Form 5884 - Work Opportunity Credit - 2015
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15884
OMB No. 1545-0219
Work Opportunity Credit
2015
Form
Attach to your tax return.
▶
Department of the Treasury
Attachment
Information about Form 5884 and its separate instructions is at
▶
77
Internal Revenue Service
Sequence No.
Name(s) shown on return
Identifying 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
1a
$
for you at least 120 hours but fewer than 400 hours .
× 25% (0.25)
b Qualified first-year wages of employees who worked
1b
$
for you at least 400 hours
. . . . . . . . . .
× 40% (0.40)
c Qualified second-year wages of employees certified as
1c
$
long-term family assistance recipients . . . . . .
× 50% (0.50)
2
Add lines 1a, 1b, and 1c. See instructions for the adjustment you must make to
2
salaries and wages . . . . . . . . . . . . . . . . . . . . . . . . .
3
Work opportunity credit from partnerships, S corporations, cooperatives, estates, and
3
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
4
and report this amount on Form 3800, Part III, line 4b . . . . . . . . . . . .
5
Amount allocated to patrons of the cooperative or beneficiaries of the estate or trust
5
(see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . .
6
Cooperatives, estates, and trusts, subtract line 5 from line 4. Report this amount on
Form 3800, Part III, line 4b . . . . . . . . . . . . . . . . . . . . . .
6
5884
For Paperwork Reduction Act Notice, see separate instructions.
Form
(2015)
Cat. No. 13570D
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