Update on Renewal of WOTC Forms
ETA Form 9058, ETA Form 9061(English and Spanish), ETA Form 9062, ETA Form 9065, and ETA Form 9175 were approved by the Office of Management and Budget (OMB) under the Paperwork Reduction Act and approved for use through November 30, 2016. The Information Collection Request (ICR) Reference Number 201502-1205-006 reviewed and approved by OMB review was for OMB Control Number 1205-0371.
Certification Request Forms for Employers
- Complete IRS Form 8850 by the day the job offer is made.
- Complete ETA Form 9061 or ETA Form 9062 if the employee has been conditionally certified as belonging to a WOTC target group by a state workforce agency, Vocational Rehabilitation agency, or another participating agency.
- ETA Form 9175: For new WOTC target group, Long-Term Unemployment Recipients, complete Long-Term Unemployment Recipient Self-Attestation Form when there is an absence of UI wage records (see TEGL 25-15).
Submit the completed and signed IRS and ETA forms to your state workforce agency . Forms must be submitted within 28 calendar days of the employee's start date.
States may accept applications via mail, fax, or e-mail or may have an automated WOTC process that accepts electronic submissions. If you are not sure how your state accepts applications, contact your state WOTC coordinator, or view our chart on state submission processes.
Employers should follow the following steps to apply for the certification to receive the Work Opportunity Tax Credit.
Spanish Language Forms
Forms for State Workforce Agencies (SWAs)
Forms for Employers after they Receive Certification from the SWA
- Once your request for certification is approved by the SWA, then you may file with the IRS to claim the tax credit. See Instructions for Filing with IRS to download a copy of Form 5884 (or Form 5884-C for non-profits) and Form 3800.
Forms for Employer Representatives
To submit a WOTC request for certification on behalf of an employer, a completed power of attorney (POA) form must be signed and submitted to the state workforce agency (SWA).