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COBRA Recipients [Line 12b].

Note:

Internal Revenue Manual Part 3. Submission Processing · 2026-10-03 edition · updated 2026-10-04 · United States

Enter the amount from this Line 23 on form revisions 2020 (Rev. April 2020) through 2021 (Rev. Mar 2021) with tax quarters of 202006 through 202103 only.

Credit from Form 5884-C, Line 11, for this quarter

Enter the amount from box 23.

Qual. Sick Lv. Wages After Mar 31(to October 1) [Line 23]

Qual. Sick Lv. Wages 3-31 to 10-1 [Line 23] is valid on form revisions 2022 (Rev. Mar 2022) through 2023 (Rev. March 2023) forms with a tax quarter of 202106 through 202312

Qual. Sick Lv. Wages After Mar 31 [Line 23] is valid on form revision 2021 (Rev. June 2021) with a tax quarter of 202106 through 202312

Qualified sick leave wages for leave taken after March 31, 2021 (and before October 1, 2021)

Enter the amount from box 23.

Qual. Wages Paid Mar. Emp. Ret. Credit [Line 24]

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