Form 5884-A Employee Retention Credit for Employers Affected by Qual

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5884-A

Employee Retention Credit for Employers
Affected by Qualified Disasters

Form
(Rev. March 2021)

Department of the Treasury
Internal Revenue Service

▶

OMB No. 1545-1978

▶ Attach to your tax return.
Go to www.irs.gov/Form5884A for instructions and the latest information.

Attachment
Sequence No. 884A
Identifying number

Name(s) shown on return

DRAFT AS OF
March 17, 2021
DO NOT FILE

1a Employers affected by a 2018 through 2019 qualified disaster, enter
the total qualified wages paid or incurred during the applicable period
while the business was inoperable. See instructions . . . . . . .

1a

b Employers affected by a 2020 qualified disaster, enter the total
qualified wages paid or incurred during the applicable period while the
business was inoperable. See instructions . . . . . . . . . .

1b

c Add amounts from lines 1a and 1b . . . . . . . . . . . . . . . . . . . . .
2
3

4

5
6

1c

Multiply line 1c by 40% (0.40). See instructions for the adjustment you must make to your
deduction for salaries and wages . . . . . . . . . . . . . . . . . . . . . .

2

Employee retention credit from partnerships, S corporations, cooperatives, estates, and
trusts (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . .

3

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 1aa . . . . . . . . . . . . . . .

4

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

5

Cooperatives, estates, and trusts, subtract line 5 from line 4. Report this amount on Form
3800, Part III, line 1aa . . . . . . . . . . . . . . . . . . . . . . . . . .

For Paperwork Reduction Act Notice, see separate instructions.

Cat. No. 47425B

6
Form 5884-A (Rev. 3-2021)