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                                                                                       Department of the Treasury
                                                                                       Internal Revenue Service
Instructions for Form 5884-D

(April 2021)
Employee Retention Credit for Certain Tax-Exempt Organizations Affected by 
Qualified Disasters

Section references are to the Internal Revenue Code           A qualified tax-exempt organization filing its own Form 
unless otherwise noted.                                     5884-D should file one Form 5884-D for the organization 
                                                            per employment tax period. A third-party payer will file a 
Future Developments                                         single separate Form 5884-D for each qualified 
For the latest information about developments related to    tax-exempt organization per employment tax period.
Form 5884-D and its instructions, such as legislation         Form 5884-D is filed separately from any other returns. 
enacted after they were published, go to IRS.gov/           The credit claimed on Form 5884-D will not affect the tax 
Form5884D.                                                  liability reported on the organization’s employment tax 
                                                            returns. Nevertheless, the organization may reduce its 
General Instructions                                        required deposits for an employment tax period by the 
                                                            amount of its anticipated credit for that employment tax 
Purpose of Form                                             period. The IRS will refund the amount shown on line 12 
A qualified tax-exempt organization (including certain      of Form 5884-D, plus any interest that applies, unless the 
governmental entities) that continued to pay or incur       IRS corrects Form 5884-D during processing or the 
wages after activities of the organization (treated as an   organization owes other taxes, penalties, or interest.
active trade or business for this purpose) became                    The amount properly claimed on Form 5884-D is 
inoperable because of damage from a qualified disaster      TIP      treated as a credit on the first day of the 
may be able to use Form 5884-D to claim the 2020                     organization’s employment tax period. Qualified 
qualified disaster employee retention credit against        tax-exempt organizations eligible to claim this credit can 
certain payroll taxes. This is similar to the credit        reduce their deposits for an employment tax period by the 
businesses claim against income taxes using Form            amount of their anticipated credit for that employment tax 
5884-A. The credit is equal to 40% of up to $6,000 of       period. However, because Form 5884-D may not be 
qualified wages paid to or incurred for each eligible       processed with the organization’s employment tax return, 
employee. The credit is claimed against the employer        an organization that reduces its required deposits in 
portion of social security tax on wages paid to all         anticipation of a Form 5884-D credit may receive a 
employees during an employment tax period. A list of        system-generated notice reflecting a balance due and 
qualified disasters is available at the end of these        associated penalties and interest, if applicable. The 
instructions.                                               balance due, including any related penalties and interest, 
                                                            resulting from the reduction in deposits to reflect the Form 
  The organization files Form 5884-D after it files its     5884-D credit will be abated when the credit is applied. 
employment tax return for the employment tax period for     Such abatement should occur without any action from the 
which it is claiming the credit. The organization begins by organization.
filing Form 5884-D for the first employment tax period in 
which qualified wages were paid to an eligible employee. 
The organization continues to file Form 5884-D for each     Qualified Tax-Exempt Organization
subsequent employment tax period in or for which it paid    A qualified tax-exempt organization is an organization 
additional amounts that affect the cumulative credit. For   described in section 501(c) and exempt from tax under 
each subsequent employment tax period, the organization     section 501(a) if:
figures the cumulative credit for that employment tax       • It conducted activities in a 2020 qualified disaster zone 
period and all previous employment tax periods beginning    at any time during the incident period of the qualified 
with the first employment tax period in which qualified     disaster, and
wages were paid. That amount is adjusted for any credit     • These activities (treated as an active trade or business 
amounts claimed on previously filed Forms 5884-D. The       for this purpose) were inoperable as a result of damage 
organization continues to file Form 5884-D for each         sustained by reason of that qualified disaster at any time 
subsequent employment tax period for which the              during the period beginning on the first day of the incident 
cumulative credit amount changes. The cumulative credit     period of the qualified disaster and ending on December 
amount may change if:                                       27, 2020.
• Additional qualified wages were paid in the subsequent      An agency or instrumentality of the federal government, 
employment tax period,                                      or of a state, local, or Indian tribal government, is not a 
• Additional employment taxes were paid for the             qualified tax-exempt organization unless it is:
subsequent employment tax period that allow the             • A federally chartered corporation described in section 
organization to claim an additional credit amount for       501(c)(1) and exempt from tax under section 501(a);
unused qualified wages paid in an earlier employment tax    • A federal, state, or local college or university; or
period, or                                                  • An entity whose principal purpose or function is 
• Both of the above apply.                                  providing medical or hospital care.

Apr 22, 2021                                          Cat. No. 75323Y

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Eligible Employee                                           Note.        The IRS cannot process Form 5884-D until the 
                                                            original employment tax return filed for the same tax 
An eligible employee is an employee whose principal         period has been processed. Please allow 8 to 12 weeks 
place of employment with the qualified tax-exempt           for the processing of Form 5884-D.
organization immediately before the incident period of the 
qualified disaster was in the 2020 qualified disaster zone.              Form 5884-D must be filed within 2 years from the 
                                                                         date the tax reported on the employment tax 
Qualified Wages                                                 CAUTION! return was paid, or 3 years from the date the 
Qualified wages are wages a qualified tax-exempt            employment tax return was filed, whichever is later.
organization paid to or incurred for eligible employees at 
any time on or after the date the organization’s activities Where To File
(treated as an active trade or business for this purpose)   Send Form 5884-D to the address provided at the bottom 
first became inoperable at the employee’s principal place   of the form.
of employment (determined immediately before the first 
day of the incident period of the qualified disaster) and   More Information
before the earlier of:                                      For more information about this credit, see Public Law 
• The date the organization resumed significant activities  116-260, Division EE, sections 301 and 303(d).
at that place, or
• The date 150 days after the last day of the incident 
period.                                                     Specific Instructions

  Qualified wages include wages paid or incurred            Name and Address
whether an eligible employee performs no services,          If the organization receives its mail in care of a third party 
performs services at a place of employment other than the   (such as an accountant or an attorney), enter on the street 
principal place of employment, or performs services at the  address line “C/O” followed by the third party’s name and 
principal place of employment before significant activities street address or P.O. box.
have resumed.
                                                                A third-party payer who files an aggregate employment 
  Qualified wages do not include any wages that exceed      tax return and is filing Form 5884-D for a qualified 
$6,000 for an eligible employee for an employment tax       tax-exempt organization client claiming the credit should 
period (reduced by the amount of qualified wages            enter the third party’s name, address, and EIN.
credited for any prior employment tax period).
                                                                Include the suite, room, or other unit number after the 
  Wages qualifying for the credit generally have the same   street address. If the Post Office does not deliver mail to 
meaning as wages subject to social security and             the street address and the organization has a P.O. box, 
Medicare taxes. However, qualified wages don't include      enter the box number instead of the street address.
any wages used to claim a coronavirus-related employee 
retention credit on an employment tax return, such as       Line 1
Form 941, Employer's QUARTERLY Federal Tax Return.          If a third-party payer who files an aggregate employment 
When To File                                                tax return is filing Form 5884-D for a qualified tax-exempt 
                                                            organization client claiming the credit, enter the name, 
File Form 5884-D after the organization has filed its       address, and EIN of the qualified tax-exempt organization 
employment tax return for the employment tax period for     (defined earlier) for whom the third-party payer is claiming 
which it is claiming the credit. File Form 5884-D for each  the credit. All information reported on Form 5884-D by a 
employment tax period in or for which the organization      third-party payer for a qualified tax-exempt organization 
paid amounts that affect the cumulative credit as           must relate solely to the organization identified on line 1.
described under Purpose of Form, earlier.
  A qualified tax-exempt organization that files its        Line 2
employment tax return under its own employer                The credit is available only to an organization that is a 
identification number (EIN) (including organizations that   qualified tax-exempt organization. The organization must 
file using a payroll service provider or reporting agent)   be able to check “Yes” on either line 2a or 2b to qualify for 
should file one Form 5884-D for the organization per        the credit.
employment tax period. A third-party payer, such as a 
certified professional employer organization, a             Line 3
non-certified professional employer organization, or an     Column (a).  Enter the DR number of the qualified 
agent under section 3504, who files an aggregate            disaster that resulted in the damage that caused the 
employment tax return and is filing Form 5884-D for a       organization’s activities (treated as an active trade or 
qualified tax-exempt organization claiming the credit       business for this purpose) to become inoperable in a 2020 
should use the third-party’s name and EIN on Form           qualified disaster zone. See 2020 Qualified Disaster 
5884-D and should enter the qualified tax-exempt            Zones, later.
organization’s name, address, and EIN on line 1. A 
                                                            Column (b).  Enter a brief description of the qualified 
third-party payer who files an aggregate employment tax 
                                                            disaster.
return must file a single separate Form 5884-D for each 
qualified tax-exempt organization claiming the credit in an Column (c).  Identify the 2020 qualified disaster zone 
employment tax period.                                      local jurisdiction(s) (county, parish, or municipality) where 

                                                            -2-          Instructions for Form 5884-D (April 2021)

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the organization’s activities (treated as an active trade or Line 10
business for this purpose) became inoperable as a result
of damage sustained from the qualified disaster. Enter the total taxable social security wages and tips
reported on the employment tax return indicated on line 4
More than four disasters. If more than four disaster for the employment tax period indicated on line 5. For
declarations apply, leave columns (a) and (c) blank on the example, taxable social security wages and tips included
fourth row and enter “See attached” in column (b). Attach on Form 941 for wages paid in the 4th quarter of 2020
a list with the information requested in columns (a) were reported on the following lines.
through (c) for each applicable qualified disaster. Include • Form 941, line 5a, column 1 (taxable social security
the name and EIN of the qualified tax-exempt organization wages).
at the top of the attached list. • Form 941, line 5b, column 1 (taxable social security
tips).
Line 5
As discussed earlier under Purpose of Form, the Note. If you filed a corrected return (for example, Form
organization claims this credit against the employer’s 941-X) for the period indicated on line 5, enter the
portion of social security tax on wages paid to all amounts as corrected.
employees during the employment tax period. The
organization files Form 5884-D for each employment tax Line 12
period during which it claims a credit. Each Form 5884-D If your credit is less than $1, we will apply it only if you ask
figures the cumulative credit the organization is entitled to us in writing to do so.
for all periods and reduces the amount claimed for the
period by any amounts claimed on previously filed Forms Line 13
5884-D. You may pay the amount you owe on line 13 electronically
using the Electronic Federal Tax Payment System
Check the box(es) on line 5 to indicate the year (and (EFTPS), by credit or debit card, or by check or money
quarter, if applicable) for the employment tax period for order.
which the organization is claiming the credit. The preferred method of payment is EFTPS. For more
•
Line 6 information, visit IRS.gov/EFTPS; call EFTPS Customer
Service at 800-555-4477 or 800-733-4829 (TDD); or see
Enter on line 6a the total qualified wages (defined earlier) Pub. 966, Electronic Federal Tax Payment System: A
the organization paid in all employment tax periods Guide To Getting Started.
through the end of the employment tax period indicated To pay by credit or debit card, visit the IRS website at
•
on line 5 to eligible employees of the organization. IRS.gov/PayByCard.
Note. For 2019, a qualified tax-exempt organization can • If you pay by check or money order, make it payable to
potentially have qualified wages only in the 4th calendar “United States Treasury.” On your check or money order,
quarter. A quarterly filer cannot claim the employee be sure to write your EIN, “Form 5884-D,” and the year
retention credit for wages paid during any other calendar (and quarter, if applicable) indicated on line 5.
quarter in 2019. Similarly, for 2021, a qualified tax-exempt You do not have to pay if the amount you owe is less
organization can potentially have qualified wages only in than $1.
the 1st and 2nd calendar quarters. A credit claim for any
period after the 1st and 2nd calendar quarters of 2021 Signature
may be made only for amounts of the credit carried Form 5884-D must be signed by the president, vice
forward from previous periods. president, treasurer, assistant treasurer, chief accounting
officer, or other corporate officer (such as a tax officer)
Line 8 authorized to sign. A receiver, trustee, or assignee must
Enter the total amount of credits claimed from line 12 of sign any return filed for the organization. For a trust, the
any previously filed Forms 5884-D minus the total amount authorized trustee must sign.
of credits repaid from line 13 of any previously filed Forms
5884-D. Each Form 5884-D figures the cumulative credit Paid Preparer
the organization is entitled to for all periods. The amount A paid preparer must sign Form 5884-D and provide the
of the cumulative credit reported on line 6b must be information in the Paid Preparer Use Only section if the
reduced by the previously claimed credits and increased preparer was paid to prepare Form 5884-D and is not an
by any previously repaid amounts to determine the credit employee of the filing entity. Paid preparers must sign
claimed for the employment tax period for which Form paper returns with a manual signature. The preparer must
5884-D is filed. 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
that period, any excess credit will be carried identification number (PTIN) in the space provided.
forward and included in the cumulative credit figured on Include your complete address. If you work for a firm,
any subsequent Form 5884-D. The excess credit is not enter the firm’s name and the EIN of the firm. You cannot
included in the amount on line 8. use your PTIN in place of the EIN of the tax preparation
firm.

Instructions for Form 5884-D (April 2021) -3-

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You can apply for a PTIN online or by filing Form W-12,                                have a valid Form 8655, Reporting Agent Authorization, 
IRS Paid Preparer Tax Identification Number (PTIN)                                     on file with the IRS. However, a reporting agent must 
Application and Renewal. For more information about                                    complete this section if the reporting agent offered legal 
applying for a PTIN online, visit the IRS website at                                   advice, for example, advising the client on determining 
IRS.gov/PTIN.                                                                          whether its employees are eligible employees for 
Generally, you are not required to complete this section                               purposes of this credit.
if you are filing Form 5884-D as a reporting agent and 

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 
average time is:

Recordkeeping. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  1hr., 50 min.
Learning about the law or the form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .           10 min.
Preparing and sending the form to the IRS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .               23 min.

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. You can send us comments from IRS.gov/FormComments. Or you can write to the 
Internal Revenue Service, Tax Forms and Publications Division, 1111 Constitution Ave. NW, IR-6526, Washington, DC 
20224. Don’t send Form 5884-D to this address. Instead, send it to the address provided at the bottom of the form.

                                                                                 -4-                               Instructions for Form 5884-D (April 2021)

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2020 Qualified Disaster Zones

The following qualified disasters Florida Hurricane Sally Louisiana Hurricane Zeta
resulted in the designation of the (DR-4564-FL) (DR-4577-LA)
2020 qualified disaster zones. The
The applicable incident period began The applicable incident period began
information needed for credit
on September 14 and ended on on October 26 and ended on
purposes is provided below.
September 28, 2020. The date 150 October 29, 2020. The date 150 days
Alabama Hurricane Sally days after the last day of the incident after the last day of the incident
period was February 25, 2021. period was March 28, 2021.
(DR-4563-AL)
The applicable incident period began Counties in qualified disaster Parishes in qualified disaster
on September 14 and ended on zone. Bay, Escambia, Okaloosa, zone. Jefferson, Lafourche,
September 16, 2020. The date 150 Santa Rosa, and Walton. Orleans, Plaquemines, St. Bernard,
days after the last day of the incident and Terrebonne.
period was February 13, 2021. Iowa Severe Storms
(DR-4557-IA) Michigan Severe Storms and
Counties in qualified disaster Flooding (DR-4547-MI)
The applicable incident period began
zone. Baldwin, Escambia, and
and ended on August 10, 2020. The The applicable incident period began
Mobile.
date 150 days after the last day of on May 16 and ended on May 22,
Alabama Hurricane Zeta the incident period was January 7, 2020. The date 150 days after the
2021. last day of the incident period was
(DR-4573-AL)
October 19, 2020.
The applicable incident period began Counties in qualified disaster
on October 28 and ended on zone. Benton, Boone, Cedar, Counties in qualified disaster
October 29, 2020. The date 150 days Clinton, Jasper, Linn, Marshall, Polk, zone. Arenac, Gladwin, Iosco,
after the last day of the incident Poweshiek, Scott, Story, and Tama. Midland, and Saginaw.
period was March 28, 2021.
Louisiana Hurricane Laura Mississippi Severe Storms,
Counties in qualified disaster (DR-4559-LA) Tornadoes, Straight-Line
zone. Clarke, Dallas, Marengo, Winds, and Flooding
The applicable incident period began
Mobile, Perry, Washington, and
on August 22 and ended on August
Wilcox. (DR-4536-MS)
27, 2020. The date 150 days after The applicable incident period began
California Wildfires the last day of the incident period and ended on April 12, 2020. The
was January 24, 2021.
(DR-4558-CA) date 150 days after the last day of
The applicable incident period began Parishes in qualified disaster the incident period was September 9,
on August 14 and ended on zone. Acadia, Allen, Beauregard, 2020.
September 26, 2020. The date 150 Caddo, Calcasieu, Cameron, Grant, Counties in qualified disaster
days after the last day of the incident Jackson, Jefferson Davis, La Salle, zone. Clarke, Covington, Grenada,
period was February 23, 2021. Lincoln, Morehouse, Natchitoches, Jasper, Jefferson Davis, Jones,
Ouachita, Rapides, Sabine, St. Lawrence, Panola, and Walthall.
Counties in qualified disaster Landry, Union, Vermilion, Vernon,
zone. Butte, Lake, Lassen, and Winn. Mississippi Hurricane Zeta
Mendocino, Monterey, Napa, San
(DR-4576-MS)
Mateo, Santa Clara, Santa Cruz, Louisiana Hurricane Delta
The applicable incident period began
Solano, Sonoma, Stanislaus, Trinity, (DR-4570-LA)
Tulare, and Yolo. on October 28 and ended on
The applicable incident period began October 29, 2020. The date 150 days
California Wildfires on October 6 and ended on October after the last day of the incident
10, 2020. The date 150 days after
(DR-4569-CA) period was March 28, 2021.
the last day of the incident period
The applicable incident period began was March 9, 2021. Counties in qualified disaster
on September 4 and ended on zone. George, Greene, Hancock,
November 17, 2020. The date 150 Parishes in qualified disaster Harrison, Jackson, and Stone.
days after the last day of the incident zone. Acadia, Allen, Beauregard,
period was April 16, 2021. Calcasieu, Cameron, Iberia, Oregon Severe Storms,
Jefferson Davis, Lafayette, Rapides, Flooding, Landslides, and
Counties in qualified disaster St. Landry, St. Martin, and Vermilion.
zone. Fresno, Los Angeles, Madera, Mudslides (DR-4519-OR)
Mendocino, Napa, San Bernardino, The applicable incident period began
San Diego, Shasta, Siskiyou, and on February 5 and ended on
Sonoma. February 9, 2020. The date 150 days

2020 Qualified Disaster Zones -5-

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after the last day of the incident Sebastián, Santa Isabel, Utuado, Tennessee Severe Storms,
period was July 8, 2020. Villalba, and Yauco. Tornadoes, Straight-Line
Counties in qualified disaster Puerto Rico Tropical Storm Winds, and Flooding
zone. Umatilla and Umatilla Indian (DR-4476-TN)
Isaias (DR-4560-PR)
Reservation. The applicable incident period began
The applicable incident period began
Oregon Wildfires and on July 29 and ended on July 31, and ended on March 3, 2020. The
Straight-Line Winds 2020. The date 150 days after the date 150 days after the last day of
(DR-4562-OR) last day of the incident period was the incident period was July 31,
December 28, 2020. 2020.
The applicable incident period began
on September 7 and ended on Municipalities in qualified disas- Counties in qualified disaster
November 3, 2020. The date 150 ter zone. Aguada, Hormigueros, zone. Davidson, Putnam, and
days after the last day of the incident Mayagüez, and Rincón. Wilson.

period was April 2, 2021. Tennessee Severe Storms,
Puerto Rico Severe Storm and
Counties in qualified disaster Flooding (DR-4571-PR) Tornadoes, Straight-Line
zone. Clackamas, Douglas, Winds, and Flooding
Jackson, Klamath, Lane, Lincoln, The applicable incident period began
Linn, and Marion. and ended on September 13, 2020. (DR-4541-TN)
The date 150 days after the last day The applicable incident period began
Puerto Rico Earthquakes of the incident period was February on April 12 and ended on April 13,
(DR-4473-PR) 10, 2021. 2020. The date 150 days after the
last day of the incident period was
The applicable incident period began Municipality in qualified disaster
September 10, 2020.
on December 28, 2019, and ended zone. Arecibo.
on July 3, 2020. The date 150 days Counties in qualified disaster
after the last day of the incident South Carolina Severe Storms, zone. Bradley and Hamilton.
period was November 30, 2020. Tornadoes, and Straight-Line
Winds (DR-4542-SC) Utah Earthquake and
Municipalities in qualified disas- Aftershocks (DR-4548-UT)
ter zone. Adjuntas, Aguada, The applicable incident period began
Añasco, Arecibo, Barceloneta, Cabo on April 12 and ended on April 13, The applicable incident period began
Rojo, Ciales, Coamo, Corozal, 2020. The date 150 days after the on March 18 and ended on April 17,
Guánica, Guayanilla, Hormigueros, last day of the incident period was 2020. The date 150 days after the
Jayuya, Juana Díaz, Lajas, Lares, September 10, 2020. last day of the incident period was
September 14, 2020.
Las Marías, Maricao, Mayagüez, Counties in qualified disaster
Moca, Morovis, Naranjito, Orocovis, zone. Aiken, Barnwell, Berkeley, Counties in qualified disaster
Peñuelas, Ponce, Sabana Grande, Colleton, Hampton, Marlboro, zone. Davis and Salt Lake.
Salinas, San Germán, San Oconee, Orangeburg, and Pickens.

-6- 2020 Qualified Disaster Zones

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