Certification Request
The documents you get with the Certification Request package
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Purpose of Form Employers use Form 8850 to pre-screen and to make a written request to the state workforce agency (SWA) of the state in which their business is located (where the employee works) to certify an individual as a member of a targeted group for purposes of qualifying for the work opportunity credit.
This form is used together with IRS Form 8850 to help state workforce agencies (SWAs) determine eligibility for the Work Opportunity Tax Credit (WOTC) Program.
CONDITIONAL CERTIFICATION (CC) ETA FORM 9062. When a SWA or participating agency (PA) determines that a job-ready applicant is, TENTATIVELY ELIGIBLE as a member of a target group under WOTC, it shall use this required form, without modification, to show that eligibility pre-determination was made for this person.
What Is ETA Form 9175? ETA Form 9175, Long-term Unemployment Recipient Self-Attestation Form, is a legal document completed by a new hire if this employee was a job seeker with employment barriers. This is one of the documents needed to apply for the Work Opportunity Tax Credit (WOTC).