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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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962 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:.

The form that is submitted to Job Service North Dakota must contain the original signatures of the new hire and the employer.

In these cases, if an employer can resubmit a properly completed Form within the day filing requirement, Job Service will ets that form for processing.

Give this form to the new hire and have him or her complete, sign, and date the front of the 906. It is the employer’s responsibility to read the instructions for forms and and to know what ea to complete, how to properly complete them, and where and how to submit them. 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.

Application Process The first step is pre-screening to determine eligibility. Before mailing the forms to JSND, 9026 sure they contain 9602 required signatures, review them for completeness, and make copies for your records. Postal Service postmark or postage meter mail stamp dated no later than the 28th calendar day after the date the new hire began work. Carefully read the instructions for this form to learn about the target groups.


If you need a response, please locate the contact information elsewhere on this page or in the footer. If the 28th day falls on a Saturday, Sunday, or federal holiday, the next business day is considered the 28th filing day.

Faxed or emailed forms cannot be accepted and will result in a denial. Auxiliary aids and services are available upon request to individuals with disabilities.

This form indicates the individual was tentatively determined as eligible for a WOTC target group. Feedback Did you find what you were looking for on this webpage? For more details on WOTC benefit amounts, go to www.

WOTC – Forms and Publications

Mail all required forms and documentation together. The employer should review this form for any “yes” responses indicated by the new hire and then obtain the required documentation era the new hire to substantiate those responses.

The job seeker or the employer must complete the following forms: If these are not in place or if signature areas are left blank, Form must be denied. The first step is pre-screening to determine eligibility. Amount rorm the Credit 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 long term TANF recipient.

We use your feedback to help us improve this site but we are not able to respond directly. Employers can obtain copies of IRS by visiting www. If this requirement is not met, Form must be denied.


What is a Designated Employer Representative?

If the new hire is under age 18 on the hire date, a parent or guardian must sign and date the form. 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 processing.

Please do not include personal or contact information. If you need to mail Form separately to meet the day filing requirement, write on the form that other documents are being mailed separately. Should an employer realize after they have fom Form to Job Service North Dakota that the form is missing original signatures, the employer can resubmit a second form that contains original signatures. 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: The employer and the job seeker must sign the Formunder penalty of perjury, attesting that the job seeker is a member of 90622 target group.

Have your company representative complete, sign, and date the back of the form. Department of Labor forms, as appropriate: Executive Office of Labor and Workforce Development.

Complete ONE of the following required U. Job Service North Dakota.

Work Opportunity Tax Credit Program (WOTC) Overview

Form has a specific day filing requirement. The employer must hire the individual by the date indicated in Question 15 in order to possibly be qualified for a tax credit.

Obtain the current forms and their instructions: