0321 Form 5884-A (PDF) — verbatim text

Official source: IRS Forms, Instructions & Publications (https://www.irs.gov/pub/irs-pdf/f5884a.pdf), retrieved 2026-10-03. U.S. Government work (17 U.S.C. § 105).

5884-A Form (Rev. March 2021) Department of the Treasury Internal Revenue Service	Employee Retention Credit for Employers Affected by Qualified Disasters ▶ Attach to your tax return. ▶ Go to www.irs.gov/Form5884A for instructions and the latest information.					OMB No. 1545-1978
Form5884-A (Rev. March 2021) Department of the Treasury Internal Revenue Service	Employee Retention Credit for Employers Affected by Qualified Disasters ▶ Attach to your tax return. ▶ Go towww.irs.gov/Form5884A for instructions and the latest information.	Employee Retention Credit for Employers Affected by Qualified Disasters ▶ Attach to your tax return. ▶ Go towww.irs.gov/Form5884A for instructions and the latest information.	Employee Retention Credit for Employers Affected by Qualified Disasters ▶ Attach to your tax return. ▶ Go towww.irs.gov/Form5884A for instructions and the latest information.	Employee Retention Credit for Employers Affected by Qualified Disasters ▶ Attach to your tax return. ▶ Go towww.irs.gov/Form5884A for instructions and the latest information.	Employee Retention Credit for Employers Affected by Qualified Disasters ▶ Attach to your tax return. ▶ Go towww.irs.gov/Form5884A for instructions and the latest information.	Attachment Sequence No.884A	Attachment Sequence No.884A
Name(s) shown on return	Name(s) shown on return	Name(s) shown on return	Name(s) shown on return	Identifying number	Identifying number	Identifying number	Identifying number
1 a Employers affected by a 2018 through 2019 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . 1a b Employers affected by a 2020 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . . . . 1b c Add amounts from lines 1a and 1b . . . . . . . . . . . . . . . . . . . . . 2 Multiply line 1c by 40% (0.40). See instructions for the adjustment you must make to your deduction for salaries and wages . . . . . . . . . . . . . . . . . . . . . . 3 Employee retention 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 III, line 1aa . . . . . . . . . . . . . . . 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 III, line 1aa . . . . . . . . . . . . . . . . . . . . . . . . . .	1 a Employers affected by a 2018 through 2019 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . 1a b Employers affected by a 2020 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . . . . 1b c Add amounts from lines 1a and 1b . . . . . . . . . . . . . . . . . . . . . 2 Multiply line 1c by 40% (0.40). See instructions for the adjustment you must make to your deduction for salaries and wages . . . . . . . . . . . . . . . . . . . . . . 3 Employee retention 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 III, line 1aa . . . . . . . . . . . . . . . 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 III, line 1aa . . . . . . . . . . . . . . . . . . . . . . . . . .	1a			1c	1c
1 a Employers affected by a 2018 through 2019 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . 1a b Employers affected by a 2020 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . . . . 1b c Add amounts from lines 1a and 1b . . . . . . . . . . . . . . . . . . . . . 2 Multiply line 1c by 40% (0.40). See instructions for the adjustment you must make to your deduction for salaries and wages . . . . . . . . . . . . . . . . . . . . . . 3 Employee retention 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 III, line 1aa . . . . . . . . . . . . . . . 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 III, line 1aa . . . . . . . . . . . . . . . . . . . . . . . . . .	1 a Employers affected by a 2018 through 2019 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . 1a b Employers affected by a 2020 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . . . . 1b c Add amounts from lines 1a and 1b . . . . . . . . . . . . . . . . . . . . . 2 Multiply line 1c by 40% (0.40). See instructions for the adjustment you must make to your deduction for salaries and wages . . . . . . . . . . . . . . . . . . . . . . 3 Employee retention 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 III, line 1aa . . . . . . . . . . . . . . . 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 III, line 1aa . . . . . . . . . . . . . . . . . . . . . . . . . .	1b
1 a Employers affected by a 2018 through 2019 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . 1a b Employers affected by a 2020 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . . . . 1b c Add amounts from lines 1a and 1b . . . . . . . . . . . . . . . . . . . . . 2 Multiply line 1c by 40% (0.40). See instructions for the adjustment you must make to your deduction for salaries and wages . . . . . . . . . . . . . . . . . . . . . . 3 Employee retention 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 III, line 1aa . . . . . . . . . . . . . . . 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 III, line 1aa . . . . . . . . . . . . . . . . . . . . . . . . . .	1 a Employers affected by a 2018 through 2019 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . 1a b Employers affected by a 2020 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . . . . 1b c Add amounts from lines 1a and 1b . . . . . . . . . . . . . . . . . . . . . 2 Multiply line 1c by 40% (0.40). See instructions for the adjustment you must make to your deduction for salaries and wages . . . . . . . . . . . . . . . . . . . . . . 3 Employee retention 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 III, line 1aa . . . . . . . . . . . . . . . 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 III, line 1aa . . . . . . . . . . . . . . . . . . . . . . . . . .	1b			2	2
1 a Employers affected by a 2018 through 2019 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . 1a b Employers affected by a 2020 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . . . . 1b c Add amounts from lines 1a and 1b . . . . . . . . . . . . . . . . . . . . . 2 Multiply line 1c by 40% (0.40). See instructions for the adjustment you must make to your deduction for salaries and wages . . . . . . . . . . . . . . . . . . . . . . 3 Employee retention 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 III, line 1aa . . . . . . . . . . . . . . . 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 III, line 1aa . . . . . . . . . . . . . . . . . . . . . . . . . .	1 a Employers affected by a 2018 through 2019 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . 1a b Employers affected by a 2020 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . . . . 1b c Add amounts from lines 1a and 1b . . . . . . . . . . . . . . . . . . . . . 2 Multiply line 1c by 40% (0.40). See instructions for the adjustment you must make to your deduction for salaries and wages . . . . . . . . . . . . . . . . . . . . . . 3 Employee retention 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 III, line 1aa . . . . . . . . . . . . . . . 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 III, line 1aa . . . . . . . . . . . . . . . . . . . . . . . . . .	1b			3	3
1 a Employers affected by a 2018 through 2019 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . 1a b Employers affected by a 2020 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . . . . 1b c Add amounts from lines 1a and 1b . . . . . . . . . . . . . . . . . . . . . 2 Multiply line 1c by 40% (0.40). See instructions for the adjustment you must make to your deduction for salaries and wages . . . . . . . . . . . . . . . . . . . . . . 3 Employee retention 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 III, line 1aa . . . . . . . . . . . . . . . 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 III, line 1aa . . . . . . . . . . . . . . . . . . . . . . . . . .	1 a Employers affected by a 2018 through 2019 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . 1a b Employers affected by a 2020 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . . . . 1b c Add amounts from lines 1a and 1b . . . . . . . . . . . . . . . . . . . . . 2 Multiply line 1c by 40% (0.40). See instructions for the adjustment you must make to your deduction for salaries and wages . . . . . . . . . . . . . . . . . . . . . . 3 Employee retention 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 III, line 1aa . . . . . . . . . . . . . . . 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 III, line 1aa . . . . . . . . . . . . . . . . . . . . . . . . . .	1b			4	4
1 a Employers affected by a 2018 through 2019 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . 1a b Employers affected by a 2020 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . . . . 1b c Add amounts from lines 1a and 1b . . . . . . . . . . . . . . . . . . . . . 2 Multiply line 1c by 40% (0.40). See instructions for the adjustment you must make to your deduction for salaries and wages . . . . . . . . . . . . . . . . . . . . . . 3 Employee retention 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 III, line 1aa . . . . . . . . . . . . . . . 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 III, line 1aa . . . . . . . . . . . . . . . . . . . . . . . . . .	1 a Employers affected by a 2018 through 2019 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . 1a b Employers affected by a 2020 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . . . . 1b c Add amounts from lines 1a and 1b . . . . . . . . . . . . . . . . . . . . . 2 Multiply line 1c by 40% (0.40). See instructions for the adjustment you must make to your deduction for salaries and wages . . . . . . . . . . . . . . . . . . . . . . 3 Employee retention 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 III, line 1aa . . . . . . . . . . . . . . . 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 III, line 1aa . . . . . . . . . . . . . . . . . . . . . . . . . .	1b			5	5
1 a Employers affected by a 2018 through 2019 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . 1a b Employers affected by a 2020 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . . . . 1b c Add amounts from lines 1a and 1b . . . . . . . . . . . . . . . . . . . . . 2 Multiply line 1c by 40% (0.40). See instructions for the adjustment you must make to your deduction for salaries and wages . . . . . . . . . . . . . . . . . . . . . . 3 Employee retention 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 III, line 1aa . . . . . . . . . . . . . . . 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 III, line 1aa . . . . . . . . . . . . . . . . . . . . . . . . . .	1 a Employers affected by a 2018 through 2019 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . 1a b Employers affected by a 2020 qualified disaster, enter the total qualified wages paid or incurred during the applicable period while the business was inoperable. See instructions . . . . . . . . . . 1b c Add amounts from lines 1a and 1b . . . . . . . . . . . . . . . . . . . . . 2 Multiply line 1c by 40% (0.40). See instructions for the adjustment you must make to your deduction for salaries and wages . . . . . . . . . . . . . . . . . . . . . . 3 Employee retention 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 III, line 1aa . . . . . . . . . . . . . . . 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 III, line 1aa . . . . . . . . . . . . . . . . . . . . . . . . . .	1b			6	6

For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 47425B Form 5884-A (Rev. 3-2021)