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 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 completes the top portion of the form, making sure all the blanks are completed. If the new hire is under age 18 on the hire date, a parent or guardian must sign and date the form.

The first step is pre-screening to determine eligibility. The employer must hire the individual by the date indicated eeta Question 15 in order to possibly be qualified for a tax credit.

Carefully read the instructions for this form to learn about the target groups. Job Service North Dakota.

Application Process The first step is pre-screening to determine eligibility. Feedback Did you find what you were looking for on this webpage? Either the new hire or employer may sign and date the form. torm

WOTC Questions: What is a Conditional Certification from the State Workforce Agency?

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.


Auxiliary aids and services are available upon request to individuals with disabilities. What is a Designated Employer Representative?

Employers can obtain copies of IRS by visiting www. The employer and the job seeker must sign the Formunder penalty of perjury, attesting that the job seeker is a member of a target group.

If the 28th day falls on a Saturday, Sunday, or federal holiday, the next business day is considered the 28th filing day. The mailing envelope must contain a U. Form is required to apply for the WOTC. We use your feedback to 99062 us improve this site but we are not able to rta directly. If you need to mail Form separately to meet the day filing requirement, write on the form that other documents are being mailed separately.

Postal Service postmark or postage meter mail stamp dated no later than the 28th calendar day after the date the new hire began work. Complete ONE of the following required U. Executive Office of Labor and Workforce Development.

If you need a response, please locate the contact information elsewhere on this page or in the footer. The job seeker or the employer must complete the following forms: Mail all required forms and documentation together.

WOTC – Forms and Publications

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. The amount of the tax credit is based on a rorm of qualified wages paid to firm new employee for the first year of employment only with the exception of the long term TANF recipient. Before mailing the forms to JSND, make sure they contain the required signatures, review them for completeness, and make copies for your records.


Both the percentage and the cap on qualifying wages vary based on which target group the new employee falls into. This form indicates the individual was tentatively determined as eligible for a WOTC target group. If you need to report child abuse, any other kind of abuse, or need urgent assistance, please click here.

The form that is submitted to Job Service North Dakota must 90662 the original signatures of the new hire and the employer. Form has a specific day filing requirement.

Amount of the Credit The amount of the tax credit is based on a percentage of qualified wages paid to the sta employee for the first year of employment only with the exception of the long term TANF recipient. Obtain the current forms and their instructions: