Form 9061

Employers use Form 9061 (ETA FORM 9061) to check if job applicants may be eligible for the Work Opportunity Tax Credit (WOTC). If an applicant indicates possible eligibility, then the company must complete IRS Form 8850 and ETA Form 9061. WOTC is the largest employment assistance program available. It helps businesses invest in American job seekers who have faced barriers to employment. It provides tax credits for taxable and tax-exempt employers alike. To claim the WOTC, employers must complete IRS Form 8850 and ETA Form 9061 as soon as a new employee starts working. Both forms must be submitted to the state workforce agency where your business is located within 28 calendar days of the new hire’s start date.

In addition to submitting ETA Form 9061, you may also complete DOL Form 9062 Conditional Certification. This form is an official pre-certification by your state workforce agency for the new hire. The ETA Form 9061 Individual Characteristics Form is a one-page, Adobe PDF-formatted form. It is intended to be used by applicants who have been Conditionally Certified as belonging to a targeted group by the employer’s state workforce agency, Vocational Rehabilitation agency, or another participating agency. This form is only available in English. However, if the applicant is Spanish-speaking, you may use a Spanish-language version of ETA Form 9061.

Form 9061 Instructions

• Enter the individual’s name, address, and social security number.
• If the individual is a veteran, indicate their veteran status in this section.
• Select the targeted group that the individual belongs to from the list provided in this section. The targeted groups include:
  • Qualified IV-A recipient
  • Qualified veteran
  • Ex-felon
  • Designated community resident
  • Vocational rehabilitation referral
  • Summer youth employee
  • Supplemental Nutrition Assistance Program (SNAP) recipient
  • Supplemental Security Income (SSI) recipient
  • Long-term family assistance recipient

• In the eligibility section, you must certify that the individual meets the eligibility criteria for their targeted group. The eligibility criteria vary depending on the targeted group but generally involve factors such as when the individual has been unemployed, their income level, and whether they have received certain government benefits.
• Sign and certify that the information on the form is true and accurate to your knowledge.