May 6, 2020

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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For more details on WOTC benefit amounts, go to www. Department of Labor forms, as appropriate: 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 etx.

Application Process The first step is pre-screening to determine eligibility. The Work Opportunity Tax Credit WOTC is a Federal tax credit incentive that employers may receive 0962 hiring individuals from certain target groups who have consistently faced significant barriers to employment. If you need a response, please locate the contact information elsewhere on this page or in the footer. This form indicates the individual was tentatively determined as eligible for a WOTC target group.

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

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 frm, how to properly complete them, and where and how to submit them.


Amount of the Credit The amount gorm 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 completes Part II of the form. Form has a specific day filing requirement. Job Service North Dakota. 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 906 with the exception of the long term TANF recipient. The employer makes sure the individual has signed the form. 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 eat liability.

If this requirement is not met, Form must be denied.

WOTC – Forms and Publications

Employers can obtain copies of IRS by visiting www. The employer has the new hire complete question 8 on the top of the form and answer the characteristics questions. Give this form to the new hire and have him or her complete, sign, and date the front of the form.

Additionally, there are situations when an employer will receive a Notice of Denial from Job Formm because Form was missing original signatures. We use your feedback to help us improve this site but we are not able to respond directly. The employer completes the top portion of the form, making sure all the blanks are completed.

Auxiliary aids and services are available upon request to individuals with disabilities. Both the percentage and the cap on qualifying wages vary based on which target group the new employee falls into. If the new hire is under age 18 on the hire date, a parent or guardian must sign and date eat form.


The form that is submitted to Job Service North Dakota must contain the original signatures of the new hire and the employer. The job seeker or the employer must complete the following forms: Have your company representative complete, sign, and date the back of the form.

How Does an Employer Apply for WOTC?

The mailing envelope must contain a U. Re-verification of target group eligibility and the date listed in Question 15 on Form may occur by Job Service North Dakota.

Before mailing the forms to JSND, make sure they contain the required signatures, review them for completeness, and make copies for your records. Faxed or emailed forms cannot be accepted and will result in a denial.

Postal Service postmark or postage meter mail stamp dated no later than the 28th calendar day after the date the new hire began work. Should an employer realize after they have mailed Form to Job Service North Dakota that the form is missing original signatures, the employer can fofm a second form that contains original signatures.

If you need to mail Form separately to meet the day filing requirement, write on the form that other documents are being mailed separately. If these are not in place or if signature areas are left blank, Form must be denied.