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Formulár 8850 Návody

Pokyny pre formulár 8850, (Pre použitie s marec 2016 revízia formy 8850, Pre-Screening Oznámenie a žiadosť o certifikáciu práce Opportunity úver)

Rev. marec 2021

Súvisiace formuláre

  • Formulár 8850 - Predpredaj Oznámenie a žiadosť o certifikáciu pre pracovnú príležitosť úveru
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Department of the Treasury  
Internal Revenue Service  
Instructions for Form 8850  
(Rev. March 2021)  
(For use with the March 2016 revision of Form 8850, Pre-Screening Notice and  
Certification Request for the Work Opportunity Credit)  
member of a targeted group (as defined later, under  
General Instructions  
Members of Targeted Groups), the employer completes the  
rest of the form no later than the day the job offer is made.  
Section references are to the Internal Revenue Code unless  
otherwise noted.  
Both the job applicant and the employer must sign Form  
8850 no later than the date for submitting the form to the  
Future Developments  
For the latest information about developments related to  
Form 8850 and its instructions, such as legislation enacted  
after they were published, go to IRS.gov/Form8850.  
Instructions for Employer  
When and Where To File  
What's New  
Don’t file Form 8850 with the IRS. Instead, you must submit it  
to the SWA of the state in which your business is located  
(where the employee works) generally no later than the 28th  
calendar day after the date the individual begins working for  
The Taxpayer Certainty and Disaster Tax Relief Act of 2020  
made the following changes.  
The work opportunity credit has been extended to cover  
certain individuals who begin working for you after 2020 and  
before 2026.  
Submitting Form 8850 to the SWA is listed in Rev.  
The empowerment zone designations expired at the end  
Proc. 2018-58 (section 15, item 12) as an act that  
may be postponed for taxpayers affected by a  
of 2020. However, the Act provides for an extension of the  
designations to the end of 2025. To extend the designations,  
state and local governments must amend their nominations  
of the designated zones in order to move the termination  
date to December 31, 2025. The IRS is working to provide  
guidance on how to amend the nomination of an  
federally declared disaster. For the latest disaster tax relief  
guidance go to IRS.gov/Disaster.  
If the credit expires and is retroactively extended, the  
IRS may allow you more time to submit Form 8850  
for an individual who began work while the credit was  
empowerment zone to provide for a new termination date. Go  
to IRS.gov/Form8850 for updates on the guidance once it  
becomes available.  
expired or for a reasonable time after it was extended. If more  
time is allowed, we will provide details at IRS.gov/Form8850  
and in revised Instructions for Form 8850.  
Purpose of Form  
Employers use Form 8850 to pre-screen and to make a  
written request to the state workforce agency (SWA) of the  
state in which their business is located (where the employee  
works) to certify an individual as a member of a targeted  
group for purposes of qualifying for the work opportunity  
Although facsimile submission of Form 8850 is permitted,  
not all states are equipped to accept a faxed copy of Form  
8850. Contact your state WOTC coordinator as discussed  
below and see Notice 2012-13 for details. Notice 2012-13,  
2012-9 I.R.B. 421, is available at IRS.gov/irb/  
Submitting Form 8850 to the SWA is but one step in the  
process of qualifying for the work opportunity credit. The  
state work opportunity tax credit (WOTC) coordinator for the  
SWA must certify the job applicant is a member of a targeted  
group. After starting work, the employee must meet the  
minimum number-of-hours-worked requirement for the work  
opportunity credit. Generally, an employer elects to take the  
credit by filing Form 5884, Work Opportunity Credit.  
However, a tax-exempt organization that hires a qualified  
veteran must report the work opportunity credit on Form  
5884-C, Work Opportunity Credit for Qualified Tax-Exempt  
Organizations Hiring Qualified Veterans.  
Although electronic submission of Form 8850 is permitted,  
not all states are equipped to receive Form 8850  
electronically. Contact your state WOTC coordinator as  
discussed next and see Announcement 2002-44 and Notice  
2012-13 for details. You can find Announcement 2002-44 on  
page 809 of Internal Revenue Bulletin 2002-17 at  
To get the name, address, phone and fax numbers, and  
email address of the WOTC coordinator for your state, visit  
the Department of Labor Employment and Training  
Administration (ETA) website at www.dol.gov/agencies/eta/  
You must receive the certification from the SWA  
Never attach Form 8850 to a tax return or otherwise  
before you can claim the related credit on Form 5884  
send it to the IRS, regardless of the employee's  
or Form 5884-C.  
targeted group. Form 8850 must be submitted to the  
SWA of the state in which your business is located (where  
the employee works).  
Who Should Complete and Sign the  
The job applicant gives information to the employer on or  
before the day a job offer is made. This information is entered  
on Form 8850. If the employer believes the applicant is a  
Feb 25, 2021  
Cat. No. 24833J  
Have served on active duty (not including training) in the  
Additional Requirements for  
Armed Forces of the United States for more than 180 days or  
have been discharged or released from active duty for a  
service-connected disability, and  
In addition to submitting Form 8850, you must complete and  
send to your state WOTC coordinator either:  
Not have a period of active duty (not including training) of  
more than 90 days that ended during the 60-day period  
ending on the hiring date.  
ETA Form 9062, Conditional Certification, if the job  
applicant received this form from a participating agency (for  
example, the Jobs Corps); or  
3. Qualified ex-felon. An ex-felon who has been  
convicted of a felony under any federal or state statute, and  
is hired not more than 1 year after the conviction or release  
from prison for that felony.  
4. Designated community resident. An individual who  
is at least age 18 but not yet age 40 on the hiring date and  
lives within an empowerment zone or rural renewal county  
(defined later).  
ETA Form 9061, Individual Characteristics Form (ICF), if  
the job applicant didn't receive a conditional certification; and  
ETA Form 9175, Long-Term Unemployment Recipient  
Self-Attestation Form, if the job applicant is a qualified  
long-term unemployment recipient.  
You can get ETA Form 9061 and ETA Form 9175 from  
your local public employment service office or you can  
download it from the ETA website at  
5. Vocational rehabilitation referral. An individual who  
has a physical or mental disability resulting in a substantial  
handicap to employment and who was referred to the  
employer upon completion of (or while receiving)  
rehabilitation services by a rehabilitation agency approved by  
the state, an employment network under the Ticket to Work  
program, or the Department of Veterans Affairs.  
Keep copies of Forms 8850, any transmittal letters that you  
submit to your state WOTC coordinator, and certification  
letters you receive from your WOTC coordinator as long as  
they may be needed for the administration of the provisions  
relating to the work opportunity credit. Records that support  
the credit usually must be kept for 3 years from the date any  
income tax return claiming the credit is due or filed,  
whichever is later.  
6. Summer youth employee. An individual who:  
Performs services for the employer between May 1 and  
September 15;  
Is at least age 16 but not yet age 18 on the hiring date (or,  
if later, on May 1);  
Has never worked for the employer before; and  
Lives within an empowerment zone.  
Members of Targeted Groups  
A job applicant may be certified as a member of a targeted  
group if he or she is described in one of the following groups.  
7. Recipient of SNAP benefits (food stamps). An  
individual who:  
1. Qualified IV-A recipient. An individual who is a  
member of a family receiving assistance under a state plan  
approved under part A of title IV of the Social Security Act  
relating to Temporary Assistance for Needy Families (TANF).  
The assistance must be received for any 9 months during the  
18-month period ending on the hiring date.  
Is at least age 18 but not yet age 40 on the hiring date, and  
Is a member of a family that:  
a. Has received SNAP benefits for the 6-month period  
ending on the hiring date; or  
b. Is no longer eligible for such assistance under section  
6(o) of the Food and Nutrition Act of 2008, but the family  
received SNAP benefits for at least 3 months of the 5-month  
period ending on the hiring date.  
8. SSI recipient. An individual who is receiving  
supplemental security income benefits under title XVI of the  
Social Security Act (including benefits of the type described  
in section 1616 of the Social Security Act or section 212 of  
Public Law 93-66) for any month ending during the 60-day  
period ending on the hiring date.  
2. Qualified veteran. A veteran who is any of the  
A member of a family that has received Supplemental  
Nutrition Assistance Program (SNAP) benefits (food stamps)  
for at least a 3-month period during the 15-month period  
ending on the hiring date.  
Unemployed for a period or periods totaling at least 4  
weeks (whether or not consecutive) but less than 6 months in  
the 1-year period ending on the hiring date.  
9. Long-term family assistance recipient. An  
Unemployed for a period or periods totaling at least 6  
individual who is a member of a family that:  
months (whether or not consecutive) in the 1-year period  
ending on the hiring date.  
Has received TANF payments for at least 18 consecutive  
months ending on the hiring date; or  
Entitled to compensation for a service-connected disability  
Receives TANF payments for any 18 months (whether or  
and is hired not more than 1 year after being discharged or  
released from active duty in the U.S. Armed Forces.  
not consecutive) beginning after August 5, 1997, and the  
earliest 18-month period beginning after August 5, 1997,  
ended during the past 2 years; or  
Entitled to compensation for a service-connected disability  
and was unemployed for a period or periods totaling at least  
6 months (whether or not consecutive) in the 1-year period  
ending on the hiring date.  
Stopped being eligible for TANF payments because  
federal or state law limits the maximum period such  
assistance is payable and the individual is hired not more  
than 2 years after such eligibility ended.  
Note. Requesting the information in box 4 or box 5 of Form  
8850 is an exception to the Americans with Disabilities Act's  
prohibition on pre-offer disability-related inquiries. The  
purpose of this request is to support the hiring of certain  
disabled veterans, which may entitle the employer to a larger  
work opportunity credit than the hiring of other targeted group  
10. Qualified long-term unemployment recipient. An  
individual who on the day before the individual begins work  
for the employer, or, if earlier, the day the individual  
completes Form 8850 as a pre-screening notice, is in a  
period of unemployment that:  
Is not less than 27 consecutive weeks, and  
To be considered a veteran, the applicant must:  
Instructions for Form 8850 (March 2021)  
Includes a period (which may be less than 27 consecutive  
Rio Grande Valley, TX (parts of Cameron, Hidalgo, Starr,  
weeks) in which the individual received unemployment  
compensation under state or federal law.  
and Willacy Counties)  
Southernmost Illinois Delta, IL (parts of Alexander and  
Johnson Counties and all of Pulaski County)  
Member of a Family  
Southwest Georgia United, GA (part of Crisp County and  
all of Dooly County)  
With respect to the qualified IV-A recipient, qualified veteran,  
recipient of SNAP benefits (food stamps), and long-term  
family assistance recipient, an individual whose family  
receives assistance for the requisite period meets the family  
assistance requirement of the applicable group if the  
individual is included on the grant (and thus receives  
assistance) for some portion of the specified period.  
Rural Renewal Counties  
A rural renewal county is a county in a rural area that lost  
population during the 5-year periods 1990 through 1994 and  
1995 through 1999. Rural renewal counties are listed below.  
Alabama. The counties of Butler, Dallas, Macon, Perry,  
Sumter, and Wilcox.  
Empowerment Zones  
Alaska. The census areas of Aleutians West,  
The following paragraphs describe areas that were  
designated empowerment zones. For the latest information  
about empowerment zone designations, go to IRS.gov/  
Wrangell-Petersburg, and Yukon-Koyukuk.  
Arkansas. The counties of Arkansas, Chicot, Clay, Desha,  
Jackson, Lafayette, Lee, Little River, Monroe, Nevada,  
Ouachita, Phillips, Union, and Woodruff.  
Urban areas. Parts of the following urban areas were  
designated empowerment zones.  
Colorado. The counties of Cheyenne, Kiowa, and San  
Baltimore, MD  
Boston, MA  
Georgia. The counties of Randolph and Stewart.  
Chicago, IL  
Cincinnati, OH  
Illinois. The counties of Alexander, Edwards, Franklin,  
Gallatin, Greene, Hancock, Hardin, Jasper, Knox,  
McDonough, Montgomery, Pulaski, Randolph, Richland,  
Scott, Warren, Wayne, and White.  
Cleveland, OH  
Columbia/Sumter, SC  
Columbus, OH  
Cumberland County, NJ  
Detroit, MI  
Indiana. Perry County.  
El Paso, TX  
Iowa. The counties of Adair, Adams, Appanoose, Audubon,  
Butler, Calhoun, Cass, Cherokee, Clay, Clayton, Emmet,  
Floyd, Franklin, Fremont, Hancock, Humboldt, Ida, Keokuk,  
Kossuth, Montgomery, Osceola, Palo Alto, Pocahontas,  
Poweshiek, Sac, Taylor, Union, Wayne, Winnebago, and  
Kansas. The counties of Atchison, Barber, Barton, Brown,  
Clay, Cloud, Comanche, Decatur, Edwards, Elk, Ellsworth,  
Gove, Graham, Greeley, Greenwood, Harper, Hodgeman,  
Jewell, Kiowa, Labette, Lane, Lincoln, Marshall, Mitchell,  
Montgomery, Ness, Osborne, Phillips, Rawlins, Republic,  
Rooks, Rush, Russell, Scott, Sheridan, Sherman, Smith,  
Stafford, Trego, Wallace, Washington, Wichita, and  
Fresno, CA  
Gary/Hammond/East Chicago, IN  
Huntington, WV/Ironton, OH  
Jacksonville, FL  
Knoxville, TN  
Los Angeles, CA (city and county)  
Miami/Dade County, FL  
Minneapolis, MN  
New Haven, CT  
New York, NY  
Norfolk/Portsmouth, VA  
Oklahoma City, OK  
Philadelphia, PA/Camden, NJ  
Pulaski County, AR  
San Antonio, TX  
Kentucky. The counties of Bell, Caldwell, Floyd, Harlan,  
Hickman, Leslie, Letcher, Pike, and Union.  
Santa Ana, CA  
St. Louis, MO/East St. Louis, IL  
Syracuse, NY  
Louisiana. The parishes of Bienville, Claiborne, Franklin,  
Jackson, Morehouse, St. Mary, Tensas, Vernon, and  
Tucson, AZ  
Yonkers, NY  
Maine. The counties of Aroostook and Piscataquis.  
Rural areas. Parts of the following rural areas were  
Michigan. The counties of Gogebic, Marquette, and  
designated empowerment zones.  
Aroostook County, ME (part of Aroostook County)  
Desert Communities, CA (part of Riverside County)  
Griggs-Steele, ND (part of Griggs County and all of Steele  
Minnesota. The counties of Big Stone, Chippewa,  
Cottonwood, Faribault, Jackson, Kittson, Koochiching, Lac  
Qui Parle, Lincoln, Marshall, Martin, Murray, Norman,  
Pipestone, Red Lake, Redwood, Renville, Stevens,  
Traverse, Wilkin, and Yellow Medicine.  
Mississippi. The counties of Adams, Coahoma,  
Humphreys, Montgomery, Quitman, Sharkey, Tallahatchie,  
and Washington.  
Kentucky Highlands, KY (part of Wayne County and all of  
Clinton and Jackson Counties)  
Mid-Delta, MS (parts of Bolivar, Holmes, Humphreys,  
Leflore, Sunflower, and Washington Counties)  
Middle Rio Grande FUTURO Communities, TX (parts of  
Dimmit, Maverick, Uvalde, and Zavala Counties)  
Oglala Sioux Tribe, SD (parts of Jackson and Bennett  
Missouri. The counties of Atchison, Carroll, Chariton, Clark,  
Counties and all of Shannon County)  
Holt, Knox, Mississippi, New Madrid, Pemiscot, and Worth.  
Instructions for Form 8850 (March 2021)  
Montana. The counties of Carter, Daniels, Dawson, Deer  
Lodge, Fallon, Garfield, Hill, Liberty, McCone, Petroleum,  
Phillips, Powder River, Prairie, Richland, Roosevelt,  
Rosebud, Sheridan, Valley, and Wibaux.  
Nebraska. The counties of Antelope, Banner, Boone, Box  
Butte, Boyd, Burt, Cedar, Chase, Deuel, Dundy, Fillmore,  
Franklin, Garden, Garfield, Greeley, Hayes, Hitchcock, Holt,  
Jefferson, Johnson, Logan, Nance, Nemaha, Nuckolls,  
Pawnee, Perkins, Red Willow, Richardson, Rock, Sheridan,  
Sherman, Thayer, Thomas, Valley, Webster, and Wheeler.  
Nevada. The counties of Esmeralda, Lander, and Mineral.  
New Hampshire. Coos County.  
New Mexico. The counties of Harding and Quay.  
New York. The counties of Clinton and Montgomery.  
Pennsylvania. The counties of Venango and Warren.  
South Carolina. Marlboro County.  
South Dakota. The counties of Aurora, Campbell, Clark,  
Day, Deuel, Douglas, Faulk, Grant, Gregory, Haakon, Hand,  
Harding, Hutchinson, Jones, Kingsbury, Marshall,  
McPherson, Miner, Perkins, Potter, Sanborn, Spink, Tripp,  
and Walworth.  
Texas. The counties of Andrews, Bailey, Baylor, Borden,  
Briscoe, Brooks, Castro, Cochran, Coleman, Collingsworth,  
Cottle, Crane, Culberson, Deaf Smith, Dimmit, Eastland,  
Fisher, Floyd, Foard, Gray, Hall, Hardeman, Haskell,  
Hemphill, Hockley, Hutchinson, Kenedy, Kent, Knox, Lamb,  
Martin, McCulloch, Morris, Nolan, Oldham, Reagan, Reeves,  
Refugio, Roberts, Scurry, Stonewall, Terrell, Terry, Upton,  
Ward, Wheeler, Wilbarger, Winkler, Yoakum, and Zavala.  
North Dakota. The counties of Adams, Barnes, Benson,  
Billings, Bottineau, Burke, Cavalier, Dickey, Divide, Dunn,  
Eddy, Emmons, Foster, Golden Valley, Grant, Griggs,  
Hettinger, Kidder, LaMoure, Logan, McHenry, McIntosh,  
McKenzie, McLean, Mercer, Mountrail, Nelson, Oliver,  
Pembina, Pierce, Ramsey, Ransom, Renville, Sargent,  
Sheridan, Slope, Stark, Steele, Stutsman, Towner, Traill,  
Walsh, Wells, and Williams.  
Virginia. The counties of Buchanan, Dickenson, Highland,  
and Lee, and the independent cities of Clifton Forge,  
Covington, Norton, and Staunton.  
West Virginia. The counties of Calhoun, Gilmer, Logan,  
McDowell, Mercer, Mingo, Summers, Tucker, Webster,  
Wetzel, and Wyoming.  
Wyoming. The counties of Carbon and Niobrara.  
Ohio. The counties of Crawford, Monroe, Paulding, Seneca,  
and Van Wert.  
Oklahoma. The counties of Alfalfa, Beaver, Cimarron,  
Custer, Dewey, Ellis, Grant, Greer, Harmon, Harper, Kiowa,  
Major, Roger Mills, Seminole, Tillman, and Woodward.  
Instructions for Form 8850 (March 2021)