To verify whether a job applicant is a first-time, qualifying member of a targeted group, employers are required to submit IRS Form 8850 together with ETA Form 9061 or ETA Form 9062 to the state workforce agency in which the employer's business is located (where the employee works) within 28 calendar days after the new hire's start date.

  1. IRS Form 8850, Pre-Screening Notice and Certification Request for the Work Opportunity Credit, available at: ; AND
  2. ETA Form 9061 (OR) ETA Form 9062 must be completed and submitted to the state workforce agency to complete the application.  Note: The Spanish - ETA Form 9061 is available for translation purposes only.

Additional forms may be required for certain targeted groups, as noted below:

  1. ETA Form 9175 is a Self-Attestation Form (SAF) completed by job applicants of the Qualified Long-Term Unemployment Recipient (LTUR) targeted group, only.

IRS Tax Relief in Disaster Situations

The Internal Revenue Service (IRS) tax relief for disaster victims and extended filing deadlines may apply to Work Opportunity Tax Credit certification requests. See Section 15, paragraph 12 of Revenue Procedure 2018-58, which is available at Information on the most recent tax relief provisions in effect for taxpayers affected by disaster situations is available on, here:

Submission instructions can be found on your state workforce agency's website. See the state workforce agency directory for additional information at: Do not send application forms to the U.S. Department of Labor, or any other federal agency.