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Page 1 of 14 Instructions for Forms 1099-R and 5498 9:50 - 13-MAY-2004

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2004 Department of the Treasury
Internal Revenue Service

Instructions for Forms
1099-R and 5498
Section references are to the Internal Revenue Code unless otherwise noted.

see, Section 457(b) plan distributions on page R-8 for
What’s New for 2004 information on distribution codes.
Nonqualified plans. Report any reportable distributions from
Form 1099-R commercial annuities. Report distributions to plan participants
from nonqualified deferred compensation plans including
Distribution codes. The explanations to distribution Codes 1, nongovernmental section 457(b) plans on Form W-2, not on
2, J, Q, and T have been modified. See Guide to Distribution Form 1099-R. However, report distributions to beneficiaries of
Codes on pages R-9 and R-10. deceased employees on Form 1099-R. See box 1 on
page R-5.
An Item To Note Charitable gift annuities. If cash or capital gain property is
In addition, see the 2004 General Instructions for Forms donated in exchange for a charitable gift annuity, report
1099, 1098, 5498, and W-2G for information on: distributions from the annuity on Form 1099-R. See Charitable
• Backup withholding gift annuities on page R-6.
• Magnetic media and electronic reporting requirements Life insurance, annuity, and endowment contracts. Report
• Penalties payments of matured or redeemed annuity, endowment, and
• Who must file (nominee/middleman) life insurance contracts. However, you do not need to file Form
• When and where to file 1099-R to report the surrender of a life insurance contract if it is
• Taxpayer identification numbers reasonable to believe that none of the payment is includible in
• Statements to recipients the income of the recipient. If you are reporting the surrender of
• Corrected and void returns a life insurance contract, see Code 7 on page R-9.
• Other general topics Also report premiums paid by a trustee or custodian for the
You can get the general instructions from the IRS website at cost of current life or other insurance protection. Costs of
www.irs.gov or call 1-800-TAX-FORM (1-800-829-3676). current life insurance protection are not subject to the 10%
additional tax under section 72(t). See Cost of current life
insurance protection on page R-6.
Specific Instructions for Form 1099-R Section 1035 exchange. A tax-free section 1035 exchange
File Form 1099-R, Distributions From Pensions, Annuities, is the exchange of (a) a life insurance contract for another life
Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, insurance, endowment, or annuity contract, (b) an endowment
etc., for each person to whom you have made a designated contract for an annuity contract or for another endowment
distribution of $10 or more from profit-sharing or retirement contract that provides for regular payments to begin no later
plans, any IRAs, annuities, pensions, insurance contracts, than they would have begun under the old contract, and (c) an
survivor income benefit plans, permanent and total disability annuity contract for another annuity contract. However, the
payments under life insurance contracts, charitable gift distribution of other property or the cancellation of a contract
annuities, etc. loan at the time of the exchange may be taxable and reportable
on a separate Form 1099-R.
Also, report on Form 1099-R death benefit payments made
by employers that are not made as part of a pension, These exchanges of contracts are generally reportable on
profit-sharing, or retirement plan. See box 1 on page R-5. Form 1099-R. However, reporting on Form 1099-R is not
required if (a) the exchange occurs within the same company,
Reportable disability payments made from a retirement plan (b) the exchange is solely a contract for contract exchange, as
must be reported on Form 1099-R. defined above, that does not result in a designated distribution,
Generally, do not report payments subject to withholding of and (c) the company maintains adequate records of the
social security and Medicare taxes on this form. Report such policyholder’s basis in the contracts. For example, a life
payments on Form W-2, Wage and Tax Statement. insurance contract issued by Company X received in exchange
solely for another life insurance contract previously issued by
Do not report amounts totally exempt from tax, such as Company X does not have to be reported on Form 1099-R as
workers’ compensation and Department of Veterans Affairs long as the company maintains the required records. See Rev.
(VA) payments. However, if part of the distribution is taxable Proc. 92-26, 1992-1 C.B. 744.
and part is nontaxable, report the entire distribution.
For more information on reporting taxable exchanges, see
Military retirement annuities. Report payments to military box 1 on page R-5.
retirees or payments of survivor benefit annuities on Form
1099-R. Report military retirement pay awarded as a property IRA Distributions
settlement to a former spouse under the name and taxpayer
identification number (TIN) of the recipient, not that of the For deemed IRAs under section 408(q), use the rules
military retiree. TIP below for traditional IRAs or Roth IRAs as applicable.
Governmental section 457(b) plans. Report on Form 1099-R,
not Form W-2, income tax withholding and distributions from a IRAs other than Roth IRAs. Distributions from any individual
governmental section 457(b) plan maintained by a state or local retirement arrangement (IRA), except a Roth IRA, must be
government employer. Distributions from a governmental reported in boxes 1 and 2a regardless of the amount. You may
section 457(b) plan to a participant or beneficiary include all check the “Taxable amount not determined” box in box 2b. But
amounts that are paid from the plan. See Notice 2003-20, see the instructions for box 2a on page R-6 for how to report
2003-19 I.R.B. 894, 2003-1 C.B. 894, for more information. Also the withdrawal of IRA contributions under section 408(d)(4).

Cat. No. 27987M
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Also see Transfers on page R-3 for information on the distribution of DECs, the other to report the distribution from
trustee-to-trustee transfers, including recharacterizations. The the other part of the plan. Report the distribution of DECs in
direct rollover provisions on this page do not apply to boxes 1 and 2a on the separate Form 1099-R. However, for the
distributions from any IRA. However, taxable distributions from direct rollover (explained below) of funds that include DECs, file
traditional IRAs and SEP IRAs may be rolled over into an only one Form 1099-R to report the direct rollover of the entire
eligible retirement plan. See section 408(d)(3). SIMPLE IRAs amount.
may also be rolled over into an eligible retirement plan, but only
after the 2-year period described in section 72(t)(6). Direct Rollovers
An IRA includes all investments under one IRA plan or You must report a direct rollover of an eligible rollover
account. File only one Form 1099-R for distributions from all distribution. A direct rollover is the direct payment of the
investments under one plan that are paid in 1 year to one distribution from a qualified plan (including a governmental
recipient, unless you must enter different codes in box 7. You section 457(b) plan) or tax-sheltered annuity to a traditional IRA
do not have to file a separate Form 1099-R for each distribution or other eligible retirement plan. A direct rollover may be made
under the plan. for the employee, for the employee’s surviving spouse, or for
the spouse or former spouse who is an alternate payee under a
Roth IRAs. For distributions from a Roth IRA, report the gross qualified domestic relations order (QDRO). If the distribution is
distribution in box 1 but generally leave box 2a blank. Check paid to the surviving spouse, the distribution is treated in the
the “Taxable amount not determined” box in box 2b. Enter Code same manner as if the spouse were the employee.
J, Q, or T as appropriate in box 7. You may enter Code 8 or P
with Code J . For the withdrawal of excess contributions, see An eligible rollover distribution is any distribution of all or
Box 2a on page R-6. It is not necessary to mark the IRA/SEP/ any portion of the balance to the credit of the employee
SIMPLE checkbox. (including net unrealized appreciation (NUA)) from a qualified
plan (including a governmental section 457(b) plan) or a
Roth IRA conversions. You must report an IRA that is tax-sheltered annuity except:
converted or reconverted this year to a Roth IRA in boxes 1 and
2a, even if the conversion is a trustee-to-trustee transfer or is 1. One of a series of substantially equal periodic payments
with the same trustee. Enter Code 2 or 7 in box 7 depending on made at least annually over:
the participant’s age. a. The life of the employee or the joint lives of the employee
Conduit IRAs. If you know the distribution is from a conduit and the employee’s designated beneficiary,
IRA, follow these rules. If a distribution from a conduit IRA is b. The life expectancy of the employee or the joint life and
paid to the participant, report the full amount in boxes 1 and 2a, last survivor expectancy of the employee and the employee’s
and use Code 1 or 7 in box 7 depending on the participant’s designated beneficiary, or
age. If a distribution from a conduit IRA is paid to the trustee of, c. A specified period of 10 years or more.
or is transferred to, an employer plan, report the distribution in 2. A required minimum distribution (under section
box 1, enter 0 (zero) in box 2a, and use Code G in box 7. 401(a)(9)). A plan administrator is permitted to assume there is
no designated beneficiary for purposes of determining the
IRA Revocation minimum distribution.
If a traditional or Roth IRA is revoked during its first 7 days 3. Elective deferrals (under section 402(g)(3)) and earnings
(under Regulations section 1.408-6(d)(4)(ii)), the distribution returned because of the section 415 limits.
from the IRA must be reported. In addition, Form 5498, IRA 4. Corrective distributions of excess deferrals (under section
Contribution Information, must be filed to report any regular, 402(g)) and earnings.
rollover, Roth IRA conversion, SEP IRA, or SIMPLE IRA 5. Corrective distributions of excess contributions under a
contribution to an IRA that is revoked. qualified cash or deferred arrangement (under section 401(k))
If a regular contribution is made to a traditional or Roth and excess aggregate contributions (under section 401(m)) and
IRA that later is revoked, and distribution is made to the earnings.
taxpayer, enter the gross distribution in box 1. If no earnings are 6. Loans treated as deemed distributions (under section
distributed, enter 0 (zero) in box 2a and Code 8 in box 7 for a 72(p)). But plan loan offset amounts can be eligible rollover
traditional IRA and Code 8 with Code J for a Roth IRA. If distributions. See Regulations section 1.402(c)-2, Q/A-9.
earnings are distributed, enter the amount of earnings in box 7. Section 404(k) dividends.
2a. For a traditional IRA, enter Code 1 in box 7; for a Roth IRA, 8. Cost of current life insurance protection.
enter Code J. These earnings could be subject to the 10% early 9. Distributions to a payee other than the employee, the
distribution tax under section 72(t). If a rollover contribution is employee’s surviving spouse, or a spouse or former spouse
made to a traditional or Roth IRA that later is revoked, and who is an alternate payee under a QDRO.
distribution is made to the taxpayer, enter in boxes 1 and 2a of 10. Any hardship distribution.
Form 1099-R the gross distribution and the appropriate code in Amounts paid under an annuity contract purchased for and
box 7 (Code J for a Roth IRA). Follow this same procedure for a distributed to a participant under a qualified plan can qualify as
transfer from a traditional or Roth IRA to another IRA of the eligible rollover distributions. See Regulations section
same type that later is revoked. The distribution could be 1.402(c)-2, Q/A-10.
subject to the 10% early distribution tax under section 72(t).
Any part of an eligible rollover distribution that is not a direct
If an IRA conversion contribution is made to a Roth IRA rollover is subject to 20% income tax withholding. See Box 4 on
that later is revoked, and distribution is made to the taxpayer, page R-7.
enter the gross distribution in box 1 of Form 1099-R. If no
earnings are distributed, enter 0 (zero) in box 2a and Code J in Reporting a direct rollover. Report a direct rollover in box 1
box 7. If earnings are distributed, enter the amount of the and a 0 (zero) in box 2a. You do not have to report capital gain
earnings in box 2a and Code J in box 7. These earnings could in box 3 or NUA in box 6. Enter Code G in box 7. Prepare the
be subject to the 10% early distribution tax under section 72(t). form using the name and social security number (SSN) of the
person for whose benefit the funds were rolled over (generally
If an employer SEP (simplified employee pension) IRA or the participant), not those of the trustee of the traditional IRA or
SIMPLE (savings incentive match plan for employees) IRA plan other plan to which the funds were rolled.
contribution is made and the SEP IRA or SIMPLE IRA is
revoked by the employee, report the distribution as fully taxable. Also, use Code G with Code 4 for a surviving spouse
For more information on IRAs that have been revoked, see TIP who elects a direct rollover to an IRA or a qualified plan.
Rev. Proc. 91-70, 1991-2 C.B. 899. Prepare the form using the name and SSN of the
surviving spouse.
Deductible Voluntary Employee Contributions If you receive a direct rollover to an IRA, you must prepare
(DECs) Form 5498. If you receive a direct rollover to a qualified plan
If you are reporting a total distribution from a plan that includes (including a governmental section 457(b) plan) or tax-sheltered
a distribution of DECs, file two Forms 1099-R — one to report annuity, no report is required.

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If part of the distribution is a direct rollover and part is check the IRA/SEP/SIMPLE checkbox. For more information,
distributed to the recipient, prepare two Forms 1099-R. see Notice 2000-30, 2000-1 C.B. 1266.
For more information on eligible rollover distributions, Roth IRA conversions. A Roth IRA conversion is not
including substantially equal periodic payments, required considered a trustee-to-trustee transfer. You must report a Roth
minimum distributions, and plan loan offset amounts, see IRA conversion or reconversion as a distribution. Therefore, for
Regulations sections 1.402(c)-2 and 1.403(b)-2. Also, see Rev. an IRA that is converted to a Roth IRA, even with the same
Rul. 2002-62, 2002-42 I.R.B. 710, 2002-2 C.B. 710, for trustee, you must report the amount converted in boxes 1 and
guidance on substantially equal periodic payments that began 2a. Use Code 2 or 7 in box 7 depending on the participant’s
after December 31, 2002. age.
SIMPLE IRAs. Do not report a trustee-to-trustee transfer from
For information on distributions of amounts attributable one SIMPLE IRA to another SIMPLE IRA. However, you must
TIP to rollover contributions separately accounted for by an report as a taxable distribution in boxes 1 and 2a a
eligible retirement plan, see Rev. Rul. 2004-12, 2004-7 trustee-to-trustee transfer from a SIMPLE IRA to an IRA that is
I.R.B. 478. not a SIMPLE IRA during the 2-year period beginning on the
Explanation to Recipients Before Eligible day contributions are first deposited in the individual’s SIMPLE
Rollover Distributions (Section 402(f) Notice) IRA by the employer. Use Code S in box 7 if appropriate.
For qualified plans, tax-sheltered annuities, and governmental Section 1035 exchange. You may have to report exchanges
section 457(b) plans, no more than 90 days and no fewer than of insurance contracts, including an exchange under section
30 days before making an eligible rollover distribution (or before 1035, under which any designated distribution may be made.
the annuity starting date), the plan administrator must provide a For a section 1035 exchange that is in part taxable, file a
written explanation to each recipient (section 402(f) notice). separate Form 1099-R to report the taxable amount. See
However, if the recipient who has received the section 402(f) Section 1035 exchange on page R-1.
notice affirmatively elects a distribution, you will not fail to Transfer of an IRA to spouse. If you transfer an interest in an
satisfy the timing requirements merely because you make the IRA from one spouse to another spouse under a divorce or
distribution fewer than 30 days after you provided the notice as separation instrument, the transfer is tax free. Do not report
long as you meet the requirements of Regulations section such a transfer on Form 1099-R.
1.402(f)-1, Q/A-2. You may provide the 402(f) notice more than Corrective Distributions
90 days before a distribution if you also provide a summary of
the notice during the 90-day/30-day period before the You must report on Form 1099-R corrective distributions of
distribution. excess deferrals, excess contributions and excess aggregate
contributions under section 401(a) plans, section 401(k) cash or
The notice must explain the rollover rules, the special tax deferred arrangements, section 403(a) annuity plans, section
treatment for lump-sum distributions, the direct rollover option 403(b) salary reduction agreements, and salary reduction
(and any default procedures), the mandatory 20% withholding simplified employee pensions (SARSEPs) under section
rules, and an explanation of how distributions from the plan to 408(k)(6). Excess contributions that are recharacterized under a
which the rollover is made may have different restrictions and section 401(k) plan are treated as distributed. Corrective
tax consequences than the plan from which the rollover is distributions of an excess plus earnings are reportable on Form
made. The notice and summary are permitted to be sent either 1099-R for the year of the distribution regardless of when the
as a written paper document or through an electronic medium distribution is taxable to the participant. Enter Code 8, P, or in
reasonably accessible to the recipient; see Regulations section some cases D, in box 7 to designate the distribution and the
1.402(f)-1, Q/A-5. year it is taxable.
For periodic payments that are eligible rollover distributions, The total amount of the elective deferral is reported in
you must provide the notice before the first payment and at TIP Box 12 of Form W-2. See the Instructions for Forms
least once a year as long as the payments continue. For W-2 and W-3 for more information.
tax-sheltered annuities, the payer must provide an explanation
of the direct rollover option within the time period described If the excess and the earnings are taxable in two different
above or some other reasonable period of time. years, you must issue two Forms 1099-R to designate the year
Notice 2002-3, 2002-2 I.R.B. 289, 2002-1 C.B. 289, contains each is taxable.
model notices that the plan administrator can use to satisfy the You must advise the plan participant at the time of the
notice requirements. distribution of the year(s) in which the distribution is taxable and
that it may be necessary to file an amended return for a prior
Transfers tax year.
Generally, do not report transfers between trustees or issuers For more information about reporting corrective distributions
(unless they are direct rollovers from qualified plans) that see: the Guide to Distribution Codes on pages R-9 and R-10;
involve no payment or distribution of funds to the participant, Notice 89-32, 1989-1 C.B. 671; Notice 88-33, 1988-1 C.B. 513;
including a trustee-to-trustee transfer from one IRA to another Notice 87-77, 1987-2 C.B. 385; Rev. Proc. 91-44, 1991-2 C.B.
(unless they are recharacterized IRA contributions or Roth IRA 733 (SARSEPs); and the Regulations under sections 401(k),
conversions) or from one tax-sheltered (section 403(b)) 401(m), 402(g), and 457.
arrangement to another. Excess deferrals. Excess deferrals under section 402(g) can
IRA recharacterizations. You must report each occur in 401(k) plans, 403(b) plans, or SARSEPs. If distributed
recharacterization of an IRA contribution. If a participant makes by April 15 of the year following the year of deferral, the excess
a contribution to an IRA (first IRA) for a year, the participant is taxable to the participant in the year of deferral, but the
may choose to recharacterize the contribution by transferring, in earnings are taxable in the year distributed. Except for a
a trustee-to-trustee transfer, any part of the contribution (plus SARSEP, if the distribution occurs after April 15, the excess is
earnings) to another IRA (second IRA). The contribution is taxable in the year of deferral and the year distributed. The
treated as made to the second IRA (recharacterization). A earnings are taxable in the year distributed. For a SARSEP,
recharacterization may be made with the same trustee or with excess deferrals not withdrawn by April 15 are considered
another trustee. The trustee of the first IRA must report the regular IRA contributions subject to the IRA contribution limits.
recharacterization as a distribution on Form 1099-R and the Corrective distributions of excess deferrals are not subject to
contribution to the first IRA and its character on Form 5498. Federal income tax withholding or social security and Medicare
Enter the fair market value (FMV) of the amount taxes. For losses on excess deferrals, see Losses on page
recharacterized in box 1, 0 (zero) in box 2a, and Code R in box R-4. See the regulations under section 457 for special rules for
7 if reporting a recharacterization of a prior-year (2003) excess deferrals under governmental section 457(b) plans.
contribution or Code N if reporting a recharacterization of a Excess contributions. Excess contributions can occur in a
contribution in the same year (2004). It is not necessary to 401(k) plan or a SARSEP. For a 401(k) plan, if the withdrawal

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of the excess plus earnings occurs within 21/2 months after the under section 3405. They are not subject to social security,
close of the plan year, the excess and earnings are taxable to Medicare, or Federal Unemployment Tax Act (FUTA) taxes. In
the participant in the year deferred. But if the corrective addition, such distributions are not subject to the 10% early
distribution is made after the 21/2-month period, or the excess distribution tax under section 72(t).
contribution (not including earnings) (and excess aggregate You may report the distribution of elective deferrals and
contributions (not including earnings) in the case of a 401(k) employee contributions (and gains attributable to such elective
plan) is less than $100 (de minimus rule), the excess and deferrals and employee contributions) on the same Form
earnings are taxable in the year distributed. For recharacterized 1099-R. However, if you made other distributions during the
excess contributions, the excess is taxable in the year a year, report them on a separate Form 1099-R. Because the
corrective distribution would have occurred. No earnings are distribution of elective deferrals is fully taxable in the year
allocated to recharacterized amounts. For a SARSEP, the distributed (no part of the distribution is a return of the
employer must notify the participant by March 15 of the year investment in the contract), report the total amount of the
after the year the excess contribution was made that the distribution in boxes 1 and 2a. Leave box 5 blank, and enter
participant must withdraw the excess and earnings. The excess Code E in box 7. For a return of employee contributions plus
contribution is taxable to the participant in the year of deferral gains, enter the gross distribution in box 1, the gains
and the earnings are taxable in the year withdrawn. If the attributable to the employee contributions being returned in box
excess contribution (not including earnings) is less than $100, 2a, and the employee contributions being returned in box 5.
the excess is taxable in the year of notification and the earnings Enter Code E in box 7. For more information, see Rev. Proc.
are taxable in the year withdrawn. An excess contribution not 92-93, 1992-2 C.B. 505.
withdrawn by April 15 of the year after the year of notification is
considered a regular IRA contribution subject to the IRA Certain Excess Amounts Under 403(b) Plans
contribution limits. A corrective distribution under the Employee Plans Compliance
Excess contributions distributed within the 21/2-month period Resolution System to the participant of contributions to a 403(b)
are not subject to Federal income tax withholding or social plan (plus gains attributable to such contributions) that were in
security and Medicare taxes. But amounts distributed from a excess of the limits under section 415 or section 403(b)(2) (the
401(k) plan after the 21/2-month period are subject to Federal exclusion allowance limit) is treated the same as corrective
income tax withholding under section 3405. distributions of elective deferrals to satisfy the limits under
Excess aggregate contributions. Excess aggregate section 415. It is taxable to the participant in the year of
contributions under section 401(m) can occur in 401(a), 401(k), distribution. See Excess Annual Additions Under
403(a), and 403(b) plans. A corrective distribution of excess Section 415 above.
aggregate contributions plus earnings within 21/2 months after Failing the ADP or ACP Test After a Total
the close of the plan year is taxable to the participant in the year
the contributions were made. A corrective distribution made
Distribution
after the 21/2-month period is taxable in the year distributed. If you make a total distribution in 2004 and file a Form 1099-R
Report the gross distribution in box 1 of Form 1099-R. In box with the IRS and then discover in 2005 that the plan failed
2a, enter the excess and earnings distributed less any after-tax either the section 401(k)(3) actual deferral percentage (ADP)
contributions. If the total excess contributions and excess test for 2004 and you compute excess contributions or the
aggregate contributions distributed are less than $100 section 401(m)(2) actual contribution percentage (ACP) test
(excluding earnings), the distribution is taxable in the year of and you compute excess aggregate contributions, you must
distribution. recharacterize part of the total distribution as excess
contributions or excess aggregate contributions. First, file a
A distribution made within 21/2 months after the close of the CORRECTED Form 1099-R for 2004 for the correct amount of
plan year is not subject to Federal income tax withholding or the total distribution (not including the amount recharacterized
social security and Medicare taxes. But amounts distributed as excess contributions or excess aggregate contributions).
after 21/2 months are subject to Federal income tax withholding Second, file a new Form 1099-R for 2004 for the excess
under section 3405. contributions or excess aggregate contributions and allocable
Losses. If a corrective distribution of an excess deferral is earnings.
made in a year after the year of deferral and a net loss has To avoid a late filing penalty if the new Form 1099-R is filed
been allocated to the excess deferral, report the corrective after the due date, enter in the bottom margin of Form 1096,
distribution amount in boxes 1 and 2a of Form 1099-R for the Annual Summary and Transmittal of U.S. Information Returns,
year of the distribution with the appropriate distribution code in the words “Filed To Correct Excess Contributions.”
box 7. However, taxpayers must include the total amount of the
excess deferral (unadjusted for loss) in income in the year of You must also issue copies of the Forms 1099-R to the plan
deferral, and they may report a loss on the tax return for the participant with an explanation of why these new forms are
year the corrective distribution is made. Therefore, if there are being issued.
no employer securities distributed, show the actual cash and/or
FMV of property distributed in boxes 1 and 2a, and make no Loans Treated as Distributions
entry in box 5. If only employer securities are distributed, show A loan from a qualified plan under sections 401 and 403(a) and
the FMV of the securities in boxes 1 and 2a and make no entry (b), and a plan maintained by the United States, a state or
in box 5 or 6. If both employer securities and other property are political subdivision, or any of its subsidiary agencies made to a
distributed, show the actual cash and/or FMV of the property participant or beneficiary is not treated as a distribution from
distributed in box 1, the gross less any NUA on employer the plan if the loan satisfies the following requirements:
securities in box 2a, no entry in box 5, and any NUA in box 6. 1. The loan is evidenced by an enforceable agreement,
2. The agreement specifies that the loan must be repaid
Excess Annual Additions Under Section 415 within 5 years, except for a principal residence,
You must report on Form 1099-R distributions made under 3. The loan must be repaid in substantially level installments
Regulations section 1.415-6(b)(6)(iv) of elective deferrals or a (at least quarterly), and
return of employee contributions (and gains attributable to such 4. The loan amount does not exceed the limits in section
elective deferrals or employee contributions) to reduce excess 72(p)(2)(A) (maximum limit is equal to the lesser of 50% of the
annual additions arising from the allocation of forfeitures, a vested account balance or $50,000).
reasonable error in estimating a participant’s compensation, or
a reasonable error in determining the amount of elective Certain exceptions, cure periods, and suspension of the
deferrals that may be made for an individual under the limits of repayment schedule may apply.
section 415. The loan agreement must specify the amount of the loan, the
Such distributions are not eligible rollover distributions term of the loan, and the repayment schedule. The agreement
although they are subject to Federal income tax withholding may include more than one document.
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If a loan fails to satisfy 1, 2, or 3, the balance of the loan is a amount paid to the beneficiary whose name appears on the
deemed distribution. The distribution may occur at the time the Form 1099-R, and enter the percentage in box 9a, if applicable.
loan is made or later if the loan is not repaid in accordance with
the repayment schedule. Alternate Payee Under a Qualified Domestic
If a loan fails to satisfy 4 at the time the loan is made, the
Relations Order (QDRO)
amount that exceeds the amount permitted to be loaned is a Distributions to an alternate payee who is a spouse or former
deemed distribution. spouse of the employee under a QDRO are reportable on Form
1099-R using the name and TIN of the alternate payee. If the
Deemed distribution. If a loan is treated as a deemed
alternate payee under a QDRO is a non-spouse, enter the
distribution, it is reportable on Form 1099-R using the normal
name and TIN of the employee. However, see Transfer of an
taxation rules of section 72, including tax basis rules. The
IRA to spouse on page R-3.
distribution also may be subject to the 10% early distribution tax
under section 72(t). It is not eligible to be rolled over to an Nonresident Aliens
eligible retirement plan nor is it eligible for the 10-year tax If income tax is withheld under section 3405 on a distribution to
option. On Form 1099-R, complete the appropriate boxes, a nonresident alien, report the distribution and withholding on
including boxes 1 and 2a, and enter Code L in box 7. Also, Form 1099-R. Also file Form 945 to report the withholding. See
enter Code 1, if applicable. the Presumption Rules in part O of the 2004 General
Interest that accrues after the deemed distribution of a loan Instructions for Forms 1099, 1098, 5498, and W-2G.
is not an additional loan, and, therefore, is not reportable on However, any payments to a nonresident alien from any trust
Form 1099-R. under section 401(a), any annuity plan under 403(a), or any
Loans that are treated as deemed distributions or that are annuity, custodial account, or retirement income account under
actual distributions are subject to Federal income tax 403(b) are subject to withholding under section 1441. Report
withholding. If a distribution occurs after the loan is made, you the distribution and withholding on Form 1042, Annual
must withhold only if you distributed cash or property (other Withholding Tax Return for U.S. Source Income of Foreign
than employer securities) at the time of the deemed or actual Persons, and Form 1042-S, Foreign Person’s U.S. Source
distribution. See section 72(p), 72(e)(4)(A), and Regulations Income Subject to Withholding.
section 1.72(p)-1.
Subsequent repayments. If a participant makes any cash Statements to Recipients
repayments on a loan that was reported on Form 1099-R as a If you are required to file Form 1099-R, you must furnish a
deemed distribution, the repayments increase the participant’s statement to the recipient. For more information about the
tax basis in the plan as if the repayments were after-tax requirement to furnish a statement to each recipient, see part H
contributions. However, such repayments are not treated as in the 2004 General Instructions for Forms 1099, 1098, 5498,
after-tax contributions for purposes of section 401(m) or and W-2G.
415(c)(2)(B). Do not enter a negative amount in any box on Form
For a deemed distribution that was reported on Form 1099-R TIP 1099-R.
but was not repaid, the deemed distribution does not increase
the participant’s basis.
If a participant’s accrued benefit is reduced (offset) to repay Box 1. Gross Distribution
a loan, the amount of the account balance that is offset against Enter the total amount of the distribution before income tax
the loan is an actual distribution. Report it as you would any or other deductions were withheld. Include direct rollovers, IRA
other actual distribution. Do not enter Code L in box 7. rollovers to accepting employer plans, premiums paid by a
trustee or custodian for the cost of current life or other
Missing Participants insurance protection, and the gross amount of any IRA
The IRS administers a letter-forwarding program that could help distribution, including a recharacterization and a Roth IRA
plan administrators contact missing retirement plan participants conversion. Also include in this box distributions to plan
(or possibly their beneficiaries). To inform individuals of their participants from governmental section 457(b) plans.
rights to benefits under a retirement plan, the IRS will forward However, in the case of a distribution by a trust representing
letters from plan administrators to the missing individuals if the CDs redeemed early, report the net amount distributed. Also,
administrators provide the names and social security numbers see Box 6 on page R-8.
(SSNs) of the missing individuals. However, the IRS cannot Include in this box the value of U.S. Savings Bonds
disclose individuals’ addresses or give confirmation of letter distributed from a plan. Enter the appropriate taxable amount in
delivery. All undelivered letters will be destroyed. For further box 2a. Furnish a statement to the plan participant showing the
information, see Rev. Proc. 94-22, 1994-1 C.B. 608, or contact value of each bond at the time of distribution. This will provide
your IRS office. him or her with the information necessary to figure the interest
Corrected Form 1099-R income on each bond when it is redeemed.
If you filed a Form 1099-R with the IRS and later discover that Include in box 1 amounts distributed from a qualified
there is an error on it, you must correct it as soon as possible. retirement plan for which the recipient elects to pay health
For example, if you transmit a direct rollover and file a Form insurance premiums under a cafeteria plan or that are paid
1099-R with the IRS reporting that none of the direct rollover is directly to reimburse medical care expenses incurred by the
taxable by entering 0 (zero) in box 2a, and you then discover recipient (see Rev. Rul. 2003-62, 2003-25 I.R.B. 1034). Also
that part of the direct rollover consists of required minimum include this amount in box 2a.
distributions under section 401(a)(9), you must file a corrected In addition to reporting distributions to beneficiaries of
Form 1099-R. See part I in the 2004 General Instructions for deceased employees, report here any death benefit payments
Forms 1099, 1098, 5498, and W-2G. made by employers that are not made as part of a pension,
Filer profit-sharing, or retirement plan. Also enter these amounts in
box 2a; enter Code 4 in box 7.
The payer, trustee, or plan administrator must file Form 1099-R
using the same name and employer identification number (EIN) Do not report accelerated death benefits on Form
used to deposit any tax withheld and to file Form 945, Annual
Return of Withheld Federal Income Tax.
!
CAUTION
1099-R. Report them on Form 1099-LTC, Long-Term
Care and Accelerated Death Benefits.
Beneficiaries For section 1035 exchanges that are reportable on Form
If you make a distribution to a beneficiary, trust, or estate, 1099-R, enter the total value of the contract in box 1, 0 (zero) in
prepare Form 1099-R using the name and TIN of the box 2a, the total premiums paid in box 5, and Code 6 in box 7.
beneficiary, trust, or estate, not that of the decedent. If there are Employer securities and other property. If you distribute
multiple beneficiaries, report on each Form 1099-R only the employer securities or other property, include in box 1 the FMV
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of the securities or other property on the date of distribution. If only the earnings in box 2a, and enter Code 8 or P, whichever
there is a loss, see Losses on page R-6. is applicable, in box 7. Enter Code 1 or 4, if applicable.
If you are distributing worthless property only, you are not For a distribution of contributions without earnings after the
required to file Form 1099-R. However, you may file and enter 0 due date of the individual’s return, under section 408(d)(5),
(zero) in boxes 1 and 2a and any after-tax employee enter 0 (zero). Use Code 1 or 7 in box 7 depending on the age
contributions in box 5. of the participant. For a traditional IRA and a SEP IRA rolled
Charitable gift annuities. If cash or capital gain property is over to an accepting employer plan, enter the gross amount in
donated in exchange for a charitable gift annuity, report the total box 1, 0 (zero) in box 2a, and Code G in box 7.
amount distributed during the year in box 1. See Charitable gift SIMPLE IRA. Enter the total amount distributed from a SIMPLE
annuities under box 3, below. IRA in box 2a. For a SIMPLE IRA rolled over to an accepting
employer plan after the 2-year period (see section 72(t)(6)),
Box 2a. Taxable Amount enter the gross amount in box 1, 0 (zero) in box 2a, and Code
Generally, you must enter the taxable amount in box 2a. G in box 7.
However, if you are unable to reasonably obtain the data Roth IRA. For a distribution from a Roth IRA, report the total
needed to compute the taxable amount, leave this box blank. distribution in box 1 and leave box 2a blank except in the case
Do not enter excludable or tax-deferred amounts reportable in of an IRA revocation (see page R-2) and a recharacterization
boxes 5, 6, and 8. (see page R-3). Use Code J, Q, or T as appropriate in box 7.
For a direct rollover from a qualified plan (including a Use Code 8 or P, if applicable, in box 7 with Code J. Do not
governmental section 457(b) plan) or tax-sheltered annuity, for combine Codes Q or T with any other codes.
a distribution from a conduit IRA that is payable to the trustee of However, for the distribution of excess Roth IRA
or is transferred to an employer plan, for an IRA contributions, report the gross distribution in box 1 and only the
recharacterization, or for a nontaxable section 1035 exchange earnings in box 2a. Enter Code J, and Code 8 or P in box 7.
of life insurance, annuity, or endowment contracts, enter 0 Roth IRA conversion. Report the total amount converted or
(zero) in box 2a. reconverted from a traditional IRA, SEP IRA, or SIMPLE IRA to
Cost of current life insurance protection. Include current life a Roth IRA in boxes 1 and 2a. A conversion or reconversion is
insurance protection costs (net premium costs) that were considered a distribution and must be reported even if it is with
reported in box 1. However, do not report these costs and a the same trustee and even if the conversion is done by a
distribution on the same Form 1099-R. Use a separate Form trustee-to-trustee transfer. For a Roth IRA conversion, use
1099-R for each. For the cost of current life insurance Code 2 in box 7 if the participant is under age 591/2 or Code 7 if
protection, enter Code 9 in box 7. See Regulations section the participant is at least age 591/2. Also check the IRA/SEP/
1.72-16(b) and Notice 2002-8, 2002-4 I.R.B. 398, 2002-1 C.B. SIMPLE box in box 7.
398, for information on the cost of premiums paid by an Losses. If a distribution is a loss, do not enter a negative
employees’ trust under a qualified plan for current life insurance amount in this box. For example, if stock is distributed from a
protection taxable to plan participants or their beneficiaries. profit-sharing plan but the value is less than the employee’s
Certain transition rules in Notice 2002-8 regarding after-tax contributions, enter the value of the stock in box 1,
leave box 2a blank, and enter the employee’s contributions in
!
CAUTION
split-dollar arrangements expired on December 31,
2003. Also, see Rev. Rul. 2003-105, 2003-40 I.R.B. 696. box 5.
For a plan with no after-tax contributions, even though the
DECs. Include DEC distributions in this box. Also see value of the account may have decreased, there is no loss for
Deductible Voluntary Employee Contributions (DECs) on reporting purposes. Therefore, if there are no employer
page R-2. securities distributed, show the actual cash and/or FMV of
Annuity starting date in 1998 or later. If you made annuity property distributed in boxes 1 and 2a, and make no entry in
payments from a qualified plan (under section 401(a), 403(a), or box 5. If only employer securities are distributed, show the FMV
403(b)) and the annuity starting date is in 1998 or later, you of the securities in boxes 1 and 2a and make no entry in box 5
must use the simplified method (under section 72(d)(1)) to or 6. If both employer securities and cash or other property are
figure the taxable amount. Under this method, the expected distributed, show the actual cash and/or FMV of the property
number of payments you use to figure the taxable amount (including employer securities) distributed in box 1, the gross
depends on whether the payments are based on the life of one less any NUA on employer securities in box 2a, no entry in box
or more than one person. See Notice 98-2, 1998-1 C.B. 266, 5, and any NUA in box 6.
and Pub. 575, Pension and Annuity Income, to help you figure Corrective distributions. Enter in box 2a the amount of
the taxable amount to enter in box 2a. excess deferrals, excess contributions, or excess aggregate
Annuity starting date after November 18, 1996, and before contributions (other than employee contributions). See
1998. Under the simplified method for figuring the taxable Corrective Distributions on page R-3.
amount, the expected number of payments is based only on the Box 2b. Taxable Amount not Determined
primary annuitant’s age on the annuity starting date. See
Notice 98-2. Enter an “X” in this box only if you are unable to reasonably
obtain the data needed to compute the taxable amount. If you
Annuity starting date before November 19, 1996. If you check this box, leave box 2a blank unless you are reporting a
properly used the rules in effect before November 19, 1996, for traditional IRA, SEP IRA, or SIMPLE IRA distribution. Except for
annuities that started before that date, continue to report using IRAs, make every effort to compute the taxable amount.
those rules. No changes are necessary. However, see IRA Revocation on page R-2 and Corrective
Traditional IRA or SEP IRA. Generally, you are not required Distributions on page R-3.
to compute the taxable amount of a traditional IRA or SEP IRA
nor designate whether any part of a distribution is a return of
Box 2b. Total Distribution
basis attributable to nondeductible contributions. Therefore, Enter an “X” in this box only if the payment shown in box 1 is a
report the total amount distributed from a traditional IRA or SEP total distribution. A total distribution is one or more distributions
IRA in box 2a. This will be the same amount reported in box 1. within 1 tax year in which the entire balance of the account is
Check the “Taxable amount not determined” box in box 2b. distributed. If periodic or installment payments are made, mark
this box in the year the final payment is made.
However, for a distribution by a trust representing CDs
redeemed early, report the net amount distributed. Do not Box 3. Capital Gain (Included in Box 2a)
include any amount paid for IRA insurance protection in this If any amount is taxable as a capital gain, report it in box 3.
box. Charitable gift annuities. Report in box 3 any amount from a
For a distribution of contributions plus earnings from an IRA charitable gift annuity that is taxable as a capital gain. Report in
under section 408(d)(4), report the gross distribution in box 1, box 1 the total amount distributed during the year. Report in box

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2a the taxable amount. Advise the annuity recipient of any To determine your withholding requirements for any
amount in box 3 subject to the 28% rate gain for collectibles designated distribution under section 3405, you must first
and any unrecaptured section 1250 gain. Report in box 5 any determine whether the distribution is an eligible rollover
nontaxable amount. Enter Code F in box 7. See Regulations distribution. See Direct Rollovers on page R-2 for a discussion
section 1.1011-2(c), Example 8. of eligible rollover distributions. If the distribution is not an
Special rule for participants born before January 2, 1936 eligible rollover distribution, the rules for periodic payments or
(or their beneficiaries). For lump-sum distributions from nonperiodic distributions apply. For purposes of withholding,
qualified plans only, enter the amount in box 2a eligible for the distributions from any IRA are not eligible rollover distributions.
capital gain election under section 1122(h)(3) of the Tax Eligible rollover distribution; 20% withholding. If an eligible
Reform Act of 1986, 1986-3 (Vol. 1) C.B. 1, 387 and section rollover distribution is paid directly to an eligible retirement plan
641(f)(3) of the Economic Growth and Tax Relief Reconciliation in a direct rollover, do not withhold Federal income tax. If any
Act of 2001. Enter the full amount eligible for the capital gain part of an eligible rollover distribution is not a direct rollover, you
election. You should not complete this box for a direct rollover. must withhold 20% of the part that is paid to the recipient. The
To compute the months of an employee’s active participation recipient cannot claim exemption from the 20% withholding but
before 1974, count as 12 months any part of a calendar year in may ask to have additional amounts withheld on Form W-4P,
which an employee actively participated under the plan; for Withholding Certificate for Pension or Annuity Payments. If the
active participation after 1973, count as 1 month any part of a recipient is not asking that additional amounts be withheld,
month in which the employee actively participated under the Form W-4P is not required for an eligible rollover distribution
plan. See the Example below. because 20% withholding is mandatory.
Active participation begins with the first month in which an Employer securities and plan loan offset amounts that are
employee became a participant under the plan and ends with part of an eligible rollover distribution must be included in the
the earliest of: amount multiplied by 20%. However, the actual amount to be
• The month in which the employee received a lump-sum withheld cannot be more than the sum of the cash and the FMV
distribution under the plan; of property (excluding employer securities and plan loan offset
• For an employee, other than a self-employed person or amounts). For example, if the only part of an eligible rollover
owner-employee, the month in which the employee separates distribution that is not a direct rollover is employer securities or
from service; a plan loan offset amount, no withholding is required. However,
• The month in which the employee dies; or any cash that is paid in the distribution must be used to satisfy
• For a self-employed person or owner-employee, the first the withholding on the employer securities or plan loan offset
month in which the employee becomes disabled within the amount.
meaning of section 72(m)(7). The payer is required to withhold 20% of eligible rollover
distributions from a qualified plan’s distributed annuity and on
Example for Computing Amount Eligible for eligible rollover distributions from a governmental section
Capital Gain Election (See Box 3.) 457(b) plan.
Step 1. Total Taxable Amount Any NUA excludable from gross income under section
402(e)(4) is not included in the amount of any eligible rollover
A. Total distribution XXXXX distribution that is subject to 20% withholding.
B. Less: You are not required to withhold 20% of an eligible rollover
1. Current actuarial value of any annuity XXXX distribution that, when aggregated with other eligible rollover
2. Employee contributions (minus any amounts distributions made to one person during the year, is less than
previously distributed that were not includible in $200.
the employee’s gross income) XXXX
3. Net unrealized appreciation in the value of IRAs. The 20% withholding does not apply to distributions from
any employer securities that was a part of the any IRA, but withholding does apply to IRAs under the rules for
lump-sum distribution. XXXX periodic payments and nonperiodic distributions. For
withholding, assume that the entire amount of an IRA
C. Total of lines 1 through 3 XXXXX distribution is taxable (except for the distribution of contributions
D. Total taxable amount. Subtract line C from XXXXX under section 408(d)(4), in which only the earnings are taxable,
line A. and 408(d)(5)). Generally, Roth IRA distributions are not subject
to withholding except on the earnings portion of excess
Step 2. Capital Gain contributions distributed under section 408(d)(4).
An IRA recharacterization is not subject to income tax
Total taxable Months of active withholding.
amount participation before 1974
Periodic payments. For periodic payments that are not eligible
Line D X _____________________ = Capital gain
rollover distributions, withhold on the taxable part as though the
Total months of active
participation
periodic payments were wages, based on the recipient’s Form
W-4P. The recipient may request additional withholding on
Form W-4P or claim exemption from withholding. If a recipient
Box 4. Federal Income Tax Withheld does not submit a Form W-4P, withhold by treating the recipient
Enter any Federal income tax withheld. This withholding as married with three withholding allowances. See Circular E,
under section 3405 is subject to deposit rules and the Employer’s Tax Guide (Pub. 15), for wage withholding tables.
withholding tax return is Form 945. Backup withholding does Rather than Form W-4P, military retirees should give
not apply. See Pub. 15-A, Employer’s Supplemental Tax TIP you Form W-4, Employee’s Withholding Allowance
Guide, and the Instructions for Form 945 for more withholding Certificate.
information.
Nonperiodic distributions. Withhold 10% of the taxable part
Even though you may be using Code 1 in box 7 to designate of a nonperiodic distribution that is not an eligible rollover
an early distribution subject to the 10% additional tax specified distribution. The recipient may request additional withholding on
in sections 72(q), (t), or (v), you are not required to withhold that Form W-4P or claim exemption from withholding.
tax.
Failure to provide TIN. For periodic payments and
The amount withheld cannot be more than the sum of nonperiodic distributions, if a payee fails to furnish his or her
TIP the cash and the FMV of property (excluding employer correct TIN to you in the manner required, or if the IRS notifies
securities) received in the distribution. If a distribution you before any distribution that the TIN furnished is incorrect, a
consists solely of employer securities and cash ($200 or less) in payee cannot claim exemption from withholding. For periodic
lieu of fractional shares, no withholding is required. payments, withhold as if the payee was single claiming no

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withholding allowances. For nonperiodic payments, withhold When applicable, enter a numeric and an alpha code. For
10%. Backup withholding does not apply. example, when using Code P for a traditional IRA distribution
under section 408(d)(4), you must also enter Code 1, if it
Box 5. Employee Contributions or Insurance applies. For a normal distribution from a qualified plan that
Premiums qualifies for the 10-year tax option, enter Codes 7 and A. For a
Enter the employee’s contributions to a profit-sharing or direct rollover to an IRA or a qualified plan for the surviving
retirement plan, or insurance premiums that the employee spouse of a deceased participant, enter Codes 4 and G.
may recover tax free this year. The entry in box 5 may include
any of the following: (a) contributions actually made by the Only three numeric combinations are permitted on one
employee over the years under the retirement or profit-sharing ! Form 1099-R: Codes 8 and 1, 8 and 2, or 8 and 4. If two
CAUTION or more other numeric codes are applicable, you must
plan that were required to be included in the income of the
employee when contributed (after-tax contributions), (b) file more than one Form 1099-R. For example, if part of a
contributions made by the employer but considered to have distribution is premature (Code 1) and part is not (Code 7), file
been contributed by the employee under section 72(f), (c) the one Form 1099-R for the part to which Code 1 applies and
accumulated cost of premiums paid for life insurance protection another Form 1099-R for the part to which Code 7 applies. In
taxable to the employee in previous years and in the current addition, for the distribution of excess deferrals, excess
year under Regulations section 1.72-16 (cost of current life contributions, or excess aggregate contributions, parts of the
insurance protection) (only if the life insurance contract itself is distribution may be taxable in 2 or 3 different years. File
distributed), and (d) premiums paid on commercial annuities. separate Forms 1099-R using Code 8, D, or P to indicate the
Also report after-tax contributions directly rolled over to an IRA. year the amount is taxable.
Do not include contributions to any DEC, 401(k) plan, or any Even if the employee/taxpayer is age 591/2 or over, use Code
other contribution to a retirement plan that was not an after-tax 1 if a series of substantially equal periodic payments was
contribution. modified within 5 years of the date of the first payment (within
Generally, for qualified plans, tax-sheltered annuities, and the meaning of section 72(q)(3) or (t)(4)). For example, Mr. B
nonqualified commercial annuities, enter in box 5 the employee began receiving payments that qualified for the exception for
contributions or insurance premiums recovered tax free during part of a series of substantially equal periodic payments under
the year based on the method you used to determine the section 72(t)(2)(A)(iv) when he was 57. When he was 61, Mr. B
taxable amount to be entered in box 2a. If periodic payments substantially modified the payments. Because the payments
began before 1993, you are not required to, but you are were modified within 5 years, use Code 1 in the year the
encouraged to, report in box 5. payments were modified, even though Mr. B is over 591/2.
If you made periodic payments from a qualified plan and For further guidance on what makes a series of
! the annuity starting date is after November 18, 1996,
CAUTION you must use the simplified method to figure the tax-free
! substantially equal periodic payments, see Notice 89-25,
CAUTION 1989-1 C.B. 662, as modified by Rev. Rul. 2002-62,

amount each year. See Annuity starting date in 1998 or later 2002-42 I.R.B. 710. Notice 2004-15, 2004-9 I.R.B. 526, allows
on page R-6. taxpayers to use one of three methods in Notice 89-25, as
modified by Rev. Rul. 2002-62, to determine whether a
If a total distribution is made, the total employee
distribution is part of a series of substantially equal periodic
contributions or insurance premiums available to be recovered
payments under section 72(q)(2)(D).
tax free must be shown only in box 5. If any previous
distributions were made, any amount recovered tax free in prior If part of an eligible rollover distribution is paid in a direct
years must not appear in box 5. rollover and part is not, you must file a separate Form 1099-R
If you are unable to reasonably obtain the data necessary to for each part showing the appropriate code on each form. If part
compute the taxable amount, leave boxes 2a and 5 blank, and of a distribution is an eligible rollover distribution and part is not
check the first box in box 2b. (e.g., a minimum distribution required by section 401(a)(9)) and
the part that is an eligible rollover distribution is directly rolled
For more information, see Rev. Proc. 92-86, 1992-2 C.B. over, you must file a separate Form 1099-R to report each part.
495 and section 72(d).
Section 457(b) plan distributions. Generally, a distribution
For reporting charitable gift annuities, see Charitable gift from a governmental section 457(b) plan is not subject to the
annuities on page R-6. 10% additional tax under section 72(t). However, an early
Box 6. Net Unrealized Appreciation (NUA) in distribution from a governmental section 457(b) plan of an
amount that is attributable to a rollover from another type of
Employer’s Securities plan or IRA is subject to the additional tax as if the distribution
Use this box if a distribution from a qualified plan includes were from a plan described in section 401(a) (see section
securities of the employer corporation (or a subsidiary or parent 72(t)(9)). If the distribution consists solely of amounts that are
corporation) and you can compute the NUA in the employer’s not attributable to a rollover, enter Code 2 in box 7. If the
securities. Enter all the NUA in employer securities if this is a distribution consists solely of amounts attributable to a rollover,
lump-sum distribution. If this is not a lump-sum distribution, then enter the appropriate code in box 7 as if the distribution
enter only the NUA in employer securities attributable to were from a plan described in section 401(a). If the distribution
employee contributions. See Regulations section 1.402(a)-1(b) is made up of amounts from both sources, you must file
for the determination of the NUA. Also see Notice 89-25, Q/A-1, separate Forms 1099-R for each part of the distribution unless
1989-1 C.B. 662. Include the NUA in box 1 but not in box 2a. Code 2 would be entered on each form.
You do not have to complete this box for a direct rollover.
Box 8. Other
Box 7. Distribution Code(s)
Enter the current actuarial value of an annuity contract that is
Enter an “X” in the IRA/SEP/SIMPLE checkbox if the part of a lump-sum distribution. Do not include this item in
distribution is from a traditional IRA, SEP IRA, or SIMPLE IRA. boxes 1 and 2a.
It is not necessary to check the box for a distribution from a
Roth IRA or for an IRA recharacterization. To determine the value of an annuity contract, show the
Enter the appropriate code(s) in box 7. Use the Guide to value as an amount equal to the current actuarial value of the
Distribution Codes on pages R-9 and R-10 to determine the annuity contract, reduced by an amount equal to the excess of
appropriate code(s) to enter in box 7 for any amounts reported the employee’s contributions over the cash and other property
on Form 1099-R. Read the codes carefully and enter them (not including the annuity contract) distributed.
accurately because the IRS uses the codes to help determine If an annuity contract is part of a multiple recipient lump-sum
whether the recipient has properly reported the distribution. If distribution, enter in box 8, along with the current actuarial
the codes you enter are incorrect, the IRS may improperly value, the percentage of the total annuity contract each Form
propose changes to the recipient’s taxes. 1099-R represents.

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Box 9a. Your Percentage of Total Distribution
If this is a total distribution and it is made to more than one
person, enter the percentage received by the person whose
name appears on Form 1099-R. You need not complete this
box for any IRA distributions or for a direct rollover.
Box 9b. Total Employee Contributions
You are not required to enter the total employee contributions in
box 9b. However, because this information may be helpful to
the recipient, you may choose to report them.
If you choose to report the total employee contributions, do
not include any amounts recovered tax free in prior years. For a
total distribution, report the total employee contributions in box
5 rather than in box 9b.
Boxes 10–15. State and Local Information
These boxes and Copies 1 and 2 are provided for your
convenience only and need not be completed for the IRS. Use
the state and local information boxes to report distributions
and taxes for up to two states or localities. Keep the information
for each state or locality separated by the broken line. If state or
local income tax has been withheld on this distribution, you may
enter it in boxes 10 and 13, as appropriate. In box 11, enter the
abbreviated name of the state and the payer’s state
identification number. The state number is the payer’s
identification number assigned by the individual state. In box
14, enter the name of the locality. In boxes 12 and 15 you may
enter the amount of the state or local distribution. Copy 1 may
be used to provide information to the state or local tax
department. Copy 2 may be used as the recipient’s copy in
filing a state or local income tax return.
Guide to Distribution Codes
*Used with code ...(if
Distribution Codes Explanations
applicable)
1 — Early distribution, no known exception. Use Code 1 only if the employee/taxpayer has not reached age 591/2, 8, D, L, or P
and if none of the exceptions under distribution Codes 2, 3, or 4 apply
when the distribution is made. Use Code 1 even if the distribution is
made for medical, first-time homebuyer, or qualified higher education
expenses, under section 72(t).
2 — Early distribution, exception applies. Use Code 2 only if the distribution is: 8, D, or P
• A Roth IRA conversion (an IRA converted to a Roth IRA) or a
reconversion if the participant is under age 591/2,
• An early distribution made from a qualified retirement plan or IRA
because of an IRS levy under section 6331,
• A section 457(b) plan distribution and not subject to the additional
10% tax. But see Section 457(b) plan distributions on page R-8 for
these distributions that may be subject to the 10% additional tax, and
• A distribution from a qualified retirement plan after separation from
service where the taxpayer has reached age 55.
3 — Disability. For these purposes, see section 72(m)(7). None
4 — Death. Use Code 4 regardless of the age of the employee/taxpayer to 8, A, D, G, L, or P
indicate payment to a decedent’s beneficiary, including an estate or
trust. Also use it for death benefit payments made by an employer but
not made as part of a pension, profit-sharing, or retirement plan.
5 — Prohibited transaction. Use Code 5 if there was an improper use of the account. Code 5 None
means the account is no longer an IRA.
6 — Section 1035 exchange. Use Code 6 to indicate the tax-free exchange of life insurance, None
annuity, or endowment contracts under section 1035.
7 — Normal distribution. Use Code 7: (a) for a normal distribution from a plan, including a A
traditional IRA, if the employee/taxpayer is at least age 591/2, (b) for a
Roth IRA conversion or reconversion if the participant is at least age
591/2, and (c) to report a distribution from a life insurance, annuity, or
endowment contract and for reporting income from a failed life
insurance contract under sections 7702(g) and (h). See Rev. Rul.
91-17, 1991-1 C.B. 190. Use Code 7 with Code A, if applicable.
Generally, use Code 7 if no other code applies. Do not use Code 7
for a Roth IRA distribution.

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Guide to Distribution Codes
*Used with code ...(if
Distribution Codes Explanations
applicable)
8 — Excess contributions plus earnings/ Use Code 8 for an IRA or Roth IRA distribution under section 1, 2, 4, or J
excess deferrals (and/or earnings) taxable in 408(d)(4), unless Code P applies. Also use this code for corrective
2004. distributions of excess deferrals, excess contributions, and excess
aggregate contributions, unless Code D or P applies. See Corrective
distributions on page R-3 and IRA revocation on page R-2 for more
information.
9 — Cost of current life insurance protection. Use Code 9 to report premiums paid by a trustee or custodian for None
current life or other insurance protection. See Box 2a on page R-6 for
more information.
A — May be eligible for 10-year tax option. Use Code A only for participants born before January 2, 1936, or their 4 or 7
beneficiaries to indicate the distribution may be eligible for the 10-year
tax option method of computing the tax on lump-sum distributions (on
Form 4972, Tax on Lump-Sum Distributions). To determine whether
the distribution may be eligible for the tax option, you need not
consider whether the recipient used this method (or capital gain
treatment) in the past.
D — Excess contributions plus earnings/ See the explanation for Code 8. Generally, do not use Code D for an 1, 2, or 4
excess deferrals taxable in 2002. IRA distribution under section 408(d)(4) or 408(d)(5).
E — Excess annual additions under section See Excess Annual Additions Under Section 415 on page R-4. None
415/certain excess amounts under section
403(b) plans.
F — Charitable gift annuity. See Charitable gift annuities on page R-6. None
G — Direct rollover and rollover contribution. Use Code G for a direct rollover from a qualified plan (including a 4
governmental section 457(b) plan) or tax-sheltered annuity to an
eligible retirement plan (another qualified plan, a tax-sheltered
annuity, or an IRA). See Direct Rollovers on page R-2. Also use
Code G for certain distributions from conduit IRAs to an employer plan
and IRA rollover contributions to an accepting employer plan. See
Conduit IRAs on page R-2.
J — Early distribution from a Roth IRA. Use Code J for a distribution from a Roth IRA when Code Q or Code 8 or P
T does not apply.
L — Loans treated as deemed distributions Do not use Code L to report a loan offset. See Loans Treated as 1 or 4
under section 72(p). Distributions on page R-4.
N — Recharacterized IRA contribution made Use Code N for a recharacterization of an IRA contribution made for None
for 2004. 2004 and recharacterized in 2004 to another type of IRA by a
trustee-to-trustee transfer or with the same trustee.
P — Excess contributions plus earnings/ See the explanation for Code 8. The IRS suggests that anyone using 1, 2, 4, or J
excess deferrals taxable in 2003. Code P for the refund of an IRA contribution under section 408(d)(4),
including excess Roth IRA contributions, advise payees, at the time
the distribution is made, that the earnings are taxable in the year in
which the contributions were made.
Q — Qualified distribution from a Roth IRA. Use Code Q for a distribution from a Roth IRA if you know that the None
participant meets the 5-year holding period and:
• The participant has reached age 59 1/2, or
• The participant died, or
• The participant is disabled.
Note: If any other code, such as 8 or P applies, use Code J.
R — Recharacterized IRA contribution made Use Code R for a recharacterization of an IRA contribution made for None
for 2003. 2003 and recharacterized in 2004 to another type of IRA by a
trustee-to-trustee transfer or with the same trustee.
S — Early distribution from a SIMPLE IRA in Use Code S only if the distribution is from a SIMPLE IRA in the first 2 None
the first 2 years, no known exception. years, the employee/taxpayer has not reached age 59 1/2, and none of
the exceptions under section 72(t) are known to apply when the
distribution is made. The 2-year period begins on the day
contributions are first deposited in the individual’s SIMPLE IRA. Do
not use Code S if Code 3 or 4 applies.
T — Roth IRA distribution, exception applies. Use Code T for a distribution from a Roth IRA if you do not know if None
the 5-year holding period has been met but:
• The participant has reached age 59 1/2, or
• The participant died, or
• The participant is disabled.
Note: If any other code, such as 8 or P applies, use Code J.
*See the Caution for box 7 instructions on page R-8.

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elective deferral contributions, see Regulations section
Specific Instructions for Form 5498 1.414(v)-1.
File Form 5498, IRA Contribution Information, with the IRS by Include any catch-up amounts when reporting contributions
May 31, 2005, for each person for whom in 2004 you for the year in boxes 1, 8, 9, or 10.
maintained any individual retirement arrangement (IRA), Roth IRA conversions. You must report the receipt of a
including a deemed IRA under section 408(q). conversion from an IRA to a Roth IRA even if the conversion is
An IRA includes all investments under one IRA plan. It is not with the same trustee. Report the total amount converted from a
necessary to file a Form 5498 for each investment under one traditional IRA, SEP IRA, or SIMPLE IRA to a Roth IRA in
plan. For example, if a participant has three certificates of box 3. Also report a reconversion to a Roth IRA after a
deposit (CDs) under one IRA plan, only one Form 5498 is recharacterization in box 3.
required for all contributions and the fair market values (FMVs) IRA revocation. If a traditional IRA, Roth IRA, or SIMPLE IRA
of the CDs under the plan. However, if a participant has is revoked during its first 7 days (under Regulations section
established more than one IRA plan with the same trustee, a 1.408-6(d)(4)(ii)), Form 5498 must be filed to report any regular,
separate Form 5498 must be filed for each plan. rollover, IRA conversion, SEP IRA, or SIMPLE IRA
Contributions. You must report contributions to any IRA on contributions to a revoked IRA. For information about reporting
Form 5498. See the instructions under boxes 1, 2, 3, 4, 8, 9, a distribution from a revoked IRA, see IRA Revocation on
and 10 on page R-13. If no reportable contributions were made page R-2.
for 2004, complete only boxes 5 and 7, and box 11 if applicable. Total distribution, no contributions. Generally, if a total
Report contributions to a spousal IRA under section 219(c) distribution was made from an account during the year and no
on a separate Form 5498 using the name and taxpayer contributions, including rollovers, recharacterizations, or Roth
identification number (TIN) of the spouse. IRA conversion amounts, were made for that year, you need
For contributions made between January 1 and April 15, not file Form 5498 nor furnish the annual statement to reflect
2005, trustees and issuers should obtain the participant’s that the FMV on December 31 was zero.
designation of the year for which the contributions are made. Required minimum distributions (RMDs). An IRA (other than
Direct rollovers, transfers, and recharacterizations. You a Roth IRA) owner/participant must begin taking distributions for
must report the receipt of a direct rollover from a qualified plan each calendar year beginning with the calendar year in which
(including a governmental section 457(b) plan) or tax-sheltered the participant attains age 701/2. The distribution for the 701/2
annuity to an IRA. Report a direct rollover in box 2. For year must be made no later than April 1 of the following
information on direct rollovers of eligible rollover distributions, calendar year; RMDs for any other year must be made no later
see Direct Rollovers on page R-2. than December 31 of the year.
If a rollover or trustee-to-trustee transfer is made from a For each IRA you held as of December 31 of the prior year,
SIMPLE IRA to an IRA that is not a SIMPLE IRA and the if an RMD is required for the year, you must provide a
trustee has adequately substantiated information that the statement to the IRA participant by January 31 regarding the
participant has not satisfied the 2-year period specified in RMD using one of two alternative methods described below.
section 72(t)(6), report the amount as a regular contribution in You are not required to use the same method for all IRA
box 1 even if the amount exceeds $3,000 ($3,500 for participants; you can use Alternative one for some IRA
participants 50 or older). participants and Alternative two for the rest. Under both
Transfers. Do not report on Form 5498 a direct methods, the statement must inform the participant that you are
trustee-to-trustee transfer from (a) a traditional IRA to another reporting to the IRS that an RMD is required for the year. The
traditional IRA or to a SEP IRA, (b) a SIMPLE IRA to another statement can be provided in conjunction with the statement of
SIMPLE IRA, (c) a SEP IRA to another SEP IRA or to a the FMV.
traditional IRA, or (d) a Roth IRA to a Roth IRA. For reporting If the IRA participant is deceased, and the surviving spouse
purposes, contributions and rollovers do not include these is the sole beneficiary, special rules apply for RMD reporting. If
transfers. the surviving spouse elects to treat the IRA as the spouse’s
Recharacterizations. You must report each own, then report with the surviving spouse as the owner.
recharacterization of an IRA contribution. If a participant makes However, if the surviving spouse does not elect to treat the IRA
a contribution to an IRA (first IRA) for a year, the participant as the spouse’s own, then you may continue to treat the
may choose to recharacterize the contribution by transferring, in surviving spouse as a beneficiary. Until further guidance is
a trustee-to-trustee transfer, any part of the contribution (plus issued, no reporting is required for IRAs of deceased
earnings) to another IRA (second IRA). The contribution is participants (except where the surviving spouse elects to treat
treated as made to the second IRA (recharacterization). A the IRA as the spouse’s own, as described above).
recharacterization may be made with the same trustee or with Alternative one. Under this method, include in the
another trustee. The trustee of the first IRA must report the statement the amount of the RMD with respect to the IRA for
amount contributed before the recharacterization as a the calendar year and the date by which the distribution must
contribution on Form 5498 and the recharacterization as a be made. The amount may be calculated assuming the sole
distribution on Form 1099-R. The trustee of the second IRA beneficiary of the IRA is not a spouse more than 10 years
must report the amount received (FMV) in box 4 on Form 5498 younger than the participant. Use the value of the account as of
and check the type of IRA box in box 7. December 31 of the prior year to compute the amount. See Box
All recharacterized contributions received by an IRA in the 11 on page R-13 for how to report.
same year must be totaled and reported on one Form 5498 in Alternative two. Under this method, the statement informs
box 4. You may report the FMV of the account on the same the participant that a minimum distribution with respect to the
Form 5498 you use to report a recharacterization of an IRA IRA is required for the calendar year and the date by which
contribution and any other contributions made to the IRA for the such amount must be distributed. You must include an offer to
year. furnish the participant with a calculation of the amount of the
Catch-up contributions. Participants, who are age 50 or older RMD if requested by the participant.
by the end of the year, may be eligible to make catch-up IRA Electronic filing. These statements may be furnished
contributions or catch-up elective deferral contributions. The electronically using the procedures described in part H of the
annual IRA regular contribution limit of $3,000 is increased to 2004 General Instructions for Forms 1099, 1098, 5498, and
$3,500 for participants age 50 or older. Catch-up elective W-2G.
deferral contributions reported on Form 5498 may be under a Reporting to the IRS. If an RMD is required, check box 11
salary reduction SEP (SARSEP) or under a SIMPLE IRA plan. (see page R-13). For example, box 11 is checked on the 2004
For 2004, up to $3,000 in catch-up elective deferral Form 5498 for a 2005 RMD. You are not required to report to
contributions may be made under a SARSEP, and up to $1,500 the IRS the amount or the date by which the distribution must
to a SIMPLE IRA plan. For more information on catch-up be made.

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For more details, see Notice 2002-27, 2002-18 I.R.B. 814, 2. If you report the contribution on Form 5498 in a
and Notice 2003-3, 2003-2 I.R.B. 258. Also see the regulations subsequent year, you must include the year for which the
under section 401(a)(9) and Notice 2003-2, 2003-2 I.R.B. 257, contribution was made, the amount of the contribution, and one
for transitional relief related to RMDs from annuity contracts. of the following indicators:
Inherited IRAs. In the year an IRA participant dies, you, as an a. Use “JG” (Joint Guard) or “AF” (Allied Force) for the
IRA trustee or issuer, generally must file a Form 5498 and Kosovo area.
furnish an annual statement for the decedent and a Form 5498 b. Use “JE” (Joint Endeavor) for the Persian Gulf area.
and an annual statement for each nonspouse beneficiary. An c. Use “EF” (Enduring Freedom) for Afghanistan,
IRA holder must be able to identify the source of each IRA he or Uzbekistan, Kyrgyzstan, Pakistan, Tajikistan, and Jordan.
she holds for purposes of figuring the taxation of a distribution d. Use “IF” (Iraqi Freedom) for the Arabian Peninsula Areas
from an IRA. Thus, the decedent’s name must be shown on the (the Persian Gulf, the Red Sea, the Gulf of Oman, the portion of
beneficiary’s Form 5498 and annual statement. For example, the Arabian Sea that lies north of 10 degrees north latitude and
you may enter “Brian Willow as beneficiary of Joan Maple” or west of 68 degrees east longitude, the Gulf of Aden, and the
something similar that signifies that the IRA was once owned by total land areas of Iraq, Kuwait, Saudi Arabia, Oman, Bahrain,
Joan Maple. You may abbreviate the word “beneficiary” as, for Qatar, and the United Arab Emirates and the airspace above
example, “bene.” such locations).
For a spouse beneficiary, unless the spouse makes the IRA Under 2 above, enter the information in the blank box to the
his or her own by making contributions to the account, including left of box 10. Do not enter the amount in box 1 (or box 10). For
a rollover contribution, or by not taking distributions required by example, enter a $2,000 IRA contribution designated for Joint
section 401(a)(9)(B), treat the spouse as a nonspouse Guard for the tax year 1998 as “JG 1998 2000” in the blank
beneficiary for reporting purposes. If the spouse makes the IRA box.
his or her own, do not report the beneficiary designation on
Form 5498 and the annual statement. See Pub. 3, Armed Forces’ Tax Guide, for a list of the
Fair market value. On the decedent’s Form 5498 and locations within the designated combat zones and qualified
annual statement, you must enter the FMV of the IRA on the hazardous duty areas.
date of death in box 5. Or you may choose the alternate Electronic/magnetic media filers. You may request an
reporting method and report the FMV as of the end of the year automatic waiver from filing combat zone Forms 5498 by
in which the decedent died. This alternate value will usually be submitting Form 8508, Request for Waiver From Filing
zero because you will be reporting the end-of-year valuation on Information Returns Magnetically. Once you have received the
the beneficiary’s Form 5498 and annual statement. The same waiver, you may report all Forms 5498 for combat zone
figure should not be shown on both the beneficiary’s and participants on paper. Alternatively, you may report
decedent’s forms. If you choose to report using the alternate contributions made by the normal contribution due date
method, you must inform the executor or administrator of the magnetically or electronically and report the contributions made
decedent’s estate of his or her right to request a date-of-death after the normal contribution due date on paper. You may also
valuation. report prior year contributions by combat zone participants on a
On the beneficiary’s Form 5498 and annual statement, the corrected Form 5498 magnetically, electronically, or on paper.
FMV of that beneficiary’s share of the IRA as of the end of the See Electronic/Magnetic Media Reporting in the 2004
year must be shown in box 5. Every year thereafter that the IRA General Instructions for Forms 1099, 1098, 5498, and W-2G for
exists, you must file Form 5498 and furnish an annual information on how to request a waiver on Form 8508.
statement for each beneficiary who has not received a total
distribution of his or her share of the IRA showing the FMV at Corrected Form 5498. If you filed a Form 5498 with the IRS
the end of the year and identifying the IRA as described above. and later discover that there is an error on it, you must correct it
as soon as possible. See part I in the 2004 General Instructions
However, if a beneficiary takes a total distribution of his or for Forms 1099, 1098, 5498, and W-2G. For example, if you
her share of the IRA in the year of death, you need not file a reported contributions as rollover contributions in box 2, and
Form 5498 nor furnish an annual statement for that beneficiary, you later discover that part of the contribution was not eligible to
but you must still file Form 5498 for the decedent. be rolled over and was, therefore, a regular contribution that
If you have no knowledge of the death of an IRA participant should have been reported in box 1, you must file a corrected
until after you are required to file Form 5498 (May 31), you are Form 5498.
not required to file a corrected Form 5498 nor furnish a Statements to participants. If you are required to file Form
corrected annual statement. However, you must still provide the 5498, you must provide a statement to the participant. By
date-of-death valuation in a timely manner to the executor or January 31, 2005, you must provide participants with a
administrator upon request. statement of the December 31, 2004, value of the participant’s
For more information about the reporting requirements for account and RMD, if applicable. Trustees of SIMPLE IRAs also
inherited IRAs, see Rev. Proc. 89-52, 1989-2 C.B. 632. must provide a statement of the account activity by January 31.
Special reporting for U.S. Armed Forces in designated Contribution information for all other types of IRAs must be
combat zones. A participant who is serving in or in support of provided by May 31, 2005. You are not required to provide
the Armed Forces in a designated combat zone or qualified information to the IRS or to participants as to whether a
hazardous duty area has an additional period after the normal contribution is deductible or nondeductible. In addition, the
contribution due date of April 15 to make IRA contributions for a participant is not required to tell you whether a contribution is
prior year. The period is the time the participant was in the deductible or nondeductible.
designated zone or area plus at least 180 days. The participant If you furnished a statement of the FMV of the account, and
must designate the IRA contribution for a prior year to claim it RMD if applicable, to the participant by January 31, 2005, and
as a deduction on the income tax return. no reportable contributions, including rollovers,
If a qualifying combat zone participant makes a contribution recharacterizations, or Roth IRA conversions, were made for
to an IRA after April 15th and designates the contribution for a 2004, you need not furnish another statement (or Form 5498) to
prior year, you must report the type of contribution (box 7) and the participant to report zero contributions. However, you must
the amount on Form 5498. Report the amount either for (1) the file Form 5498 with the IRS by May 31, 2005, to report the
year for which the contribution was made or (2) a subsequent December 31, 2004 FMV of the account. This rule also applies
year. to beneficiary accounts under the inherited IRA rules on this
page.
1. If you report the contribution for the year it is made, no
special reporting is required. Include the contribution in box 1 of For more information about the requirement to furnish
an original Form 5498 or of a corrected Form 5498 if an original statements to participants, see part H in the 2004 General
was previously filed. Instructions for Forms 1099, 1098, 5498, and W-2G.

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If you do not furnish another statement to the participant Box 6. Life Insurance Cost Included in Box 1
! because no reportable contributions were made for the
CAUTION year, the statement of the FMV of the account must
For endowment contracts only, enter the amount included in
box 1 allocable to the cost of life insurance.
contain a legend designating which information is being
furnished to the Internal Revenue Service. Box 7. Checkboxes
Box 1. IRA Contributions (Other Than Amounts If you did not enter an amount in box 1, 3, 8, 9, or 10, even if
you entered an amount in box 2 or 4, you must check the
in Boxes 2–4 and 8–10) appropriate box. If you entered an amount in box 1, 3, 8, 9, or
Enter contributions to a traditional IRA made in 2004 and 10, you may, but you do not have to, check the appropriate box.
through April 15, 2005, designated for 2004. IRA. Check “IRA” if you are filing Form 5498 to report
Report gross contributions, including the amount allocable to information about a traditional IRA account.
the cost of life insurance (see Box 6) and including any excess SEP. Check “SEP” if you are filing Form 5498 to report
contributions, even if the excess contributions were withdrawn. information about a SEP IRA. If you do not know whether the
If an excess contribution is treated as a contribution in a account is a SEP IRA, check the “IRA” box.
subsequent year, do not report it on Form 5498 for the SIMPLE. Check “SIMPLE” if you are filing Form 5498 to report
subsequent year. It has already been reported as a contribution information about a SIMPLE IRA account. Do not check this
on Form 5498 for the year it was actually contributed. box for a SIMPLE 401(k) plan. See section 408(p).
Also include employee contributions to an IRA under a SEP Roth IRA. Check “Roth IRA” if you are filing Form 5498 to
plan. These are contributions made by the employee, not by the report information about a Roth IRA account.
employer, that are treated as regular IRA contributions subject
to the 100% of compensation and $3,000 ($3,500 for Box 8. SEP Contributions
participants 50 or older) limits of section 219. Do not include Enter employer contributions made to a SEP IRA (including
employer SEP IRA contributions or SARSEP contributions salary deferrals under a SARSEP) during 2004 including
under section 408(k)(6). Instead, include them in box 8. contributions made in 2004 for 2003, but not including
Also, do not include in box 1 contributions to a SIMPLE IRA contributions made in 2005 for 2004. Do not enter employee
(report them in box 9) and a Roth IRA (report them in box 10). contributions to an IRA under a SEP plan. Report any
In addition, do not include in box 1 rollovers and employee contributions to an IRA under a SEP plan in box 1.
recharacterizations (report rollovers in box 2 and Also include in box 8 SEP contributions made by a
recharacterizations in box 4), or a Roth IRA conversion amount self-employed person to his or her own account.
(report in box 3). Box 9. SIMPLE Contributions
Box 2. Rollover Contributions Enter any contributions made to a SIMPLE IRA during 2004.
Enter any rollover contributions to any IRA received by you Do not include contributions to a SIMPLE 401(k) plan.
during 2004. Include a direct rollover from a qualified plan Box 10. Roth IRA Contributions
(including a governmental section 457(b) plan) or tax-sheltered Enter any contributions made to a Roth IRA in 2004 and
annuity to an IRA. For the rollover of property, enter the FMV of through April 15, 2005, designated for 2004. However, report
the property on the date you receive it. This value may be Roth IRA conversion amounts in box 3.
different from the value of the property on the date it was
distributed to the participant. Box 11. Check if RMD for 2005
Box 3. Roth IRA Conversion Amount Check the box if the participant must take a required minimum
distribution (RMD) for 2005. You are required to check the box
Enter the amount converted or reconverted from a traditional for the year in which the IRA participant reaches age 701/2 even
IRA, SEP IRA, or SIMPLE IRA to a Roth IRA during 2004. Do though the RMD for that year need not be made until April 1 of
not include a rollover from one Roth IRA to another Roth IRA. the following year. Then check the box for each subsequent
Include a rollover in box 2. year an RMD is required to be made.
Box 4. Recharacterized Contributions On Form 5498, or in a separate statement, report the
Enter any amounts recharacterized plus earnings from one type information required by Alternative one or Alternative two
of IRA to another. (see page R-11). To determine the RMD, see the regulations
under sections 401(a)(9) and 408(a)(6) and (b)(3). If you use
Box 5. Fair Market Value of Account Form 5498 to report the additional information under Alternative
Enter the FMV of the account on December 31. For inherited one, enter the amount and date in the blank box to the left of
IRAs, see Inherited IRAs on page R-12. box 10 on the form.

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Index

A Form 945 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Required minimum distribution . . . . 11, 13
Alternate payee under QDRO . . . . . . . . . . 5 Retirement payments . . . . . . . . . . . . . . . . 1-9
Annuity distributions . . . . . . . . . . . . . . . . . 1-9 I Revocation, IRA . . . . . . . . . . . . . . . . . . . 2, 11
Inherited IRAs . . . . . . . . . . . . . . . . . . . . 12, 13 RMD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11, 13
B Insurance contracts . . . . . . . . . . . . . . . . . . 1, 8 Rollovers . . . . . . 2, 3, 5, 6, 7, 8, 11, 12, 13
Beneficiaries . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 IRA contributions . . . . . . . . . . . . . . . . . . . . . 11 Roth IRA contributions . . . . . . . . . . . . 11, 13
IRA distributions . . . . . . . . . . . . . . . . . . . . . 1, 9 Roth IRA conversions . . . . . . 2, 3, 6, 7, 11,
C IRA recharacterizations . . . . 1, 3, 6, 7, 11, 12, 13
Charitable gift annuities . . . . . . . . . . . . . . . . 6 12, 13 Roth IRA distributions . . . . . . . . . . . . . 2, 6, 7
Combat zones, designated . . . . . . . . . . . . 12 IRA revocation . . . . . . . . . . . . . . . . . . . . . 2, 11
Conduit IRAs . . . . . . . . . . . . . . . . . . . . . . . . . . 2 S
Corrected Form 1099-R . . . . . . . . . . . . . . . . 5 L Section 1035 exchange . . . . . . . . . . . 1, 3, 5
Corrected Form 5498 . . . . . . . . . . . . . . . . . 12 Life insurance contract distributions . . . . 1 Section 402(f) notice . . . . . . . . . . . . . . . . . . . 3
Corrective distributions . . . . . . . . . . . . . . . . . 3 Loans treated as distributions . . . . . . . . 2, 4 SEP contributions . . . . . . . . . . . 2, 6, 11, 13
Cost of current life insurance Losses, retirement distributions . . . . . . 4, 6 SEP distributions . . . . . . . . . . . . . . . . . 2, 6, 8
protection . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 SIMPLE contributions . . . . . . . . . . . . . 11, 13
M SIMPLE distributions . . . . . . . . . . . . 2, 3, 6, 8
D Military retirement . . . . . . . . . . . . . . . . . . . . . . 1 State and local information . . . . . . . . . . . . . 9
Death benefit payments . . . . . . . . . . . . . . . . 5 Missing retirement plan participants . . . . 5 Statements to
DECs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 recipients/participants . . . . . . . . . . . 5, 12
Direct rollovers . . . . 2, 3, 5, 6, 7, 8, 11, 13 N
Net unrealized appreciation . . . . 2, 4, 6, 7, T
E 8 Taxable amount, retirement
Nonperiodic distributions . . . . . . . . . . . . . . . 7 distributions . . . . . . . . . . . . . . . . . . . . . . . . . 6
Eligible rollover distribution . . . . . . . . 2, 7, 8
Nonqualified plan distributions . . . . . . . . . 1 Transfers:
Employee contributions, retirement Form 1099-R . . . . . . . . . . . . . . . . . . . . . . . . 3
plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8, 9 Nonresident aliens . . . . . . . . . . . . . . . . . . . . . 5 Form 5498 . . . . . . . . . . . . . . . . . . . . . . . . . 11
Employer securities, distributions . . . . . . 4,
5, 6, 7, 8 P
Endowment contracts . . . . . . . . . . . . . . 1, 13 U
Pension distributions . . . . . . . . . . . . . . . . . 1-9 U.S. Armed Forces, special
Excess annual additions . . . . . . . . . . . . . . . 4 Periodic payments . . . . . . . . . . . . . . . . . . . . . 7
Excess deferrals, excess contributions, reporting . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Profit-sharing distributions . . . . . . . . . . . 1-9
corrective distributions of . . . . . . . . . . . . 3
W
Q What’s new for 2004 . . . . . . . . . . . . . . . . . . . 1
F QDRO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2, 3, 5
Failing ADP or ACP test, Withholding:
Qualified plan distributions . . . . . . . . . . . 1-9 Federal income tax . . . . . . . . . . . . . . . . . . 7
corrections . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Federal income tax withholding . . . . . . . . 7
R ■
Form 1099-R . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Form 5498 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Recharacterized IRA contributions . . . . 3,
5, 7, 11

R-14