Font) 58844 (December 2010) Depelment ol the Treasury Internal Revenue Service New Hire Retention Credit to Attach to your tax return. Use Part II to list additional retained workers. OMB No. 1545-2202 Attachment Sequence No. 65 Name(s) shown on return Identify' g number A credit of up to $1.000 is allowed for each retained worker. A retained worker generally is a qualified employee (see instructions) whose first 52 consecutive weeks of employment ended in the current tax year. However, the workers wages (as defined for income tax withholding purposes) for the second 26 consecutive weeks must equal at least 80% of the worker's wages for the first 26 consecutive weeks. Part I New Hire Retention Credit for Retained Workers Use a separate column for each retained worker. If you need more columns, use Part II and include the totals on line 10. (a) Retained Worker No. 1 (b) Retained Worker No. 2 (c) Retained Worker No. 3 1 2 3 4 5 6 7 8 9 10 11 12 13 Enter the retained worker's social security number . Enter the first date of employment from the retained worker's Form W-11 or similar statement . . . Enter the retained worker's wages for the first 26 consecutive weeks of employment Multiply line 3 by 80% (.80) Enter the retained worker's wages for the second 26 consecutive weeks of employment. If line 4 is larger than this amount, the qualified employee is not a retained worker and should not be listed on this form Add lines 3 and 5 Multiply line 6 by 6.2% (.062) Maximum credit allowable Enter the smaller of line 7 or line 8 Add columns (a) through (c) on line 9 above and columns Parts II Enter the total number of retained workers for whom credit on line 10 (see instructions) New hire retention credit from partnerships and S corporations Current year credit. Add lines 10 and 12. Partnerships and Schedule K: all others, report this amount on the applicable 2010 Form 3800) 8 1.000 00 1.000