3131                      VOID            CORRECTED
                                                                                                      OMB No. 1545-1760
PAYER’S/TRUSTEE'S name, street address, city or town, state or province, 1 Gross distribution                                         Payments From 
country, ZIP or foreign postal code, and telephone no.
                                                                                                                                      Qualified 
                                                                         $                                                            Education 
                                                                         2 Earnings                   2019                            Programs 
                                                                                                                                      (Under Sections 
                                                                                                                                      529 and 530)
                                                                         $                            Form 1099-Q
PAYER’S/TRUSTEE'S TIN               RECIPIENT’S TIN                      3 Basis                      4 Trustee-to-trustee            Copy A
                                                                                                        transfer
                                                                         $                                                            For 
RECIPIENT’S name                                                         5 Distribution is from:      6 Check if the recipient is     Internal Revenue 
                                                                         • Qualified tuition program—   not the designated            Service Center
                                                                                                        beneficiary
                                                                           Private       or State                                     File with Form 1096.
Street address (including apt. no.)                                      • Coverdell ESA                                              For Privacy Act 
                                                                                                                                      and Paperwork 
                                                                                                                                      Reduction Act 
City or town, state or province, country, and ZIP or foreign postal code                                                              Notice, see the 
                                                                                                                                      2019 General 
                                                                                                                                      Instructions for 
Account number (see instructions)                                                                                                     Certain Information 
                                                                                                                                      Returns.
Form 1099-Q           Cat. No. 32223J                 www.irs.gov/Form1099Q                             Department of the Treasury - Internal Revenue Service
Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page

                                                      CORRECTED (if checked)
                                                                                                      OMB No. 1545-1760
PAYER’S/TRUSTEE'S name, street address, city or town, state or province, 1 Gross distribution                                         Payments From 
country, ZIP or foreign postal code, and telephone no.
                                                                                                                                      Qualified 
                                                                         $                                                            Education 
                                                                         2 Earnings                   2019                            Programs 
                                                                                                                                      (Under Sections 
                                                                                                                                      529 and 530)
                                                                         $                            Form 1099-Q
PAYER’S/TRUSTEE'S TIN               RECIPIENT’S TIN                      3 Basis                      4 Trustee-to-trustee            Copy B
                                                                                                        transfer
                                                                         $                                                            For Recipient
RECIPIENT’S name                                                         5 Distribution is from:      6 If this box is checked, the   This is important tax 
                                                                         • Qualified tuition program—   recipient is not the          information and is 
                                                                                                        designated beneficiary        being furnished to 
                                                                           Private       or State                                     the IRS. If you are 
Street address (including apt. no.)                                      • Coverdell ESA                                              required to file a return, 
                                                                         If the fair market value (FMV) is shown below, see Pub. 970,  a negligence penalty 
                                                                         Tax Benefits for Education, for how to figure earnings.      or other sanction may 
City or town, state or province, country, and ZIP or foreign postal code                                                              be imposed on you 
                                                                                                                                       if this income is 
                                                                                                                                      taxable and the IRS 
Account number (see instructions)                                                                                                     determines that it has 
                                                                                                                                      not been reported.
Form 1099-Q      (keep for your records)              www.irs.gov/Form1099Q                             Department of the Treasury - Internal Revenue Service

Instructions for Recipient                                                            Under a CESA, the amount in box 2 is included in income if there has been a 
Distributions from Coverdell education savings accounts (CESAs) under section         change in the designated beneficiary and the new designated beneficiary is not 
530, and qualified tuition programs (QTPs) under section 529, including rollovers,    a family member or is over age 30 (except for beneficiaries with special needs).
may be taxable. Nontaxable distributions from CESAs and QTPs are not required         Also, an additional 10% tax may apply to part or all of any amount included in 
to be reported on your income tax return. You must determine the taxability of        income from the CESA or QTP. See Form 5329 and your tax return instructions 
any distribution. See Pub. 970 and Form 1040 and its separate instructions for        for more information.
more information. Also see Form 5329 and its separate instructions.                   If a final (total) distribution is made from your account and you have not 
Recipient's taxpayer identification no. (TIN). For your protection, this form         recovered your contributions, see Pub. 970 to determine if you have a 
may show only the last four digits of your TIN (SSN, ITIN, ATIN, or EIN).             deductible loss and how to claim it.
However, the payer or trustee has reported your complete TIN to the IRS.              Box 3. Shows your basis in the gross distribution reported in box 1.
Account number. May show an account or other unique number the payerhas               Box 4.This box is checked if a trustee-to-trustee transfer was made from    oneQTP to 
assigned to distinguish your account.                                                 another QTP, from one CESA to another CESA, from a CESA to aQTP, or from a QTP 
Box 1. Shows the gross distribution (including in-kind distributions) paid to you     to an ABLE account. However, in certain transfers from a CESA, the box will be blank.
this year from a QTP or aCESA. This amount is the total of theamounts shown           Box 5. Shows whether the gross distribution was from a QTP (private or state) 
in box 2 and box 3. See Pub. 970 for more information.                                or from a CESA.
Caution: For CESA distributions (other than earnings on excess contributions)made     Box 6. The designated beneficiary is the individual named in the document 
during 2019, the payer/trustee is not required to report amounts in boxes2  and 3.    creating the trust or custodial account to receive the benefit of the funds in the 
Instead, the payer/trustee may report the fair market value of the CESAas  of         account. If you are not the designated beneficiary, see Pub. 970 and the 
December 31, 2019, in the blank box below boxes 5 and 6. To figure   yourearnings and Instructions for Form 1040.
basis, use the Coverdell ESA—Taxable Distributions and Basisworksheet     in Pub. 970.Distribution codes. For 2019, the payer/trustee may, but is not required to, 
Box 2.Shows the earnings part of the gross distribution shown in box 1.Generally,     report (in the box below boxes 5 and 6) one of the following codes to identifythe 
amounts distributed that are used topay for qualified education expenses,             distribution you received: 1—Distributions (including transfers); 2—Excess 
transferred between trustees, or rolledover to another qualified education            contributions plus earnings taxable in 2019; 3—Excess contributions plus 
program, or to an ABLE account, within 60 days, are not included in income.           earnings taxable in 2018; 4—Disability; 5—Death; 6—Prohibited transaction.  
 Under a QTP, the amount in box 2 is included in income if there has been (a)         Future developments. For the latest information about developments related to 
more than one transfer or rollover within any 12-month period with respect to         Form 1099-Q and its instructions, such as legislation enacted after they were 
the same beneficiary, or (b) a change in the designated beneficiary and the new       published, go to www.irs.gov/Form1099Q.
designated beneficiary is not a family member. 

                                    VOID              CORRECTED
                                                                                                      OMB No. 1545-1760
PAYER’S/TRUSTEE'S name, street address, city or town, state or province, 1 Gross distribution                                         Payments From 
country, ZIP or foreign postal code, and telephone no.
                                                                                                                                      Qualified 
                                                                         $                                                            Education 
                                                                         2 Earnings                   2019                            Programs 
                                                                                                                                      (Under Sections 
                                                                                                                                      529 and 530)
                                                                         $                            Form 1099-Q
PAYER’S/TRUSTEE'S TIN               RECIPIENT’S TIN                      3 Basis                      4 Trustee-to-trustee        
                                                                                                        transfer                      Copy C
                                                                         $
RECIPIENT’S name                                                         5 Distribution is from:      6 Check if the recipient is     For Payer
                                                                         • Qualified tuition program—   not the designated            For Privacy Act 
                                                                                                        beneficiary
                                                                           Private       or State                                     and Paperwork 
Street address (including apt. no.)                                      • Coverdell ESA                                              Reduction Act 
                                                                                                                                      Notice, see the 
                                                                                                                                      2019 General 
City or town, state or province, country, and ZIP or foreign postal code                                                              Instructions for 
                                                                                                                                      Certain 
Account number (see instructions)                                                                                                     Information 
                                                                                                                                      Returns.
Form 1099-Q                                           www.irs.gov/Form1099Q                             Department of the Treasury - Internal Revenue Service

Instructions for Payer/Trustee
To complete Form 1099-Q, use:                           File Copy A of this form with the IRS by February 28, 
• The 2019 General Instructions for Certain Information 2020. If you file electronically, the due date is March 31, 
Returns, and                                            2020. To file electronically, you must have software that 
                                                        generates a file according to the specifications in Pub. 
• The 2019 Instructions for Form 1099-Q.                1220. 
To order these instructions and additional forms, go    Need help? If you have questions about reporting on 
to www.irs.gov/Form1099Q.                               Form 1099-Q, call the information reporting customer 
Due dates. Furnish Copy B of this form to therecipient  service site toll free at 866-455-7438 or304-263-8700 
by January 31, 2020.                                    (not toll free). Persons with a hearing or speech 
                                                        disability with access to TTY/TDD equipment can call 
                                                        304-579-4827 (not toll free).