OMB No. 1545-1978 Form 5884-A Credits for Employers Affected by

(January 2006) Hurricane Katrina, Rita, or Wilma

Department of the Treasury

Internal Revenue Service  Attach to your tax return. Attachment

Sequence No. 77A

Name(s) shown on return Identifying number

1a Employers affected by Hurricane Katrina, enter the total

qualified wages paid or incurred after August 28, 2005, and

before January 1, 2006, while the business was inoperable 1a

Enter 40% of line 1d. You must subtract this amount from your deduction for salaries

and wages

2

2

If you are a— Then enter the total of the current year credits from—

Schedule K-1 (Form 1120S), box 13, code F, G, or U

Schedule K-1 (Form 1065), box 15, code F, G, or U

Schedule K-1 (Form 1041), box 13, code R

Written statement from cooperative

a Shareholder

b Partner

c Beneficiary

d Patron

Employee

retention

credit(s) from

pass-through

entities:

3

3

Current year credit. Add lines 2 and 3. Report this amount on Form 3800, line 1z. If you

have a credit from Section B, see instructions. S corporations, partnerships, estates,

trusts, cooperatives, regulated investment companies, and real estate investment

trusts, see instructions

4

4

Form 5884-A (1-2006)



For Paperwork Reduction Act Notice, see page 4. Cat. No. 47425B

b Employers affected by Hurricane Rita, enter the total qualified

wages paid or incurred after September 23, 2005, and before

January 1, 2006, while the business was inoperable 1b

c Employers affected by Hurricane Wilma, enter the total qualified

wages paid or incurred after October 23, 2005, and before

January 1, 2006, while the business was inoperable 1c

SECTION A. Employee Retention Credit (see instructions)

d Add amounts from lines 1a, 1b, and 1c 1d

SECTION B. Hurricane Katrina Housing Credit (see instructions)

Enter the value (up to $600 per month per employee) of qualified lodging furnished

in-kind to qualified employees during the tax year from January 1, 2006, through July 1,

2006 (see instructions)

5

5

Enter 30% of line 5. You must subtract this amount from your deduction for salaries and

wages

6

6

If you are a— Then enter the total of the current year credits from—

Schedule K-1 (Form 1120S), box 13, code F, G, or U

Schedule K-1 (Form 1065), box 15, code F, G, or U

Schedule K-1 (Form 1041), box 13, code R

Written statement from cooperative

a Shareholder

b Partner

c Beneficiary

d Patron

Hurricane

Katrina housing

credit(s) from

pass-through

entities:

7

7



Current year credit. Add lines 6 and 7. Report this amount on Form 3800, line 1z. If you

have a credit from Section A, see instructions. S corporations, partnerships, estates,

trusts, cooperatives, regulated investment companies, and real estate investment

trusts, see instructions

8

8
Form 5884-A (1-2006) Page 2

General Instructions

Purpose of Form

An eligible employer who conducted an active trade or

business in the Gulf Opportunity (GO) Zone, the Rita GO

Zone, or the Wilma GO Zone (defined below) may claim

the employee retention credit. The credit is equal to

40% of qualified wages for each eligible employee (up

to a maximum of $6,000 in qualified wages per

employee). See Employee Retention Credit below. The

employer must use Form 5884-A to figure the credit.

A qualified employer may also claim the Hurricane

Katrina housing credit. This credit is equal to 30 percent

of the value (up to $600 per month, per employee) of

in-kind lodging furnished to a qualified employee which

is excluded from the employee’s income. See Employer

Credit for Housing Employees Affected by Hurricane

Katrina below. The employer must use Form 5884-A to

figure the credit.

The employee retention credit and the Hurricane

Katrina housing credit are part of the general business

credit claimed on Form 3800, General Business Credit.

No portion of the unused business credit attributable to

the Hurricane Katrine housing credit may be carried

back to any tax year before 2005. However, you may be

able to carry the unused portion forward. See the

instructions for Form 3800 for details.

You can claim or elect not to claim the credits any

time within 3 years from the due date of your tax return

(excluding extensions) on either your original or an

amended return.

Employee Retention Credit

Employers Affected by Hurricane Katrina

Eligible employer. For this purpose, an eligible

employer is any employer who conducted an active

trade or business on August 28, 2005, in the GO Zone,

and whose trade or business was inoperable on any day

after August 28, 2005, and before January 1, 2006,

because of damage sustained from Hurricane Katrina.

Eligible employee. For this purpose, an eligible

employee is an employee whose principal place of

employment on August 28, 2005, with such eligible

employer, was in the GO Zone.

Employers Affected by Hurricane Rita

Caution. An employee is not an eligible employee for

purposes of Hurricane Katrina if the employee is treated

as an eligible employee for purposes of the work

opportunity credit or for purposes of either the

Hurricane Rita or the Hurricane Wilma employee

retention credit.

Eligible employer. For this purpose, an eligible

employer is any employer who conducted an active

trade or business on September 23, 2005, in the Rita

GO Zone, and whose trade or business was inoperable

on any day after September 23, 2005, and before

January 1, 2006, because of damage sustained from

Hurricane Rita.

Eligible employee. For this purpose, an eligible

employee is an employee whose principal place of

employment on September 23, 2005, with such eligible

employer, was in the Rita GO Zone.

Caution. An employee is not an eligible employee for

purposes of Hurricane Rita if the employee is treated as

an eligible employee for purposes of the work

opportunity credit or for purposes of either the

Hurricane Katrina or the Hurricane Wilma employee

retention credit.

Employers Affected by Hurricane Wilma

Eligible employer. For this purpose, an eligible

employer is any employer who conducted an active

trade or business on October 23, 2005, in the Wilma GO

Zone, and whose trade or business was inoperable on

any day after October 23, 2005, and before January 1,

2006, because of damage sustained from Hurricane

Wilma.

Eligible employee. For this purpose, an eligible

employee is an employee whose principal place of

employment on October 23, 2005, with such eligible

employer, was in the Wilma GO Zone.

Caution. An employee is not an eligible employee for

purposes of Hurricane Wilma if the employee is treated

as an eligible employee for purposes of the work

opportunity credit or for purposes of either the

Hurricane Katrina or the Hurricane Rita employee

retention credit.

GO Zones

Areas in a “GO Zone” are areas determined by the

President to warrant individual or individual and public

assistance, from the federal government because of

Hurricane Katrina, Rita, or Wilma.

The following counties and parishes are in the Hurricane

Katrina GO Zone.

Hurricane Katrina GO Zone

Alabama. Baldwin, Choctaw, Clarke, Greene, Hale,

Marengo, Mobile, Pickens, Sumter, Tuscaloosa, and

Washington counties.

Louisiana. Acadia, Ascension, Assumption, Calcasieu,

Cameron, East Baton Rouge, East Feliciana, Iberia,

Iberville, Jefferson, Jefferson Davis, Lafayette,

Lafourche, Livingston, Orleans, Plaquemines, Pointe

Coupee, St. Bernard, St. Charles, St. Helena, St.

James, St. John the Baptist, St. Martin, St. Mary, St.

Tammany, Tangipahoa, Terrebonne, Vermilion,

Washington, West Baton Rouge, and West Feliciana.

Mississippi. Adams, Amite, Attala, Choctaw,

Claiborne, Clarke, Copiah, Covington, Forrest, Franklin,

George, Greene, Hancock, Harrison, Hinds, Holmes,

Humphreys, Jackson, Jasper, Jefferson, Jefferson

Davis, Jones, Kemper, Lamar, Lauderdale, Lawrence,

Leake, Lincoln, Lowndes, Madison, Marion, Neshoba,

Newton, Noxubee, Oktibbeha, Pearl River, Perry, Pike,

Rankin, Scott, Simpson, Smith, Stone, Walthall,

Warren, Wayne, Wilkinson, Winston, and Yazoo.
Form 5884-A (1-2006) Page 3

Line 2

In general, you must reduce your deduction for salaries

and wages by the amount on line 2. You must make this

reduction even if you cannot take the full credit this year

because of the tax liability limit on Form 3800. If you

capitalized any costs on which you figured the credit,

reduce the amount capitalized by the amount of the

credit attributable to these costs.

The following counties are in the Wilma GO Zone.

Employer Credit for Housing Employees

Affected by Hurricane Katrina

Qualified employer. A qualified employer is any

employer with a trade or business located in the GO

Zone that was affected by Hurricane Katrina.

Qualified employee. A qualified employee is an

individual who had a principal residence in the GO Zone

on August 28, 2005, and who performs substantially all

employment services in the GO Zone for the qualified

employer. The employee cannot be related to you.

Qualified lodging. Qualified lodging is lodging furnished

in-kind to a qualified employee (and to the employee’s

spouse or dependents) by or on behalf of the qualified

employer from January 1, 2006, through July 1, 2006.

Qualified lodging is excluded from the employee’s

income. However, the amount excluded is treated as

wages for purposes of FICA and FUTA tax.

Specific Instructions

Section A. Employee Retention Credit

Special instructions for controlled group members.

The group member contributing the highest dollar

amount of qualified wages figures the group credit. See

sections 52(a) and 1563. On separate Forms 5884-A,

that member and every other member of the group

should skip line 1 and enter its share of the group credit

on line 2. Each member then completes lines 3 and 4 on

its separate form, and Form 3800. Each member must

attach to its Form 5884-A a schedule showing how the

group credit was divided among all the members. The

members share the credit in the same proportion that

they contribute qualifying wages.

Enter the total qualified wages (defined above) paid or

incurred. Do not enter more than $6,000 for each

qualified employee.

Use Section A to figure the employee retention credit.

Use Section B to figure the Hurricane Katrina housing

credit.

Qualified Wages. Qualified wages are wages you paid

to or incurred for eligible employees on any day after

August 28, 2005, in the case of Hurricane Katrina (after

September 23, 2005, in the case of Hurricane Rita, and

after October 23, 2005, in the case of Hurricane Wilma)

and before January 1, 2006, during the period beginning

on the date your trade or business first became

inoperable at the employee’s principal place of

employment immediately before the applicable

hurricane, and ending on the date your trade or

business resumed significant operations at that place.

Louisiana. Acadia, Allen, Ascension, Beauregard,

Calcasieu, Cameron, Evangeline, Iberia, Jefferson,

Jefferson Davis, Lafayette, Lafourche, Livingston,

Plaquemines, Sabine, St. Landry, St. Martin, St. Mary,

St. Tammany, Terrebonne, Vermilion, Vernon, and West

Baton Rouge.

Florida. Brevard, Broward, Collier, Glades, Hendry,

Indian River, Lee, Martin, Miami-Dade, Monroe,

Okeechobee, Palm Beach, and St. Lucie.

Wilma GO Zone

Line 3

Enter the amount of credit allocated to you as a

shareholder, beneficiary, partner, or patron of a

cooperative.

Line 4

Report the current year credit on line 1z of Form 3800,

except for the entities that report as indicated below. If

you also have a Hurricane Katrina housing credit from

line 8, combine that amount with the amount on line 4

and enter the total on line 1z of Form 3800.

Wages qualifying for the credit generally have the

same meaning as wages subject to the Federal

Unemployment Tax Act (FUTA). Qualified wages also

include amounts you paid for medical or hospitalization

expense in connection with sickness or accident

disability. Qualified wages do not include wages paid to

your dependent or wages paid to an employee related

to you.

For agricultural employees, if the work performed by

any employee during more than half of any pay period

qualifies under FUTA as agricultural labor, the first

$6,000 of that employee’s wages subject to social

security and Medicare taxes are qualified wages.

Qualified wages for any employee must be reduced

by the amount of any work supplementation payment

you received under the Social Security Act for the

employee.

Line 1

Texas. Angelina, Brazoria, Chambers, Fort Bend,

Galveston, Hardin, Harris, Jasper, Jefferson, Liberty,

Montgomery, Nacogdoches, Newton, Orange, Polk,

Sabine, San Augustine, San Jacinto, Shelby, Trinity,

Tyler, and Walker.

For purposes of the Hurricane Katrina housing credit,

the following apply.

The amount of qualified wages that may be taken into

account is limited to $6,000 per employee. This includes

wages paid 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 operations have resumed.

The following counties and parishes are in the Rita GO

Zone.

Rita GO Zone
Form 5884-A (1-2006) Page 4

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If you have comments concerning the accuracy of

these time estimates or suggestions for making this

form simpler, we would be happy to hear from you. See

the instructions for the tax return with which this form is

filed.

Recordkeeping 3 hr., 6 min.

Learning about the law

or the form 24 min.

Preparing and sending

the form to the IRS 27 min.

The time needed to complete and file this form will

vary depending on individual circumstances. The

estimated burden for individual taxpayers filing this form

is approved under OMB control number 1545-0074 and

is included in the estimates shown in the instructions for

their individual income tax return. The estimated burden

for all other taxpayers who file this form is shown below.

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.

Line 7

Enter the amount of credit allocated to you as a

shareholder, beneficiary, partner, or patron of a

cooperative.

Line 8

Report the current year credit on line 1z of Form 3800,

except for the entities that report as indicated below. If

you also have an employee retention credit on line 4,

combine that amount with the amount on line 8 and

enter the total on line 1z of Form 3800.

S corporations and partnerships. Allocate the credit

on line 8 to the shareholders or partners. Attach Form

5884-A to the return and on Schedule K-1 show the

credit for each shareholder or partner. Electing large

partnerships include this credit in “general credits.”

Estates and trusts. Allocate the credit on line 8

between the estate or trust and beneficiaries in

proportion to the income allocable to each. On the

dotted line next to line 8, the estate or trust should enter

its part of the total credit. Label it “1041 Portion” and

use this amount on Form 3800 to figure the credit to

claim on Form 1041.

Cooperatives. Most tax-exempt organizations cannot

take the credit. However, a cooperative described in

section 1381(a) takes the credit to the extent it has tax

liability.

Cooperatives. Most tax-exempt organizations cannot

take the credit. However, a cooperative described in

section 1381(a) takes the credit to the extent it has tax

liability.

Section B. Hurricane Katrina Housing

Credit

Special instructions for controlled group members.

The group member contributing the highest dollar

amount of qualified lodging figures the group credit. See

sections 52(a) and 1563. On separate Forms 5884-A,

that member and every other member of the group

should skip line 5 and enter its share of the group credit

on line 6. Each member then completes lines 7 and 8 on

its separate form, and Form 3800. Each member must

attach to its Form 5884-A a schedule showing how the

group credit was divided among all the members. The

members share the credit in the same proportion that

they contributed qualified lodging.

Line 5

Enter the value of qualified lodging furnished in-kind to

qualified employees between January 1, 2006, and July

1, 2006. Do not enter more than $600 per month, per

employee.

Regulated investment companies and real estate

investment trusts. Reduce the allowable credit to the

company’s or trust’s ratable share of the credit.

Regulated investment companies and real estate

investment trusts. Reduce the allowable credit to the

company’s or trust’s ratable share of the credit.

Estates and trusts. Allocate the credit on line 4

between the estate or trust and beneficiaries in

proportion to the income allocable to each. On the

dotted line next to line 4, the estate or trust should enter

its part of the total credit. Label it “1041 Portion” and

use this amount on Form 3800 to figure the credit to

claim on Form 1041.

S corporations and partnerships. Allocate the credit

on line 4 to the shareholders or partners. Attach Form

5884-A to the return and on Schedule K-1 show the

credit for each shareholder or partner. Electing large

partnerships include this credit in “general credits.”