Instructions For Form 8850 (Rev. June 2007) printable pdf download

Department of the Treasury

Instructions for Form 8850

Internal Revenue Service

(Rev. June 2007)

Pre-Screening Notice and Certification Request for the Work Opportunity Credit

3 for a list of these areas). The employer is not required

General Instructions

to ask employees to furnish any documentary evidence.

Section references are to the Internal Revenue Code

unless otherwise noted.

Who Should Complete and

What’s New

Sign the Form

The Small Business and Work Opportunity Act of 2007

The job applicant gives information to the employer on or

made the following changes.

before the day a job offer is made. This information is

•

The work opportunity credit has been extended to

entered on Form 8850. Based on the applicant’s

cover individuals who begin work for you before

information, the employer determines whether or not he

September 1, 2011.

or she believes the applicant is a member of a targeted

•

group (as defined under Members of Targeted Groups). If

For individuals who begin work for you after May 25,

2007, the qualified veterans group is expanded to include

the employer believes the applicant is a member of a

veterans entitled to compensation for a

targeted group, the employer completes the rest of the

service-connected disability and who, during the

form no later than the day the job offer is made. Both the

one-year period ending on the hiring date, were (a)

job applicant and the employer must sign Form 8850 no

discharged or released from active duty in the U.S.

later than the date for submitting the form to the SWA.

Armed Forces or (b) unemployed for a period or periods

totaling at least 6 months. The first-year wages taken into

account for these disabled veterans is $12,000.

Instructions for Employer

•

For individuals who begin work for you after May 25,

2007, the high-risk youth group has been renamed

When and Where To File

“designated community residents” and expanded to

include individuals who are at least age 18 but not yet

Do not file Form 8850 with the Internal Revenue Service.

age 40. In addition, residents of rural renewal counties

Instead, if required, file it with your SWA no later than the

(see page 4) have been added to this group.

28th day after the job applicant begins work for you.

Although electronic filing of Form 8850 is permitted, at

You should use this version of Form 8850 for

the time these instructions were published, Colorado was

individuals who begin work for you after May 25,

the only state equipped to receive Form 8850

2007. Use the February 2007 revision for

CAUTION

electronically. See Announcement 2002-44 for details.

individuals who began work for you before May 26, 2007.

You can find Announcement 2002-44 on page 809 of

Internal Revenue Bulletin 2002-17 at

Purpose of Form

Employers use Form 8850 to pre-screen and to make a

To get the name, address, phone and fax numbers,

written request to their state workforce agency (SWA)

and email address of the WOTC coordinator for your

(unless the employee checks only the Hurricane Katrina

state, visit the Department of Labor Employment and

employee box) to certify an individual as a member of a

Training Administration (ETA) website at

targeted group for purposes of qualifying for the work

opportunity credit.

Submitting Form 8850 to the SWA (unless the

Never attach Form 8850 to a tax return or

employee checks only the Hurricane Katrina employee

otherwise send it to the IRS, regardless of the

box) is but one step in the process of qualifying for the

employee’s targeted group. Form 8850 should be

CAUTION

work opportunity credit. The state work opportunity tax

filed with the SWA unless the employee checks only the

credit (WOTC) coordinator for the SWA must certify the

Hurricane Katrina employee box, in which case the

job applicant is a member of a targeted group. After

employer should keep the Form 8850 for its records.

starting work, the employee must meet the minimum

number-of-hours-worked requirement for the work

Additional Requirements for

opportunity credit. The employer elects to take the credit

Certification

by filing Form 5884, Work Opportunity Credit.

In addition to filing Form 8850, you must complete and

The certification requirements described above do

send to your state WOTC coordinator either:

not apply to Hurricane Katrina employees. For an

•

ETA Form 9062, Conditional Certification Form, if the

employer of a Hurricane Katrina employee, this

CAUTION

job applicant received this form from a participating

form is used to accept reasonable evidence that the

agency (e.g., the Jobs Corps) or

worker is a Hurricane Katrina employee. It is the

•

ETA Form 9061, Individual Characteristics Form, if the

employer’s responsibility to ascertain that the place

job applicant did not receive a conditional certification.

where the employee lived on August 28, 2005, (the

address on line 1 of the form) is in fact in the Gulf

You can get ETA Form 9061 from your local public

Opportunity Zone (core disaster area) (see pages 2 and

employment service office or you can download it from

Cat. No. 24833J

Instructions For Form 8850 (Rev. June 2007)

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