Information Collection

Employee Retention Credit for Employers Affected by Qualified Disaster

IC 19719 under ICR 202105-1545-004 · OMB 1545-1978.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-1978 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5884-A Employee Retention Credit for Employers Affected by Qualified Disaster	Form
i5884-a--2021-03-00.pdf	Instruction
i5884-a--2021-03-00.pdf	Instruction
5884-A Employee Retention Credit for Employers Affected by Qual f5884-a--2021-03-00.pdf	Form
5884-A Employee Retention Credit for Employers Affected by Qual f5884-a--2021-03-00.pdf	Form

IC Title:

Employee Retention Credit for Employers Affected by Qualified Disaster

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	5884-A	Employee Retention Credit for Employers Affected by Qualfied Disasters	f5884-a--2021-03-00.pdf		Yes	Yes	Fillable Fileable
Instruction			i5884-a--2021-03-00.pdf		Yes	No	Printable Only

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title: IRS 24.046 BMF and IRS 34.047 Audit Trail and Security Records System

FR Citation: 80 FR 54064

Number of Respondents: 250,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Farms, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 65 %

table that charts list of burden
	Approved	Program Change Due to New Statute	Previously Approved
Annual Number of Responses for this IC	250,000	0	250,000
Annual IC Time Burden (Hours)	637,500	-122,500	760,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.