Form 5884 Work Opportunity Credit

Form

5884

(Rev. December 2016)
Department of the Treasury
Internal Revenue Service
Name(s) shown on return

1

Work Opportunity Credit
▶ Information

OMB No. 1545-0219

▶ Attach to your tax return.
about Form 5884 and its separate instructions is at www.irs.gov/form5884.

Attachment
Sequence No. 77
Identifying number

Enter on the applicable line below the total qualified first- or second-year wages paid
or incurred during the tax year, and multiply by the percentage shown, for services of
employees who are certified as members of a targeted group.
a Qualified first-year wages of employees who worked
for you at least 120 hours but fewer than 400 hours . $

× 25% (0.25)

1a

b Qualified first-year wages of employees who worked
for you at least 400 hours . . . . . . . . . . $

× 40% (0.40)

1b

c Qualified second-year wages of employees certified as
long-term family assistance recipients . . . . . . $

× 50% (0.50)

1c

2

Add lines 1a, 1b, and 1c. See instructions for the adjustment you must make to
salaries and wages . . . . . . . . . . . . . . . . . . . . . . . . .

2

3

Work opportunity credit from partnerships, S corporations, cooperatives, estates, and
trusts (see instructions) . . . . . . . . . . . . . . . . . . . . . . .

3

4

Add lines 2 and 3. Cooperatives, estates, and trusts, go to line 5. Partnerships and
S corporations, stop here and report this amount on Schedule K. All others, stop here
and report this amount on Form 3800, Part III, line 4b . . . . . . . . . . . .

4

5

Amount allocated to patrons of the cooperative or beneficiaries of the estate or trust
(see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . .

5

6

Cooperatives, estates, and trusts, subtract line 5 from line 4. Report this amount on
Form 3800, Part III, line 4b . . . . . . . . . . . . . . . . . . . . . .

6

For Paperwork Reduction Act Notice, see separate instructions.

Cat. No. 13570D

Form 5884 (Rev. 12-2016)