Form 5884-B - New Hire Retention Credit
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35884-B
New Hire Retention Credit
OMB No. 1545-2202
Form
(December 2010)
Attach to your tax return.
▶
Department of the Treasury
Attachment
Use Part II to list additional retained workers.
65
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Internal Revenue Service
Sequence No.
Name(s) shown on return
Identifying number
A credit of up to $1,000 is allowed for each retained worker. A retained worker generally is a qualified employee (see instructions)
whose first 52 consecutive weeks of employment ended in the current tax year. However, the worker's wages (as defined for income
tax withholding purposes) for the second 26 consecutive weeks must equal at least 80% of the worker's wages for the first 26
consecutive weeks.
Part I
New Hire Retention Credit for Retained Workers
(a)
(b)
(c)
Use a separate column for each retained worker.
Retained
Retained
Retained
If you need more columns, use Part II and include
Worker
Worker
Worker
the totals on line 10.
No. 1
No. 2
No. 3
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1
Enter the retained worker's social security number
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2
Enter the first date of employment from the retained
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/ 2010
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/ 2010
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/ 2010
worker's Form W-11 or similar statement
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3
Enter the retained worker's wages for the first 26
consecutive weeks of employment
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4
Multiply line 3 by 80% (.80) .
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4
5
Enter the retained worker's wages for the second 26
consecutive weeks of employment. If line 4 is larger
than this amount, the qualified employee is not a
retained worker and should not be listed on this form
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6
Add lines 3 and 5 .
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6
7
7
Multiply line 6 by 6.2% (.062)
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8
Maximum credit allowable
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1,000 00
1,000 00
1,000 00
9
Enter the smaller of line 7 or line 8
9
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10
Add columns (a) through (c) on line 9 above and columns (a) through (c) on lines 9 of any attached
Parts II
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10
11
Enter the total number of retained workers for whom you are receiving a
credit on line 10 (see instructions)
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11
12
New hire retention credit from partnerships and S corporations (see instructions) .
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12
13
Current year credit. Add lines 10 and 12. Partnerships and S corporations, report this amount on
Schedule K; all others, report this amount on the applicable line of Form 3800 (e.g., line 1aa of the
2010 Form 3800)
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5884-B
For Paperwork Reduction Act Notice, see instructions.
Form
(12-2010)
Cat. No. 55035V
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