WOTC youth self-attestation clarification

Accessible letter PDF: https://www.dol.gov/sites/dolgov/files/ETA/advisories/TEGL/2010/TEGL03-09c3acc.pdf

CLASSIFICATION
   EMPLOYMENT AND TRAINING ADMINISTRATION           WOTC
               ADVISORY SYSTEM                      CORRESPONDENCE SYMBOL
          U.S. DEPARTMENT OF LABOR                  OWI
             Washington, D.C. 20210                 DATE
                                                    May 24, 2010


ADVISORY: TRAINING AND EMPLOYMENT GUIDANCE LETTER NO. 3-09
          CHANGE 3

TO:          ALL STATE WORKFORCE AGENCIES
             ALL STATE WORKFORCE LIAISONS
             ALL REGIONAL WOTC COORDINATORS

FROM:        JANE OATES /s/
             Assistant Secretary

SUBJECT:     Clarification to Final Guidance to State Workforce Agencies (SWAs) and
             Employers for the Implementation of the Two American Recovery and
             Reinvestment Act (ARRA) of 2009 Work Opportunity Tax Credit (WOTC)
             Target Groups Requirements

1. Purpose. The purpose of this advisory is to clarify the requirements regarding
   timing of submission of the Youth Self-Attestation Form and to transmit the revised
   instructions to the Youth Self-Attestation Form.

2. References. The American Recovery and Reinvestment Act (ARRA or Recovery
   Act) of 2009 (Public Law 111-5); Internal Revenue Code of 1986, Section 51, as
   amended; Paperwork Reduction Act of 1995; Notice 2009-28, 2009-24 I.R.B. 1082,
   dated June 15, 2009; Notice 2009-69, dated August 31, 2009; the Small Business and
   Work Opportunity Tax Credit Act of 2007 (Public Law 110-28); the Tax Relief and
   Health Care Act of 2006 (Public Law 109-432); Training and Employment Guidance
   Letter (TEGL) 3-09 Change 1, dated October 7, 2009, Extension Period Granted to All
   State Workforce Agencies (SWAs) and Employers for the Uninterrupted Use of 2007 Work
   Opportunity Tax Credit (WOTC) Processing Forms; TEGL 3-09, dated September 1, 2009,
   Groups Introduced by the American Recovery and Reinvestment Act Of 2009; TEGL 03-09
   Change 1, Extension Period Granted to all State Workforce Agencies (SWAs) and
   Employers for the Uninterrupted Use of All 2007 Work Opportunity Tax Credit (WOTC)


RESCISSIONS                                       EXPIRATION DATE
None                                              Continuing

                                          -2-



   Processing Forms; TEGL 3-09, Change 2, Final Guidance to State Workforce Agencies
   (SWAs) and Employers for the Implementation of the Two American Recovery and
   Reinvestment Act (ARRA) of 2009 Work Opportunity Tax Credit (WOTC) Target Groups
   Requirements; TEGL No. 11-08, dated February 19, 2009, Extension of the Information
   Collection for the Consolidated Work Opportunity Tax Credit Program: Revised Reporting
   and Processing Forms; TEGL No. 11-08, Change 1, Extension Period Granted to the State
   Workforce Agencies and Employers for the Uninterrupted Use of All 2007 and 2008 Work
   Opportunity Tax Credit (WOTC) Program Processing Forms; ETA Handbook No. 408,
   November 2002, Third Edition (the Handbook); and the updated August 2009 Addendum to
   the Handbook (Addendum, OMB No. 1205-0371).

3. Background. Following the release of TEGL 03-09 Change 2, ETA received inquiries
   asking for clarification about the timing of submission of the national Youth Self-
   Attestation Form together with IRS Form 8850 and ETA Form 9061.

4. New Guidance. To address the questions raised, ETA issues the following
   clarifications:

      a. TEGL 03-09, Change 2 stated, in a paragraph designated as a “Note,” that
         “employers are instructed to submit the national Youth Self-Attestation Form
         at the same time as the ETA Form 9061 and IRS Form 8850 for each
         certification request for the Disconnected Youth target group.” ETA
         recognizes that IRS Form 8850 is the only certification request form that has a
         28-day statutory filing period requirement to be considered timely filed.
         ETA clarifies that the intent behind the “Note” was not to require that the
         SAF, ETA 9061 and IRS 8850 be filed within 28 days of the employment-start
         day of the new hire, but rather that the SAF be filed with either ETA 9061 or
         IRS 8850. Therefore, if the SAF cannot be submitted with IRS 8850 within the
         statutory 28-day time period, it should be submitted to the SWA with ETA
         9061 when both are signed and completed.

         ETA recognizes that in infrequent and limited numbers of cases, employers
         may not be able to obtain the Youth SAF from the employee in a timely
         manner and may choose to submit the ETA Form 9061 without the SAF.
         States have the flexibility to accept ETA 9061s without the SAF in these
         infrequent cases.

         ETA strongly recommends and encourages all three forms to be submitted
         together to prevent unnecessary processing delays by the SWAs trying to find
         and match ETA 9061s, SAFs, and IRS 8850s when these forms are filed
         separately. This delay can increase backlogs. ETA reiterates its position and
         guidance during the early implementation years and strongly recommends
         that the ETA 9061, IRS 8850, and now the SAF, be filed at the same time,

                                           -3-


          when feasible, as a “best business practice” that benefits employers and the
          SWAs at the same time.

      b. ETA has updated the instructions on the national SAF (attached). Please note,
         the content of the form has not changed; only the instructions have been
         modified to be consistent with the guidance in paragraph a.

      c. To assist the SWAs in implementing this guidance, attached is a copy of the
         signed 3-09 Change 2 TEGL.

      d. No later than 90 calendar days after issuance of this TEGL, ETA requires
         employers and states to use only this national Youth Self-attestation Form
         and cease use of any previously created forms.

5. Reporting Authority. Recovery Act reporting, program administration and
   processing forms and all other program-related materials are approved according to
   the Paperwork Reduction Act of 1995, under Office of Management and Budget
   (OMB) No. 1205-0371, and all are dated August 2009. This authority is effective
   through November 30, 2011. SWAs are to report all program workload processing
   data using the August 2009, ETA Form 9058 beginning with the first quarter of
   Fiscal Year 2010, which closed on December 31, 2009.

6. Paperwork Reduction Act (PRA) Notice. According to the PRA, no persons are
   required to respond to a collection of information unless such collection displays a
   valid OMB control number. The Department notes that a Federal agency may not
   conduct or sponsor a collection of information, nor is the public required to respond
   to a collection of information unless it is approved by OMB under the PRA, and
   displays a currently valid OMB control number (44 U.S.C. 3507). Also,
   notwithstanding any other provisions of law, no person shall be subject to penalty
   for failing to comply with a collection of information if the collection of information
   does not display a currently valid OMB control number (44 U.S.C. 3512). The
   currently valid OMB Control Number for this collection is OMB 1205-0371.

   Please note that while self-attestation requirements are mandated by the IRS to
   document two of the four eligibility requirements for the new ARRA Disconnected
   Youth group, use of the attached national Youth SAF supersedes past ETA guidance
   in TEGL 3-09 and in the Change 1 to TEGL 3-09. This guidance clarifies the
   guidance issued in the 03-09 Change 2 TEGL, and the attached Youth SAF
   supersedes the previously issued SAF. ETA is providing the national SAF to states
   so they can uniformly meet DOL’s policy guidance and IRS’s legal interpretations to
   the Internal Revenue Code’s current ARRA legislative requirements for this ARRA
   target group. Additionally, the national Youth SAF attached to this TEGL does not
   add to or change the states’ burden in processing requests for certification or for

                                         -4-


   individuals/employers in applying for certification. The burden for providing the
   information to meet the self-attestation requirements is estimated to average five
   minutes per respondent.

7. Action Requested. SWA administrators are requested to provide this TEGL to all
   WOTC State Coordinators and related program staff, and ensure the information
   and guidance provided is shared with the private sector businesses, their
   representatives, and all other Federal and state partners effective, immediately,
   upon receipt of this TEGL.

8. Inquiries. Direct all questions to the appropriate Regional WOTC Coordinator.

9. Attachments.
   I. Youth Self-Attestation Form (May 2010)
   II. Spanish Version of the Youth Self Attestation Form (May 2010)
   III. TEGL 03-09 Change 2

Attachment 1 (official PDF): https://www.dol.gov/sites/dolgov/files/ETA/advisories/TEGL/2010/TEGL03-09c3a1.pdf

U.S. Department Labor
                                                                                                            OMB Control No. 1205-0371
                 Employment and Training Administration
                                                                                                     Expiration Date: November 30, 2011



                                           YOUTH SELF-ATTESTATION FORM
                                          Work Opportunity Tax Credit Program


Instructions: This Self-Attestation Form (SAF) is to be completed, signed, and dated by the new hire
only. Employers or consultants submit this SAF to the State Workforce Agency with Form ETA 9061 for
each certification request filed.

New Hire Name: ___________________________________________________________

Social Security Number: _________________ Date of Birth:_______________________

Employer Name: ___________________________________________________________

Employer Federal ID (EIN) Number: ___________________________________________

Please check all the statements that apply to you. Sign and date this form where
indicated below.

           In the past 6 months, I have not attended a secondary, technical or
           postsecondary school for more than an average of 10 hours per week, not
           counting periods during which the school is closed for scheduled vacations.

           I do not have a High School Diploma or GED certificate.

           I have a High-School diploma or GED certificate awarded more than 6 months
           ago and I have not attended or been admitted to a technical or post-secondary
           school. I also have not held a job (other than occasionally) since receiving my
           High-School diploma or GED certificate.


Under penalties of perjury, I declare that this information is true and correct to the best of my knowledge.



New Hire’s Signature: _______________________________________________Date_________
Privacy Act Notice:
The Internal Revenue Code of 1986, Section 51, as amended and its enacting legislation, P.L. 104-188, specify that the State Workforce Agencies are
the "designated" agencies responsible for administering the WOTC certification procedures of this program. The information you have provided
completing this form, including the Social Security Number, will be disclosed by your employer to the State Workforce Agency. Provision of this
information is voluntary; however the information is required to determine your employer's eligibility for the federal tax credit.


Public Burden Statement:
Persons are not required to respond to this collection of information unless it displays a currently valid OM B control number. Respondents' obligation to
complete this form is required to obtain or retain benefits (P.L. 111-5). Public reporting burden is estimated to average 5 minutes per response, including
the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the
collection of Information. Send comments regarding this burden estimate to the U.S. Department of Labor, Division of Adult Services, Room S-4209,
Washington, D.C. 20210 (Paperwork Reduction Project 1205-0371). Please do not submit completed forms to this address.
                                                                                                            ETA Form 9154 (Rev. May 2010)

Attachment 2 (official PDF): https://www.dol.gov/sites/dolgov/files/ETA/advisories/TEGL/2010/TEGL03-09c3a2.pdf

Versión en Español                                                                                            OMB No: 1205-0371
                                                                                            Expiration Date: November 30, 2011
                                  YOUTH SELF-ATTESTATION FORM
                        (Forma de Auto-Juramentación o Declaración Personal)
                               “Work Opportunity Tax Credit Program”

Instrucciones: Esta forma debe ser completada, debidamente firmada, y fechada por el joven empleado. El
patrón, o su representante, deberá enviar esta Auto-Juramentación o Declaración Personal junto con la forma ETA
9061 a la Agencia Estatal de Empleo o SWA.

Nombre del Empleado: __________________________________________________________

Numero de Seguro Social: ___________________ Fecha de Nacimiento:_________________

Nombre del Patrono ____________________________________________________________

Numero o ID Federal (EIN) del Patrono:____________________________________________

Por favor marque todos los encasillados que le apliquen a Usted. Luego firme y feche esta
forma en los blancos al final de la forma.

           En los últimos 6 meses, no he asistido a ninguna escuela secundaria o técnica, ni he
           cursado estudios post secundarios durante mas de un promedio de 10 horas por
           semana, sin contar los periodos durante los cuales la escuela esta cerrada por
           vacaciones programadas.

           No tengo ni un Diploma de Escuela Secundaria ni un Certificado GED.

           Tengo un Diploma de Escuela Secundaria o un Certificado GED otorgado hace mas de 6
           meses y no he asistido ni he sido aceptado en una escuela técnica o de estudios post
           secundarios. Tampoco he tendido ningún empleo (excepto de vez en cuando) desde
           que recibí mi Diploma de Escuela Secundaria o mi Certificado de GED.


      Bajo las sanciones o penalidades de perjurio, declaro que esta información es correcta y verdadera.


Firma del Empleado: ________________________________________________Fecha: _______


Privacy Act Notice (Aviso): El Código de Rentas Internas (Departamento del Tesoro de EUA) de 1986, Sección 51, como legislación enmendada, y
P.L. 104-188, decretan, que la Agencia Estatal de Empleo es la única agencia gubernamental autorizada y responsable para administrar los
procedimientos de certificación del programa WOTC. La información que usted ha proporcionado al llenar este formulario, incluyendo el Número de
Seguro Social, será divulgada por su patrón a la Agencia Estatal de Empleo. La disposición de esta información es voluntaria; sin embargo la
información se requiere para poder determinar la elegibilidad de su patrón para reclamar el WOTC o crédito de impuesto federal.

=================================================================================================================

 “Public Burden Statement (Declaración):” Las personas no están obligadas a proveer la información que esta forma pide a menos que dicha
forma despliegue o muestre un número de control valido de OMB. Las personas interesadas en obtener y mantener los beneficios que este
programa ofrece tienen la obligación de responder a las preguntas en esta forma. (P.L. 111-5). El tiempo que toma contestar esta forma se ha
estimado que toma un promedio de 5 minutos por cada contestación, incluyendo el tiempo para leer las instrucciones, reunir y mantener los
datos necesarios y completar y revisar esta colección de información. Puede enviar comentarios sobre este estimado de tiempo al
Departamento del Trabajo, División de Servicios a Personas Adultas (Division of Adult Services) Room S-4209, Washington, D.C. 20210
(Paperwork Reduction Project 1205-0371).

                                                                                                ETA Form 9154 (Rev. May 2010)