Work Opportunity Tax Credit Self-Attestation Form
The Self-Attestation Form (SAF) is required for applicants applying for the Work Opportunity Tax Credit. It collects essential information from long-term unemployment recipients to determine eligibility for the credit. Employers must submit this form along with IRS Form 8850.
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How do I fill this out?
To fill out the Self-Attestation Form, start by providing your personal information accurately. Make sure to declare your unemployment duration as specified in the form. Finally, review and sign the form to verify the information provided.

How to fill out the Work Opportunity Tax Credit Self-Attestation Form?
1
Read the instructions carefully before starting.
2
Fill in your personal details, including your social security number.
3
State your unemployment duration and any compensation received.
4
Sign the declaration statement to affirm the information is truthful.
5
Submit the completed form to your employer or the State Workforce Agency.
Who needs the Work Opportunity Tax Credit Self-Attestation Form?
1
Job applicants seeking the Work Opportunity Tax Credit.
2
Employers hiring individuals from targeted groups.
3
State Workforce Agencies managing unemployment benefits.
4
HR departments requiring documentation for tax credit claims.
5
Individuals who have received unemployment compensation.
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With PrintFriendly, you can easily edit the Self-Attestation Form directly in your browser. Modify any fields and save your updates on the go for a seamless experience. Enjoy a user-friendly interface that helps you customize the form to suit your needs.
1
Upload the Self-Attestation Form to PrintFriendly.
2
Use the editing tools to fill in your information.
3
Review changes for accuracy.
4
Save the edited PDF to your device.
5
Prepare the PDF for submission to your employer.

What are the instructions for submitting this form?
Submit the Self-Attestation Form along with IRS Form 8850 to the State Workforce Agency. You can send submissions via email to your designated SWA contact or fax it directly to the agency. Physical submissions should be directed to your local SWA office address, ensuring that all required documentation accompanies your application to facilitate quicker processing.
What are the important dates for this form in 2024 and 2025?
The Self-Attestation Form must be submitted before the expiration of the tax year deadlines. For 2024, ensure all claims are submitted by December 31, 2024. For 2025, submissions should also be completed by December 31, 2025, to qualify for the respective tax credits.

What is the purpose of this form?
The Self-Attestation Form serves as an essential document for individuals seeking to claim the Work Opportunity Tax Credit. It enables applicants to declare their unemployment status and verify their eligibility for benefits. This form is crucial for employers wanting to take advantage of federal tax incentives during their hiring processes.

Tell me about this form and its components and fields line-by-line.

- 1. Applicant's Full Name: This field captures the full name of the individual applying.
- 2. Social Security Number: This is used for identification and when processing tax credits.
- 3. Date of Birth: The applicant's date of birth is required for verification.
- 4. Employer's Name: This field records the name of the employer submitting the form.
- 5. Unemployment Period: Applicants declare their period of unemployment here.
What happens if I fail to submit this form?
Failing to submit the Self-Attestation Form can result in the inability to claim the Work Opportunity Tax Credit. This may lead to missed financial benefits for both the applicant and the employer. Proper documentation ensures compliance and eligibility under federal law.
- Loss of Tax Credits: Without submission, applicants risk losing out on valuable tax incentives.
- Compliance Issues: Employers may face compliance issues if necessary forms are not submitted.
- Delays in Processing: Failure to submit the form can delay the processing of unemployment benefits.
How do I know when to use this form?

- 1. When Hiring Long-Term Unemployed: Employers should use this form when hiring individuals who have been unemployed for an extended period.
- 2. For Tax Credit Claims: Applicants must complete this form to qualify for tax credit incentives.
- 3. Assisting Unemployment Verifications: This form aids in verifying applicant claims of unemployment compensation.
Frequently Asked Questions
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Yes, you can download the edited PDF once you finish.
Is there a way to share the edited form?
Absolutely! You can share a link or email the PDF directly.
What information do I need to fill out the form?
You will need to provide your personal details and unemployment information.
Can I print the Self-Attestation Form after editing?
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Is there a time limit to fill out the form?
No, you can fill it out at your convenience before submission.
What if I make a mistake on the form?
You can easily edit any fields in the PDF before saving.
Do I need to sign the form?
Yes, an electronic signature is required to validate the form.
How do I know if I qualify for the tax credit?
Review the criteria outlined in the form to see if you qualify.
Can I submit the form online?
You can submit the PDF via email or direct submission as required.
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