Employer Credit for Paid Family and Medical Leave                                  OMB No. 1545-2282
Form  (Rev. January 2021)8994         ▶ Attach to your tax return. 
                                                                                                                 Attachment   
Department of the Treasury    ▶ Go to www.irs.gov/Form8994 for instructions and the latest information.          Sequence No. 994
Internal Revenue Service  
Name(s) shown on return                                                                                   Identifying number 

A     Do you have a written policy providing for at least 2 weeks of annual paid family and medical leave for your qualifying 
      employee(s) to whom wages are paid (prorated for any part-time employees)? See instructions.
      Yes. 
      No. Stop. Do not file Form 8994 (see instructions for an exception that may apply to a partnership or S corporation).

B     Does the written policy provide paid family and medical leave of at least 50% of the wages normally paid to a qualifying 
      employee? See instructions.
      Yes. 
      No. Stop. Do not file Form 8994 (see instructions for an exception that may apply to a partnership or S corporation).

C     Did you pay family and medical leave to at least one qualifying employee during the tax year? See instructions.
      Yes. 
      No. Stop. Do not file Form 8994 (see instructions for an exception that may apply to a partnership or S corporation).

D     If you employed at least one qualifying employee who was not covered by the Family and Medical Leave Act, did you include
      in your written policy and otherwise comply with “non-interference” language? See instructions.
      Yes. 
      No. Stop. Do not file Form 8994 (see instructions for an exception that may apply to a partnership or S corporation).

1     Enter the total paid family and medical leave credit figured for wages paid during your tax year to your 
      qualifying employee(s) while on family and medical leave (if you use the Paid Family and Medical
      Leave Credit Worksheet, the total from column (d)). See instructions for the adjustment you must 
      make to your deduction for salaries and wages  .      .  . . . . . . . . . . .       . . .        . .     1

2     Employer credit for paid family and medical leave from partnerships and S corporations (see instructions) 2

3     Add lines 1 and 2. Partnerships and S corporations, report this amount on Schedule K. All others, 
      report this amount on Form 3800, Part III, line 4j  . .  . . . . . . . . . . .       . . .        . .     3
For Paperwork Reduction Act Notice, see separate instructions.             Cat. No. 37804G                      Form 8994 (Rev. 1-2021)