Form    

5884

Department of the Treasury Internal Revenue Service

Work Opportunity Credit

a Attach to your tax return. 

a Information about Form 5884 and its instructions is at www.irs.gov/form5884.

OMB No. 1545-02192013

Attachment 

Sequence No. 77

Name(s) shown on returnIdentifying number

1 

 

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% (.25)1a

b Qualified first-year wages of employees who worked 

for you at least 400 hours ..........$×  40% (.40)1b

c Qualified second-year wages of employees certified as 

long-term family assistance recipients ......$×  50% (.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 ..............................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, 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, line 4b .........................6

For Paperwork Reduction Act Notice, see instructions.Cat. No. 13570DForm 5884 (2013) 

----------------Page (0) Break----------------