Form 5884

Form 5884 (Rev. December 2016) Department of the Treasury Internal Revenue Service Name(s) shown on return Work Opportunity Credit ► Attach to your tax return. ► Information about Form 5884 and its separate instructions is at wwwirs.govilonn5884. OMB No. 1545-0219 Attachment Sequence No. 77 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 . S x 25% (0.25) b Qualified first-year wages of employees who worked for you at least 400 hours x 40% (0.40) c Qualified second-year wages of employees certified as long-term family assistance recipients x 50% (0.50) 2 Add lines la, lb, and lc. See instructions for the adjustment you must make to salaries and wages 3 Work opportunity credit from partnerships, S corporations, cooperatives, estates, and trusts (see instructions) 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 Ill, line 4b 5 Amount allocated to patrons of the cooperative or beneficiaries of the estate or trust (see instructions) 6 Cooperatives, estates, and trusts, subtract line 5 from line 4. Report this amount on Form 3800. Part Ill, line 4b Identifying number la lb lc 4 5 6 For Paperwork Reduction Act Notice, see separate instructions. Form 5884 (Rev. 12-2016) EFTA01222741