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:
202308-1205-002
Status:
Active
Previous ICR Reference No:
202302-1205-001
Agency/Subagency:
DOL/ETA
Agency Tracking No:
Title:
Work Opportunity 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:
02/28/2024
Retrieve Notice of Action (NOA)
Date Received in OIRA:
02/15/2024
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
05/31/2026
05/31/2026
05/31/2026
Responses
18,604,708
0
18,604,708
Time Burden (Hours)
10,205,416
0
10,205,416
Cost Burden (Dollars)
0
0
0
Abstract:
The Work Opportunity Tax Credit (WOTC) is a Federal tax credit available to employers for hiring individuals from certain target groups who have consistently faced significant barrier to employment. This submission includes seven WOTC program forms as follows: • ETA Form 9175, Revised November 2016 – Self-Attestation Form (SAF) for the Long-Term Unemployment Recipient • ETA Form 9058 - Report 1, Revised November 2016 - Certification Workload and Characteristics of Certified Individuals • ETA Form 9061, Revised November 2016 - Individual Characteristics Form • ETA Form 9062, Revised April 2016 - Conditional Certification • ETA Form 9063, Revised April 2016 - Employer Certification • ETA Form 9065, Revised April 2016 - Agency Declaration of Verification Results Worksheet
Authorizing Statute(s):
PL:
Pub.L. 104 - 188 1201
Name of Law: Small Business Job Protection Act of 1996
US Code:
26 USC 51
Name of Law: Internal Revenue Code of 1986
US Code:
26 USC 3111
Name of Law: Internal Revenue Code of 1986
PL:
Pub.L. 116 - 260 113
Name of Law: Consolidated Appropriations Act, 2021
PL:
Pub.L. 101 - 508 11405(c)
Name of Law: The Omnibus Budget Reconciliation Act of 1990
PL:
Pub.L. 97 - 34 261(f)(2)
Name of Law: Economic Recovery Act of 1981
Citations for New Statutory Requirements:
None
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:
87 FR 69048
11/17/2022
30-day Notice:
Federal Register Citation:
Citation Date:
88 FR 15457
03/13/2023
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
4
IC Title
Form No.
Form Name
Certification Workload and Characteristic of Certified Individuals
ETA Form 9058, ETA-9065
Audit Summary Worksheet
,
Certification Workload and Characteristics of Certified Individuals
Individual Characteristics
ETA-9061, ETA-9062, ETA-9198, ETA-9061
Individual Characteristics Form (ICF)
,
Conditional Certification Form (CC)
,
Employer Representative Declaration
,
Individual Characteristics Form (Spanish)
Qualified Long-term Unemployment Recipient (LTUR)
ETA-9175
LONG-TERM UNEMPLOYMENT RECIPIENT SELF-ATTESTATION FORM Work Opportunity Tax Credit (WOTC) Program
Work Opportunity Tax Credit (WOTC)
ETA 9061, ETA-9061, ETA-9062, ETA-9063, ETA-9175, ETA-9198
Conditional Certification Work Opportunity Tax Credit
,
Employer Certification Work Opportunity Tax Credit
,
Individual Characteristics Form (ICF) Work Opportunity Tax Credit
,
LONG-TERM UNEMPLOYMENT RECIPIENT (LTUR) SELF-ATTESTATION FORM (SAF)
,
Employer Representative Declaration
,
ETA Form 9061 - Individual Characteristics Form (Spanish)
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
18,604,708
18,604,708
0
0
0
0
Annual Time Burden (Hours)
10,205,416
10,205,416
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:
Annual Cost to Federal Government:
$12,962
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
No
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
No
Agency Contact:
Patrice Gibson 202 693-0158 gibson.patrice.a@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:
02/15/2024
Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.