mail Form separately to meet the day filing requirement, write on the form that other documents are being mailed separately.

Should an employer realize after they have mailed Form to Job Service North Dakota that the form is missing original signatures, the employer can resubmit a second form that contains original signatures.

The employer has the new hire complete question 8 on the top of the form and answer the characteristics questions. The employer and the job seeker must sign the Formunder penalty of perjury, attesting that the job seeker is a member of a target group.

Mail all required forms and documentation together. This form indicates the individual was tentatively determined as eligible for a WOTC target group. The employer completes the top portion of the form, making sure all the blanks are completed. The employer completes Part II of the form.


If you need a response, please locate the contact information elsewhere on this page or in the footer. The mailing envelope must contain a Corm. Department of Labor forms, as appropriate: For more information and additional filing options fax, email, onlinecontact the Department of Career Services at Additionally, there are situations when an employer will receive a Notice of Denial from Job Service for, Form was missing original signatures.

Feedback Did you find what you were looking for on this webpage? It is the employer’s responsibility to read the instructions for forms and and to know what forms to complete, how to properly complete them, and where and how to submit them. Executive Office of Labor and Workforce Development.

Auxiliary aids and services are available upon request to individuals with disabilities.

Form has a specific day filing requirement. Application Process The first step is pre-screening to determine eligibility. The main objective of this program is to enable the targeted employees to gradually move from economic dependency into self-sufficiency as they earn a steady income and become contributing taxpayers, while participating employers are compensated by being able to reduce their federal income tax liability. If these are not in place or if signature areas are left blank, Form formm be denied.

Obtain the current forms and their instructions: Corm this requirement is not met, Form must be denied.

Work Opportunity Tax Credit Program (WOTC) Overview |

If the 28th day falls on a Saturday, Sunday, or federal holiday, the next business day is considered the 28th filing day. Before mailing the forms for, JSND, make sure they contain the required signatures, review them for completeness, and ofrm copies for your records. The employer should review this form for any “yes” responses indicated by the new hire and then obtain the required documentation from the new hire to substantiate those responses.


Either the new hire or employer may sign and date the form.

How Does an Employer Apply for WOTC?

If you need to report child abuse, any other kind of abuse, or need urgent assistance, please click here. Complete ONE of the following required U.

If the new hire is under age etq on the hire date, a parent or guardian must sign and date the form. Employers can obtain copies of IRS by visiting www. In these cases, if an employer can resubmit torm properly completed Form within the day filing requirement, Job Service will consider that form for processing.

What is a Designated Employer Representative? Skip to main content. The job seeker or the employer must complete the following forms:. Faxed or emailed forms cannot be accepted and will result in a denial.

The second form must meet the day filing requirement in order for it to be considered timely and in order for Job Service to consider it for processing.

Give this form to the new hire and have him or her complete, sign, and date the front of the form. Amount of the Credit The amount of the tax 99062 is based on a percentage of qualified wages paid to the new employee for the first year of employment only with the exception of the long term TANF recipient.