Information Collection

Work Opportunity Tax Credit (WOTC)

IC 43791 under ICR 201912-1205-010 · OMB 1205-0371.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0371 can be found here:

Documents and Forms

Document Name Document Type
Form ETA-9061 Work Opportunity Tax Credit (WOTC) Form and Instruction
ETA-9061 Individual Characteristics Form (ICF) Work Opportunity T Attachment 5A- ETA FORM 9061 (ENGLISH).pdf Form and Instruction
ETA-9062 Conditional Certification Work Opportunity Tax Credit Attachment 6A- ETA Form 9062, Conditional Certification.pdf Form and Instruction
ETA-9063 Employer Certification Work Opportunity Tax Credit Attachment 7A- ETA Form 9063.pdf Form and Instruction
ETA-9065 Agency Declaration of Verification Results (ADVR) Worksh Attachment 8A- ETA Form 9065.pdf Form and Instruction
ETA-9061 Individual Characteristics Form (ICF) Work Opportunity T Attachment 5A- ETA FORM 9061 (SPANISH).doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Work Opportunity Tax Credit (WOTC)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ETA-9061	Individual Characteristics Form (ICF) Work Opportunity Tax Credit	Attachment 5A- ETA FORM 9061 (ENGLISH).pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA-9062	Conditional Certification Work Opportunity Tax Credit	Attachment 6A- ETA Form 9062, Conditional Certification.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA-9063	Employer Certification Work Opportunity Tax Credit	Attachment 7A- ETA Form 9063.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA-9065	Agency Declaration of Verification Results (ADVR) Worksheet	Attachment 8A- ETA Form 9065.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	ETA-9061	Individual Characteristics Form (ICF) Work Opportunity Tax Credit	Attachment 5A- ETA FORM 9061 (SPANISH).doc	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title: DOL/ETA-15	FR Citation: 75 FR 6884

Number of Respondents: 52	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	7,833,595	4,003,537	3,830,058
Annual IC Time Burden (Hours)	2,585,226	1,272,616	1,312,610
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.