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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The employer completes the top portion of the form, making sure all the blanks are completed. Skip to main content. If the 28th day falls on a Saturday, Sunday, or federal holiday, the next business day is considered the 28th filing day. 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.

Department of Labor forms, as appropriate: 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. Please do not include personal or contact information.

Have your company representative complete, sign, and date the back of the form. Give this form to the new hire and 0962 him or her complete, sign, and date the front of the form. Before mailing the forms to JSND, make sure they contain the required signatures, review them for completeness, and make copies for your records.

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.

Obtain the current forms and their instructions: 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 90662.


Re-verification of target group eligibility and the date listed in Question 15 on Form may occur by Job Service North Dakota.

Work Opportunity Tax Credit Program (WOTC) Overview

The mailing envelope must contain a U. Executive Office of Labor and Workforce Development. The job seeker or the employer must complete the following forms:. The first step is pre-screening to determine eligibility.

Auxiliary aids and services are available upon request to individuals with disabilities. The employer must hire the individual by the date indicated in Question 15 in order to possibly be qualified for a tax credit. For more information and additional filing options fax, email, onlinecontact the Department of Career Services at If this requirement is not met, Form must be denied.

If you need to mail Form separately to meet the day filing requirement, write on the form that other documents are being mailed separately.

How Does an Employer Apply for WOTC?

Mail all required forms and documentation together. 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 9026 term TANF recipient. 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 forj sign and date the form. Additionally, there are situations when an employer will receive a Notice of Denial from Job Service because Form was missing original signatures.

era Job Service North Dakota. 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.

Work Opportunity Tax Credit Program (WOTC) Overview |

This form indicates the individual was tentatively determined as eligible for a WOTC target group. We use your feedback to help us improve this site but we are not able to respond directly.


The Work Opportunity Tax Credit WOTC is a Federal tax credit incentive that employers vorm receive for hiring individuals from certain target groups who have consistently faced significant barriers to employment. 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: Faxed eya emailed forms cannot be accepted and will result in a denial. Form is required to apply for the WOTC. The second form must meet the day filing requirement in order for it to be considered timely and in order for Job Service to frm it for processing.

Form has a specific day filing requirement. Application Process The first step is pre-screening to determine eligibility.

WOTC – Forms and Publications

The job seeker or the employer must complete the following forms: The form that is submitted to Job Service North Dakota must contain the original signatures of the new hire and the employer. 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 9602 the hire date, a parent or guardian must sign and date the form.

For more details on WOTC benefit amounts, go to www. Complete ONE of the following required U. Employers can obtain copies of IRS by visiting www.

If these are not in place or if signature areas are left blank, Form must be denied.

Feedback Did you find what you were looking for on this webpage? The employer completes Part II of the form. Carefully read the instructions for this form to learn about the target groups. The employer and the job seeker fom sign the Formunder penalty of perjury, attesting that the job seeker is a member of a target group.