ETA FORM 9062 PDF

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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WOTC Questions: What is a Conditional Certification from the State Workforce Agency?

Employers make the hiring decision, and there is no limit to the number of new hires who can qualify the employer for the tax savings, but individuals must be identified as members of one of these targeted groups before a job offer is made. Auxiliary aids and services are available upon request to individuals with disabilities. Employers can obtain copies of IRS by visiting www. If you need to mail Form separately to meet the day filing requirement, write on the form that other documents are being mailed separately.

The employer then forwards the forms to the Department of Career Services no later than the 28th day after the job seeker begins work at the following address: 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. Either the new hire or employer may sign and date the form.

If the 28th day falls on a Saturday, Sunday, or federal holiday, the next business day is considered the 28th filing day. For, employer completes the top portion of the form, making sure all the blanks are completed. Have your company representative complete, tea, and date the back of the form. If this requirement is not met, Form must be denied. 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.

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Complete ONE of the following required U.

File for a Tax Credit Online (WOTC) |

The job seeker or the employer must complete the following forms:. 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 completes Dorm II of the form. For more information and additional filing options fax, email, onlinecontact the Department of Career Services at This form indicates the individual was tentatively determined as eligible for a WOTC target group.

Carefully read the instructions for this form to learn about the target groups. If these are not in place or if signature areas are left blank, Form must be denied.

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. The employer must hire the individual by the date indicated in Question 15 in order to possibly be qualified for a tax credit. Feedback Did you find what you were looking for on this webpage? 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 you need to report child abuse, any other kind of abuse, or need urgent assistance, please click here. Faxed or emailed forms cannot be accepted and will result in a denial. If the new hire is under age 18 on the hire date, a parent or guardian must sign and date the form. 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 credit 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. The employer makes sure the individual has signed the form. The Work Opportunity Tax Credit WOTC is a Federal tax credit incentive that employers may receive for hiring individuals from certain target groups who have consistently faced significant barriers to employment.

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Application Process The first step is pre-screening to determine eligibility. The amount of the tax credit 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.

Form has a specific day filing requirement. Before mailing the forms to JSND, make sure they contain the required signatures, review them for completeness, and make copies for your records. Additionally, there are situations when an employer will receive a Notice of Denial from Job Service because Form was missing original signatures.

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For more details on WOTC benefit amounts, go to www. The job seeker or the employer must complete the following forms: What is a Designated Employer Representative? Both the percentage and the cap on qualifying wages vary based on which target group the new employee falls into.

We use your feedback to help us improve this site but we are not able to respond directly. The form that is submitted to Job Service North Dakota must contain the original signatures of the new hire and the employer.

Obtain the current forms and their instructions: Form is required to apply for the WOTC. The employer then forwards the forms to the Department of Career Services no later than the 28th day after the job seeker begins work 90622 the following address:. Re-verification of target group eligibility and the date listed in Question 15 on Form may occur by Job Service North Dakota. Executive Office of Labor and Workforce Development.

In these cases, if an employer can resubmit a properly completed Form within the day filing requirement, Job Service will consider that form for processing.