On this page:
Overview
To apply for the Work Opportunity Tax Credit, employers must submit the following:
- A complete IRS Form 8850, Pre-Screening Notice and Certification Request for the Work Opportunity Credit
; and - A complete ETA Form 9061, Individual Characteristics Form (ETA Form 9062, Conditional Certification, provided to the job seeker by TWC or a participating agency, may be submitted in lieu of the ETA Form 9061).
If one of the submitted forms is incomplete, you will receive a letter asking you to complete the form.
Please review your copy of the IRS Form 8850 and ETA Form 9061 against the following list of requirements and common errors to determine the necessary information that is required to continue processing your claim.
Requirements for IRS Form 8850 and ETA Form 9061:
- Both forms must be submitted to process the request.
- Both forms must be legible.
- The Spanish version of the forms can only be used for translation purposes and cannot be used as a substitution for the English version.
- The employer must submit the most current version of the forms; older versions are not accepted.
IRS Form 8850 - Page 1
| Field | Explanation |
|---|---|
| Your name | New hire name |
| Social security number | New hire’s SSN (must be 9 characters long) |
| Street address where you live | Physical street address where the new hire resides (P.O. Box not acceptable) |
| City or town, state, and ZIP code | City, state, and zip code where the new hire resides |
| If you are under age 40, enter your date of birth (month, day, year) | New hire’s birth date (MM/DD/YY) |
| Number 1 through 7 | Check all boxes that the new hire would qualify for |
| Job applicant’s signature | New hire signature |
| Date | Date new hire signed the form |
IRS Form 8850 - Page 2
| Field | Explanation |
|---|---|
| Employer name | Employer’s name that the certification should be issued under. |
| Telephone number | Employer’s telephone number (include area code) |
| EIN | Employer’s EIN number (must be 9 characters long) |
| Street Address | Employer’s physical street address |
| City or town, state and ZIP code | Employer’s city, state and ZIP code |
| Person to Contact, if different from above | Consultant’s firm name and EIN number |
| Telephone Number | Consultant’s telephone number (include area code) |
| Street Address | Consultant’s street address |
| City or town, state, and ZIP code | Consultant’s city, state and ZIP code |
| Gave information | Date applicant was given information on the position |
| Was offered job | Date the applicant was offered the position |
| Was hired* | Date the applicant was hired |
| Started job* | Date the applicant started working for employer |
| Employer’s signature | Employer’s signature |
| Title | Employer’s title |
| Date | Date the employer signed the form |
* The hired date cannot be a later date than the start date. Please verify that the dates entered in both of the sections are correct.
ETA Form 9061
| Field | Explanation |
|---|---|
| Box 3. Employer Name | Company’s name |
| Box 4. Employer Address and Telephone | Employer’s complete physical address and phone number |
| Box 5. Employer Federal ID Number (EIN) | Employer’s EIN number (must be 9 characters long) |
| Box 6. Applicant Name (Last, First, MI) | New hire’s name with last name first, first name second, and middle initial, if applicable |
| Box 7. Social Security Number | SSN for new hire (must be 9 characters long) |
| Box 8.Prior Employee? | Questions for the new hire |
| Box 9. Employment Start Date | Date new hire started working for employer |
| Box 10. Starting Wage | Wage offer |
| Box 11. Position | Position offered to new hire (or O*Net code) |
| Box 12 to 21. | Eligibility questions |
| Box 22. Sources | List all documentation provided |
| Box 23(a). Signature | Signature of person completing form |
| Box 23(b). Completed By | Indicate who signed form |
| Box 24. Signature Date | Date the form was signed |
