View Information Collection Request (ICR) Package
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
1205-0371
ICR Reference No:
201003-1205-008
Status:
Historical Active
Previous ICR Reference No:
201001-1205-003
Agency/Subagency:
DOL/ETA
Agency Tracking No:
012-05-01-02-02-2025-00.
Title:
Work Opportunity Tax Credit (WOTC) and Welfare-to-Work (WtW) Tax Credit
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
04/09/2010
Retrieve Notice of Action (NOA)
Date Received in OIRA:
04/02/2010
Terms of Clearance:
OMB appreciates DOL's efforts to ensure that the Form ETA-9154 complies with Section 7 of the Privacy Act of 1974, as amended (Pub. L. 93-579). ETA is instructed to review the other forms inventoried under this OMB Control Number to determine if a Privacy Act notice similar to that provided on the Form ETA-9154 is required. ETA will submit the revised forms as a non-substantive no material change request to OMB by no later than May 2010.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
11/30/2011
11/30/2011
11/30/2011
Responses
2,527,028
0
2,527,028
Time Burden (Hours)
883,305
0
883,305
Cost Burden (Dollars)
0
0
0
Abstract:
Tax Credit Program Administration: Data and information provided by the states on these forms are used for program planning, evaluation of Program performance and outcomes through states' quarterly report and for oversight/verification activities as mandated by the Omnibus Budget Reconciliation Act of 1990 (P.L. 101-508) Section 11405(c), which extended indefinitely the $5 million set-aside for testing whether individuals certified as members of WOTC targeted groups are eligible for certification (including use of statistical sampling techniques). As long as there is a WOTC appropriation, this is a continuing requirement.
Authorizing Statute(s):
PL:
Pub.L. 110 - 28 8211
Name of Law: Small Business and Work Opportunity Tax Act
PL:
Pub.L. 109 - 432 105
Name of Law: Tax Relief and Health Care Act of 2006
PL:
Pub.L. 101 - 508 11405(c)
Name of Law: Omnibus Budget Reconciliation Act of 1989
Citations for New Statutory Requirements:
PL: Pub.L. 110 - 28 8211 Name of Law: Small Business and Work Opportunity Tax Act
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
73 FR 1648
01/09/2008
30-day Notice:
Federal Register Citation:
Citation Date:
73 FR 24315
05/02/2008
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
3
IC Title
Form No.
Form Name
Individual Characteristics
ETA-9061, ETA Form 9061, ETA-9061 in Spanish
WOTC Individual Characteristics
,
Individual Characteristics Form
,
Individual Characteristics
WOTC Self-Attestation Form (ETA-9154)
ETA-9154
YOUTH SELF-ATTESTATION FORM Work Opportunity Tax Credit Program
Work Opportunity Tax Credit (WOTC) and Welfare-to-Work (WtW) Tax Credit
ETA-9063, ETA-9058, ETA-9057, ETA-9062, ETA-9065, ETA-9059
Verification Results: Audit Summary Worksheet, for SWA Internal Unse Only
,
Consolidated Work Opportunity Tax Credit Report #1
,
Agency Declaration of Verification Results
,
Conditional Certification
,
Conditional Certifications Issued
,
Employer Certification
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
2,527,028
2,527,028
0
0
0
0
Annual Time Burden (Hours)
883,305
883,305
0
0
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
The additional burden associated with the collections is the result of the fact that the American Recovery and Reinvestment Act made the two new WOTC target populations, unemployed veteran and disconnected youth, eligible for employers to receive the tax credit retroactively to January 1, 2009. However, guidance was not issued to the State Workforce Agencies on implementation of these two new target groups until September 1, 2009. Therefore, SWAs will need to request employers to provide the necessary documentation for applications submitted prior September 1, for these two new target groups, thus creating an additional burden.
Annual Cost to Federal Government:
$23,847
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Uncollected
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
Uncollected
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
Yes
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Bonnie Naradzay 202-693-3675 Naradzay.Bonnie@dol.gov
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
04/02/2010
An official website of the United States government
The .gov means it's official.
The site is secure.
