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Form    
5884
Department of the Treasury 
Internal Revenue Service
Work Opportunity Credit
a
 
Attach to your tax return.
 
a
 
Information about Form 5884 and its instructions is at 
www.irs.gov/form5884.
OMB No. 1545-0219
20
13
Attachment 
Sequence No. 
77
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 
for you at least 120 hours but fewer than 400 hours  .
$
×  25% (.25)
1a
b 
Qualified first-year wages of employees who worked 
for you at least 400 hours 
..........
$
×  40% (.40)
1b
c 
Qualified second-year wages of employees certified as 
long-term family assistance recipients 
......
$
×  50% (.50)
1c
2 
Add lines 1a, 1b, and 1c. See instructions for the adjustment you must make to 
salaries and wages
.........................
2
3 
Work opportunity credit from partnerships, S corporations, cooperatives, estates, and 
trusts 
..............................
3
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, line 4b 
...............
4
5 
Amount allocated to patrons of the cooperative or beneficiaries of the estate or trust 
(see instructions) 
..........................
5
6 
Cooperatives, estates, and trusts, subtract line 5 from line 4. Report this amount on 
Form 3800, line 4b 
.........................
6
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 13570D
Form 
5884
 (2013) 
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