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Federal Free Printable Form W-11 (Rev. April 2010 & June 2010) for 2024 Federal Hiring Incentives to Restore Employment (HIRE) Act Employee Affidavit

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Hiring Incentives to Restore Employment (HIRE) Act Employee Affidavit
Form W-11 (Rev. April 2010 & June 2010)

W-11 Form (April 2010) Department of the Treasury Internal Revenue Service Hiring Incentives to Restore Employment (HIRE) Act Employee Affidavit ▶ Do not send this form to the IRS. Keep this form for your records. To be completed by new employee. Affidavit is not valid unless employee signs it. I certify that I have been unemployed or have not worked for anyone for more than 40 hours during the 60-day period ending on the date I began employment with this employer. Your name First date of employment Social security number ▶ / / Name of employer Under penalties of perjury, I declare that I have examined this affidavit and, to the best of my knowledge and belief, it is true, correct, and complete. Date Employee's signature ▶ Instructions to the Employer Section references are to the Internal Revenue Code. Purpose of Form Use Form W-11 to confirm that an employee is a qualified employee under the HIRE Act. You can use another similar statement if it contains the information above and the employee signs it under penalties of perjury. Only employees who meet all the requirements of a qualified employee may complete this affidavit or similar statement. You cannot claim the HIRE Act benefits, including the payroll tax exemption or the new hire retention credit, unless the employee completes and signs this affidavit or similar statement under penalties of perjury and is otherwise a qualified employee. A “qualified employee” is an employee who: • begins employment with you after February 3, 2010, and before January 1, 2011; • certifies by signed affidavit, or similar statement under penalties of perjury, that he or she has not been employed for more than 40 hours during the 60-day period ending on the date the employee begins employment with you; ▶ / / your sibling or stepsibling, your parent or an ancestor of your parent, your stepparent, your niece or nephew, your aunt or uncle, or your in-law. An employee also is related to you if he or she is related to anyone who owns more than 50% of your outstanding stock or capital and profits interest or is your dependent or a dependent of anyone who owns more than 50% of your outstanding stock or capital and profits interest. • is not employed by you to replace another employee unless the other employee separated from employment voluntarily or for cause (including downsizing); and If you are an estate or trust, see section 51(i)(1) and section 152(d)(2) for more details. • is not related to you. An employee is related to you if he or she is your child or a descendent of your child, CAUTION Cat. No. 10744F ! ▲ Do not send this form to the IRS. Keep it with your other payroll and income tax records. Form W-11 (4-2010) W-11 Form (Rev. June 2010) Hiring Incentives to Restore Employment (HIRE) Act Employee Affidavit Department of the Treasury Internal Revenue Service ▶ OMB No. 1545-2173 Do not send this form to the IRS. Keep this form for your records. To be completed by new employee. Affidavit is not valid unless employee signs it. I certify that I have been unemployed or have not worked for anyone for more than 40 hours during the 60-day period ending on the date I began employment with this employer. Your name First date of employment Social security number ▶ / / Name of employer Under penalties of perjury, I declare that I have examined this affidavit and, to the best of my knowledge and belief, it is true, correct, and complete. Date Employee's signature ▶ Instructions to the Employer Section references are to the Internal Revenue Code. Purpose of Form Use Form W-11 to confirm that an employee is a qualified employee under the HIRE Act. You can use another similar statement if it contains the information above and the employee signs it under penalties of perjury. Only employees who meet all the requirements of a qualified employee may complete this affidavit or similar statement. You cannot claim the HIRE Act benefits, including the payroll tax exemption or the new hire retention credit, unless the employee completes and signs this affidavit or similar statement under penalties of perjury and is otherwise a qualified employee. A “qualified employee” is an employee who: • begins employment with you after February 3, 2010, and before January 1, 2011; • certifies by signed affidavit, or similar statement under penalties of perjury, that he or she has not been employed for more than 40 hours during the 60-day period ending on the date the employee begins employment with you; • is not employed by you to replace another employee unless the other employee separated from employment voluntarily or for cause (including downsizing); and / ▶ / • is not related to you. An employee is related to you if he or she is your child or a descendent of your child, your sibling or stepsibling, your parent or an ancestor of your parent, your stepparent, your niece or nephew, your aunt or uncle, or your in-law. An employee also is related to you if he or she is related to anyone who owns more than 50% of your outstanding stock or capital and profits interest or is your dependent or a dependent of anyone who owns more than 50% of your outstanding stock or capital and profits interest. Our legal right to ask for information is Internal Revenue Code section 6001 and the purpose of the form is stated in the instructions. This collection of the information is required to obtain certain tax benefits. If you are an estate or trust, see section 51(i)(1) and section 152(d)(2) for more details. The time needed to complete this form will vary depending on individual circumstances. The estimated average time is: ¶ ! CAUTION Do not send this form to the IRS. Keep it with your other payroll and income tax records. Paperwork Reduction Act Notice. The Paperwork Reduction Act of 1980 requires that when we ask you for information we must first tell you our legal right to ask for the information, why we are asking for it, and how it will be used. We must also tell you what could happen if we do not receive it and whether your response is voluntary, required to obtain a benefit, or mandatory under the law. You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax returns and return information are confidential, as stated in Code section 6103. Cat. No. 10744F If you do not retain this record or give fraudulent information, we may have to disallow certain exemptions and credits, and you also may be charged penalties and be subject to criminal prosecution. This could make the tax higher or delay any refund. Interest may also be charged. Recordkeeping . . Preparing the form Learning about the law or the form . . . . 1 hr., 25 min. . . . 25 min. . . . . 24 min. If you have comments regarding the accuracy of this time estimate or you have suggestions for making this form simpler, we would be happy to hear from you. You can write to the Internal Revenue Service, Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave. NW, IR-6526, Washington, DC 20224. Do not send the form to this address. Please keep this notice with your records. It may help you if we ask you for other information. If you have any questions about the rules for filing and giving information, please call or visit any Internal Revenue Service office. Form W-11 (Rev. 6-2010)
Extracted from PDF file 2023-federal-form-w-11.pdf, last modified January 2010

More about the Federal Form W-11 Corporate Income Tax TY 2023

No longer on site. Only available for 2010.

We last updated the Hiring Incentives to Restore Employment (HIRE) Act Employee Affidavit in February 2024, so this is the latest version of Form W-11, fully updated for tax year 2023. You can download or print current or past-year PDFs of Form W-11 directly from TaxFormFinder. You can print other Federal tax forms here.


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Other Federal Corporate Income Tax Forms:

TaxFormFinder has an additional 774 Federal income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form 1040 U.S. Individual Income Tax Return
1040 (Schedule B) Interest and Ordinary Dividends
Form W-3 Transmittal of Wage and Tax Statements
Form 1096 Annual Summary and Transmittal of U.S. Information Returns
Form 1120-H U.S. Income Tax Return for Homeowners Associations

Download all  tax forms View all 775 Federal Income Tax Forms


Form Sources:

The Internal Revenue Service usually releases income tax forms for the current tax year between October and January, although changes to some forms can come even later. We last updated Federal Form W-11 from the Internal Revenue Service in February 2024.

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About the Corporate Income Tax

The IRS and most states require corporations to file an income tax return, with the exact filing requirements depending on the type of company.

Sole proprietorships or disregarded entities like LLCs are filed on Schedule C (or the state equivalent) of the owner's personal income tax return, flow-through entities like S Corporations or Partnerships are generally required to file an informational return equivilent to the IRS Form 1120S or Form 1065, and full corporations must file the equivalent of federal Form 1120 (and, unlike flow-through corporations, are often subject to a corporate tax liability).

Additional forms are available for a wide variety of specific entities and transactions including fiduciaries, nonprofits, and companies involved in other specific types of business.

Historical Past-Year Versions of Federal Form W-11

We have a total of ten past-year versions of Form W-11 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2023 Form W-11

Form W-11 (Rev. April 2010 & June 2010)

2022 Form W-11

Form W-11 (Rev. April 2010 & June 2010)

2021 Form W-11

Form W-11 (Rev. April 2010 & June 2010)

2020 Form W-11

Form W-11 (Rev. April 2010 & June 2010)

2019 Form W-11

Form W-11 (Rev. April 2010 & June 2010)

2017 Form W-11

Form W-11 (Rev. June 2010)

2016 Form W-11

Form W-11 (Rev. June 2010)

Hiring Incentives to Restore Employment (HIRE) Act Employee Affidavit 2015 Form W-11

Form W-11 (Rev. June 2010)

Hiring Incentives to Restore Employment (HIRE) Act Employee Affidavit 2012 Form W-11

Form W-11 (Rev. June 2010)

Hiring Incentives to Restore Employment (HIRE) Act Employee Affidavit 2011 Form W-11

Form W-11 (Rev. June 2010)


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