Form 5884-D Instructions 3-19-2021

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2021

Instructions for Form 5884-D

Department of the Treasury
Internal Revenue Service

Employee Retention Credit for Certain Tax-Exempt Organizations Affected by
Qualified Disasters
5884-D during processing or the organization owes other
taxes, penalties, or interest.

Section references are to the Internal Revenue Code
unless otherwise noted.

Future Developments

The amount properly claimed on Form 5884-D is

For the latest information about developments related to
Form 5884-D and its instructions, such as legislation
enacted after they were published, go to IRS.gov/
Form5884D.

General Instructions
Purpose of Form

A qualified tax-exempt organization (including certain
governmental entities) that continued to pay or incur
wages after activities of the organization became
inoperable because of damage from a qualified disaster
may be able to use Form 5884-D to claim the 2020
qualified disaster employee retention credit against
certain payroll taxes. This is the same credit businesses
claim against income taxes using Form 5884-A. The credit
is equal to 40% of up to $6,000 of qualified wages paid to
or incurred for each eligible employee. The credit is
claimed against the employer portion of social security tax
on wages paid to all employees during an employment tax
period. A list of qualified disasters is available at the end
of these instructions.
The organization files Form 5884-D after it files its
employment tax return for the employment tax period for
which it is claiming the credit. The organization begins by
filing Form 5884-D for the first employment tax period
during which qualified wages are paid to an eligible
employee. The organization continues to file Form 5884-D
for each subsequent employment tax period during which
either additional qualified wages were paid, or additional
employment taxes needed to claim a credit for unused
qualified wages reported for an earlier employment tax
period were paid. Each Form 5884-D figures the
cumulative credit the organization is entitled to for all
periods and reduces that amount by any amounts claimed
on previously filed Forms 5884-D.
A qualified tax-exempt organization filing its own Form
5884-D should file one Form 5884-D for the organization
per employment tax period. A third-party payer will file a
single separate Form 5884-D for each qualified
tax-exempt organization per employment tax period.
Form 5884-D is filed separately from any other returns.
The credit claimed on this form will not affect the tax
liability reported on the organization’s employment tax
returns. Nevertheless, the organization may reduce its
required deposits in anticipation of any credit. The IRS will
refund the amount shown on line 12 of Form 5884-D, plus
any interest that applies, unless the IRS corrects Form
Mar 16, 2021

TIP treated as a credit on the first day of the

organization’s employment tax return period.
Qualified tax-exempt organizations eligible to claim this
credit can reduce their deposits in an employment tax
period by the amount of their anticipated credits for that
employment tax period. However, because Form 5884-D
may not be processed with the organization’s employment
tax return, an organization that reduces its required
deposits in anticipation of a Form 5884-D credit may
receive a system-generated notice reflecting a balance
due and associated penalties and interest, if applicable.
The balance due, including any related penalties and
interest, resulting from the reduction in deposits to reflect
the Form 5884-D credit will be abated when the credit is
applied. Such abatement should occur without any action
from the organization.

Qualified Tax-Exempt Organization

A qualified tax-exempt organization is an organization
described in section 501(c) and exempt from tax under
section 501(a) if:
• It conducted activities in a 2020 qualified disaster zone
at any time during the incident period of the qualified
disaster, and
• These activities were inoperable as a result of damage
sustained by reason of that qualified disaster at any time
during the period beginning on the first day of the incident
period of the qualified disaster and ending on December
27, 2020.
An agency or instrumentality of the Federal
government, or of a state, local, or Indian tribal
government, is not a qualified tax-exempt organization
unless it is:
• A federally chartered corporation described in section
501(c)(1) and exempt from tax under section 501(a); or
• A federal, state, or local college or university; or
• An entity whose principal purpose or function is
providing medical or hospital care.

Eligible Employee

An eligible employee is an employee whose principal
place of employment with the qualified tax-exempt
organization immediately before the incident period of the
qualified disaster was in the 2020 qualified disaster zone.

Qualified Wages

Qualified wages are wages paid or incurred for eligible
employees at any time on or after the date the
organization’s activities first became inoperable at the
employee’s principal place of employment (determined

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immediately before the first day of the incident period of
the qualified disaster) and before the earlier of:
• The date the organization resumed significant activities
at that place, or
• The date 150 days after the last day of the incident
period.

Where To File
Send Form 5884-D to the address provided at the bottom
of the form.
More information. For more information about this
credit, see P. L. 116-260, Div. EE, sections 301 and
303(d).

Qualified wages do not include any wages that exceed
$6,000 for an eligible employee for a calendar quarter
(reduced by the amount of qualified wages credited for
any prior calendar quarter).

Specific Instructions
Name and Address

The amount of qualified wages that may be taken into
account is limited to $6,000 per employee. This includes
wages paid or incurred whether the employee performs
no services, performs services at a place of employment
other than the principal place of employment, or performs
services at the principal place of employment before
significant activities have resumed.

If the organization receives its mail in care of a third-party
(such as an accountant or an attorney), enter on the street
address line “C/O” followed by the third party’s name and
street address or P.O. box.
A third-party payer who files an aggregate employment
tax return an is filing Form 5884-D for a qualified
tax-exempt organization client claiming the credit should
enter the third party’s name, address, and EIN.

Wages qualifying for the credit generally have the same
meaning as wages subject to social security and
Medicare taxes. However, qualified wages don't include
any wages used to figure a coronavirus-related employee
retention credit on an employment tax return, such as
Form 941, Employer's QUARTERLY Federal Tax Return.

Include the suite, room, or other number after the
number address. If the Post Office does not deliver mail to
the street address and the organization has a P.O. box,
enter the box number instead of the street address.

When To File

Line 1

File Form 5884-D after the organization has filed its
employment tax return for the employment tax period for
which it is claiming the credit. File Form 5884-D for each
employment tax period during which the organization
either:
• Paid qualified wages to an eligible employee, or
• Paid additional employment taxes needed to claim a
credit for excess qualified wages reported for an earlier
employment tax period.

If a third-party payer who files an aggregate employment
tax return is filing Form 5884-D for a qualified tax-exempt
organization client claiming the credit, enter the name,
address, and EIN of the qualified tax-exempt organization
(defined earlier) for whom the third-party payer is claiming
the credit. All information reported on Form 5884-D by a
third-party payer for a qualified tax-exempt organization
must relate solely to the organization identified on line 1.

Line 2

A qualified tax-exempt organization that files its
employment tax return under its own employer
identification number (EIN) (including organizations that
file using a payroll service provider or reporting agent)
should file one Form 5884-D for the organization per
employment tax period. A third-party payer, such as a
certified professional employer organization, a
non-certified professional employer organization, or an
agent under section 3504, who files an aggregate
employment tax return and is filing Form 5884-D for a
qualified tax-exempt organization claiming the credit
should use the third-party’s name and EIN on Form
5884-D and should enter the qualified tax-exempt
organization’s name, address, and EIN on line 1. A
third-party payer who files an aggregate employment tax
return must file a single separate Form 5884-D for each
qualified tax-exempt organization claiming the credit in an
employment tax period.

The credit is available only to an organization that is a
qualified tax-exempt organization. The organization must
be able to check “Yes” on either line 2a or 2b to qualify for
the credit.

Line 3
Column (a). Enter the DR number of the qualified
disaster that resulted in the damage that caused the
organization’s activities to become inoperable in a 2020
qualified disaster zone. See 2020 Qualified Disaster
Zones, later.
Column (b). Enter a brief description of the qualified
disaster.
Column (c). Identify the 2020 qualified disaster zone
local jurisdiction(s) (county, parish, or municipality) where
the organization’s activities became inoperable as a result
of damage sustained from the qualified disaster.

Note. The IRS cannot process Form 5884-D until the
original employment tax return filed for the same tax
period has been processed. Please allow 8 to 12 weeks
for the processing of Form 5884-D.

More than four disasters. If more than four disaster
declarations apply, leave columns (a) and (c) blank on the
fourth row and enter “See attached” in column (b). Attach
a list with the information requested in columns (a)
through (c) for each applicable qualified disaster. Include
the name and EIN of the qualified tax-exempt organization
at the top of the attached list.

Form 5884-D must be filed within 2 years from the
date the tax reported on the employment tax
CAUTION return was paid, or 3 years from the date the
employment tax return was filed, whichever is later.

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Line 5

Line 12

As discussed earlier under Purpose of Form, the
organization claims this credit against the employer’s
portion of social security tax on wages paid to all
employees during the employment tax period. The
organization files Form 5884-D for each employment tax
period during which it claims a credit. Each Form 5884-D
figures the cumulative credit the organization is entitled to
for all periods and reduces the amount claimed for the
period by any amounts claimed on previously filed Forms
5884-D.

If your credit is less than $1, we will apply it only if you ask
us in writing to do so.

Line 13

You may pay the amount you owe on line 13 electronically
using the Electronic Federal Tax Payment System
(EFTPS), by credit or debit card, or by a check or money
order.
• The preferred method of payment is EFTPS. For more
information, visit IRS.gov/EFTPS; call EFTPS Customer
Service at 800-555-4477 or 800-733-4829 (TDD); or see
Pub. 966, Electronic Federal Tax Payment System: A
Guide To Getting Started.
• To pay by credit or debit card, visit the IRS website at
IRS.gov/PayCard.
• If you pay by check or money order, make it payable to
“United States Treasury.” On your check or money order,
be sure to write your EIN, “Form 5884-D,” and the year
(and quarter, if applicable) indicated on line 5.
You do not have to pay if the amount you owe is less
than $1.

Check the box(es) on line 5 to indicate the year (and
quarter, if applicable) for the employment tax period for
which the organization is claiming the credit. If qualified
wages the organization is reporting on line 6a are not
more than the amount reported on line 6a for the previous
employment tax period, check “Carryforward only” and
enter the year and quarter to which the credit carried
forward is being applied.

Line 6

Enter on line 6a the total qualified wages (defined earlier)
the organization paid in all periods through the end of the
employment tax period indicated on line 5 to eligible
employees of the organization.

Signature

Form 5884-D must be signed by the president, vice
president, treasurer, assistant treasurer, chief accounting
officer, or other corporate officer (such as a tax officer)
authorized to sign. A receiver, trustee, or assignee must
sign any return filed for the organization. For a trust, the
authorized trustee must sign.

Line 8

Enter the total amount of credits claimed from line 12 of
any previously filed Forms 5884-D minus the total amount
of credits repaid from line 13 of any previously filed Forms
5884-D. Each Form 5884-D figures the cumulative credit
the organization is entitled to for all periods. The amount
of the cumulative credit reported on line 6b must be
reduced by the previously claimed credits and increased
by any previously repaid amounts to determine the credit
claimed for the employment tax period for which Form
5884-D is filed.

Paid Preparer

A paid preparer must sign Form 5884-D and provide the
information in the Paid Preparer Use Only section if the
preparer was paid to prepare Form 5884-D and is not an
employee of the filing entity. Paid preparers must sign
paper returns with a manual signature. The preparer must
give the organization a copy of Form 5884-D in addition to
the copy to be filed with the IRS.

If the credit claimed for a prior period was limited

TIP by the employer’s social security tax liability for

If you are a paid preparer, enter your preparer tax
identification number (PTIN) in the space provided.
Include your complete address. If you work for a firm,
enter the firm’s name and the EIN of the firm. You cannot
use your PTIN in place of the EIN of the tax preparation
firm.

that period, any excess credit will be carried
forward and included in the cumulative credit figured on
any subsequent Form 5884-D. The excess credit is not
included in the amount on line 8.

Line 10

You can apply for a PTIN online or by filing Form W-12,
IRS Paid Preparer Tax Identification Number (PTIN)
Application and Renewal. For more information about
applying for a PTIN online, visit the IRS website at
IRS.gov/PTIN.

Enter the total taxable social security wages and tips
reported on the employment tax return indicated on line 4
for the employment tax period indicated on line 5. For
example, taxable social security wages and tips included
on Form 941 for wages paid in the 4th quarter of 2020
were reported on the following lines.
• Form 941, line 5a, column 1 (taxable social security
wages).
• Form 941, line 5b, column 1 (taxable social security
tips).

Generally, you are not required to complete this section
if you are filing Form 5884-D as a reporting agent and
have a valid Form 8655, Reporting Agent Authorization,
on file with the IRS. However, a reporting agent must
complete this section if the reporting agent offered legal
advice, for example, advising the client on determining
whether its employees are eligible employees for
purposes of this credit.

Note. If you filed a corrected return (for example, Form
941-X) for the period indicated on line 5, enter the
amounts as corrected.

Instructions for Form 5884-D (March 2021)

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2020 Qualified Disaster Zones

Natchitoches, Ouachita, Rapides, Sabine, St. Landry,
Union, Vermilion, Vernon, and Winn.

Alabama Hurricane Sally (DR-4563-AL)

The applicable incident period began on October 6 and
ended on October 10, 2020. The date 150 days after the
last incident period was March 9, 2021.

The following qualified disasters resulted in the
designation of the 2020 qualified disaster zones. The
information needed for credit purposes is provided below.

Louisiana Hurricane Delta (DR-4570-LA)

The applicable incident period began on September 14
and ended on September 16, 2020. The date 150 days
after the last incident period was February 13, 2021.

Parishes in qualified disaster zone. Acadia, Allen,
Beauregard, Calcasieu, Cameron, Iberia, Jefferson Davis,
Lafayette, Rapides, St. Landry, St. Martin, and Vermilion.

Counties in qualified disaster zone. Baldwin,
Escambia, and Mobile.

Louisiana Hurricane Zeta (DR-4577-LA)

The applicable incident period began on October 26 and
ended on October 29, 2020. The date 150 days after the
last incident period was March 28, 2021.

Alabama Hurricane Zeta (DR-4573-AL)

The applicable incident period began on October 28 and
ended on October 29, 2020. The date 150 days after the
last incident period was March 28, 2021.

Parishes in qualified disaster zone. Jefferson,
Lafourche, Orleans, Plaquemines, St. Bernard, and
Terrebonne.

Counties in qualified disaster zone. Clarke, Dallas,
Marengo, Mobile, Perry, Washington, and Wilcox.

Michigan Severe Storms and Flooding
(DR-4547-MI)

California Wildfires (DR-4558-CA)

The applicable incident period began on August 14 and
ended on September 26, 2020. The date 150 days after
the last incident period was February 23, 2021.

The applicable incident period began on May 16 and
ended on May 22, 2020. The date 150 days after the last
incident period was October 19, 2020.

Counties in qualified disaster zone. Butte, Lake,
Lassen, Mendocino, Monterey, Napa, San Mateo, Santa
Clara, Santa Cruz, Solano, Sonoma, Stanislaus, Trinity,
Tulare, and Yolo.

Counties in qualified disaster zone. Arenac, Gladwin,
Iosco, Midland, and Saginaw.

Mississippi Severe Storms, Tornadoes,
Straight-Line Winds, and Flooding
(DR-4536-MS)

California Wildfires (DR-4569-CA)

The applicable incident period began on September 4 and
ended on November 17, 2020. The date 150 days after
the last incident period was April 16, 2021.

The applicable incident period began and ended on April
12, 2020. The date 150 days after the last incident period
was September 9, 2020.

Counties in qualified disaster zone. Fresno, Los
Angeles, Madera, Mendocino, Napa, San Bernardino,
San Diego, Shasta, Siskiyou, and Sonoma.

Counties in qualified disaster zone. Clarke,
Covington, Grenada, Jasper, Jefferson Davis, Jones,
Lawrence, Panola, and Walthall.

Florida Hurricane Sally (DR-4564-FL)

Mississippi Hurricane Zeta (DR-4576-MS)

The applicable incident period began on September 14
and ended on September 28, 2020. The date 150 days
after the last incident period was February 25, 2021.

The applicable incident period began on October 28 and
ended on October 29, 2020. The date 150 days after the
last incident period was March 28, 2021.

Counties in qualified disaster zone. Bay, Escambia,
Okaloosa, Santa Rosa, and Walton.

Counties in qualified disaster zone. George, Greene,
Hancock, Harrison, Jackson, and Stone.

Iowa Severe Storms (DR-4557-IA)

Oregon Severe Storms, Flooding, Landslides,
and Mudslides (DR-4519-OR)

The applicable incident period began and ended on
August 10, 2020. The date 150 days after the last incident
period was January 7, 2021.

The applicable incident period began on February 5 and
ended on February 9, 2020. The date 150 days after the
last incident period was July 8, 2020.

Counties in qualified disaster zone. Benton, Boone,
Cedar, Clinton, Jasper, Linn, Marshall, Polk, Poweshiek,
Scott, Story, and Tama.

Counties in qualified disaster zone. Umatilla and
Umatilla Indian Reservation.

Louisiana Hurricane Laura (DR-4559-LA)

Oregon Wildfires and Straight-Line Winds
(DR-4562-OR)

The applicable incident period began on August 22 and
ended on August 27, 2020. The date 150 days after the
last incident period was January 24, 2021.

The applicable incident period began on September 7 and
ended on November 3, 2020. The date 150 days after the
last incident period was April 2, 2021.

Parishes in qualified disaster zone. Acadia, Allen,
Beauregard, Caddo, Calcasieu, Cameron, Grant,
Jackson, Jefferson Davis, La Salle, Lincoln, Morehouse,

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Counties in qualified disaster zone. Clackamas,
Douglas, Jackson, Klamath, Lane, Lincoln, Linn, and
Marion.

Counties in qualified disaster zone. Aiken, Barnwell,
Berkeley, Colleton, Hampton, Marlboro, Oconee,
Orangeburg, and Pickens.

Puerto Rico Earthquakes (DR-4473-PR)

Tennessee Severe Storms, Tornadoes,
Straight-Line Winds, and Flooding (DR-4476-TN)

The applicable incident period began on December 28
and ended on July 3, 2020. The date 150 days after the
last incident period was November 30, 2020.

The applicable incident period began and ended on
March 3, 2020. The date 150 days after the last incident
period was July 31, 2020.

Municipalities in qualified disaster zone. Adjuntas,
Aguada, Añasco, Arecibo, Barceloneta, Cabo Rojo,
Ciales, Coamo, Corozal, Guánica, Guayanilla,
Hormigueros, Jayuya, Juana Díaz, Lajas, Lares, Las
Marías, Maricao, Mayagüez, Moca, Morovis, Naranjito,
Orocovis, Peñuelas, Ponce, Sabana Grande, Salinas,
San Germán, San Sebastián, Santa Isabel, Utuado,
Villalba, and Yauco.

Counties in qualified disaster zone. Davidson,
Putnam, and Wilson.

Tennessee Severe Storms, Tornadoes,
Straight-Line Winds, and Flooding (DR-4541-TN)
The applicable incident period began on April 12 and
ended on April 13, 2020. The date 150 days after the last
incident period was September 10, 2020.

Puerto Rico Tropical Storm Isaias (DR-4560-PR)

Counties in qualified disaster zone. Bradley and
Hamilton.

The applicable incident period began on July 29 and
ended on July 31, 2020. The date 150 days after the last
incident period was December 28, 2020.

Utah Earthquake and Aftershocks (DR-4548-UT)

Municipalities in qualified disaster zone. Aguada,
Hormigueros, Mayagüez, and Rincón.

The applicable incident period began on March 18 and
ended on April 17, 2020. The date 150 days after the last
incident period was September 14, 2020.

Puerto Rico Severe Storms and Flooding
(DR-4571-PR)

Counties in qualified disaster zone. Davis and Salt
Lake.

The applicable incident period began and ended on
September 13, 2020. The date 150 days after the last
incident period was February 10, 2021.

Municipality in qualified disaster zone. Arecibo.

South Carolina Severe Storms, Tornadoes, and
Straight-Line Winds (DR-4542-SC)

The applicable incident period began on April 12 and
ended on April 13, 2020. The date 150 days after the last
incident period was September 10, 2020.

Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of the
United States. You are required to give us the information. We need it to ensure that you are complying with these laws
and to allow us to figure and collect the right amount of tax.
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act
unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be
retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax
returns and return information are confidential, as required by section 6103. However, certain returns and return
information of tax-exempt organizations and trusts are subject to public disclosure and inspection, as provided by
section 6104.
The time needed to complete and file this form will vary depending on individual circumstances. The estimated burden
for tax-exempt organizations filing this form is approved under OMB control number 1545-0047 and is included in the
estimates shown in the instructions for their information return.

Instructions for Form 5884-D (March 2021)

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