Self attestation form 2026

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The document is a Youth Self-Attestation Form for the Work Opportunity Tax Credit Program, issued by the U.S. Department of Labor's Employment and Training Administration. It requires new hires to provide personal information and confirm their eligibility based on specific criteria related to education and employment history. The form must be completed and submitted by employers to the State Workforce Agency alongside Form ETA 9061 for tax credit certification.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your New Hire Name in the designated field. Ensure that you provide your full legal name for accurate processing.
Next, input your Social Security Number and Date of Birth. This information is crucial for identification purposes.
Fill in the Employer Name and Employer Federal ID (EIN) Number. This connects your self-attestation to the correct employer.
Review the statements provided and check all that apply to you. This section is essential for determining eligibility under the Work Opportunity Tax Credit Program.
Finally, sign and date the form at the bottom. Your signature confirms that all information provided is true and correct.

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Versions	Form popularity	Fillable & printable
2010	4.9 Satisfied (413 Votes)

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