Overview
Updated 06/25/2021
The 8850 form is a pre-screening notice and certification request for the Work Opportunity Credit.
Federal PDF Version: https://www.irs.gov/pub/irs-pdf/f8850.pdf
Federal PDF Version Instructions: https://www.irs.gov/pub/irs-pdf/i8850.pdf
Employee Fields
Below is a screenshot of the employee portion of the eDocument with field details.

| Field Key # | Field Description | Pre-Populates From | Required |
|---|---|---|---|
| 1 | Name | Employee > Firstname Lastname | Yes |
| 2 | Social Security Number | Employee > SSN | Yes |
| 3 | Address (Street) | Employee > Address (Primary) > Street 1, Street 2 | Yes |
| 4 | Address (City, State, Zip) | Employee > Address (Primary) > City, State, ZipCode | Yes |
| 5 | County | N/A | Yes |
| 6 | Phone Number | Employee > Contact Method
|
Yes |
| 7 | Birth Date | N/A | Yes |
| 8 | Checkbox Options | N/A | No |
| 9 | Employee Signature | N/A | Yes |
| 10 | Date | Current Date | Yes |
Employer Fields
Below is a screenshot of the employer portion of the eDocument with field details.
| Field Key # | Field Description | Pre-Populates From | Required |
|---|---|---|---|
| 1 | Employer's Name | MasterStaffingSupplier > SupplierDescription | Yes |
| 2 | Phone Number | Supplier > Contact Method
|
Yes |
| 3 | EIN | MasterStaffingSupplier > FEIN Number | Yes |
| 4 | Address (Street) | MasterStaffingSupplier > Address > Street 1, Street 2 | Yes |
| 5 | Address (City, State, ZipCode) | MasterStaffingSupplier > Address > City, State, ZipCode | Yes |
| 6 | Contact | N/A | Yes |
| 7 | Phone Number (contact) | N/A | Yes |
| 8 | Address (Contact Street) | N/A | |
| 9 | Address (Contact City, State, ZipCode) | N/A | |
| 10 | Member's Group | N/A | No |
| 11 | Date - Gave Information | N/A | No |
| 12 | Date - Offered Job | N/A | No |
| 13 | Date - Was Hired | N/A | No |
| 14 | Date - Started Job | N/A | No |
| 15 | Employer Signature | N/A | Yes |
| 16 | Title | N/A | Yes |
| 17 | Date | Current Date | Yes |
Additional Notes
- Revision date (shown in screenshots as "Rev. 3-2016") is a non-editable field.
- Nothing is updated in the core application once the eDocument is completed.
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