Follow the steps to complete the form effectively.

1. Press the ‘Get Form’ button to access the LA DoR R-10605 and open it in your preferred online editing tool.
2. In Section I, input employer information including your LA Revenue Account Number or SSN, FEIN, date of application, legal name, trade name, and address. Make sure all entries are accurate.
3. Proceed to Section II to provide employee information. Include the employee's name, SSN, address, and city. This section verifies that the deduction is applied for the designated individual.
4. In Section III, you will make a declaration. Confirm that the provided information is true and compliant with relevant laws. Sign, print your name, and date the application for authenticity.
5. Once you submit the form, it will be reviewed by the Department of Health, which will fill out Section IV. This section requires their signature, printed name, and title, as well as confirmation of the employee meeting qualifications.
6. In Section V, provide details regarding employment. Include employment start date, end date, hourly rate of pay, average number of hours worked weekly, position, location of employment, and the disability related to the employee.
7. Finally, Section VI requires you to calculate the total deduction for the tax year. Enter the gross wages for the first four months, apply the 50% calculation, then enter the gross wages for months five through the end of the tax year at a 30% rate. Sum these amounts for the total deduction.
8. Save changes to the form. You can then download, print, or share the completed document as needed. Remember to attach this form to your tax return to claim the deduction.

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