Tax Credit Eligibility
Additional Information Thank you for taking the time to complete this survey related to IRS Form 8850 (Pre-screening Notice and Certification Request for the Work Opportunity Tax Credit) and the ETA Form 9175 (Long-Term Unemployment Recipient Self-Attestation Form). These forms are used to verify the information you have provided and to manage the important WOTC jobs program. If you agree with the following declaration, click the confirmation box below your name to electronically sign the Form 8850 and the ETA Form 9175. If the name is incorrect, please type in your correct name and then click the confirmation box to electronically sign the forms. Under penalties of perjury, I declare that I gave the above information to the employer on or before the day I was offered a job, and it is, to the best of my knowledge, true, correct, and complete. Please confirm your Full Name:*