Attention: Copy A of this form is provided for informational purposes only. Copy A appears in red, similar to the official IRS form. The official printed version of Copy A of this IRS form is scannable, but the online version of it, printed from this website, is not. Do not print and file copy A downloaded from this website; a penalty may be imposed for filing with the IRS information return forms that can’t be scanned. See part O in the current General Instructions for Certain Information Returns, available at IRS.gov/Form1099, for more information about penalties. Please note that Copy B and other copies of this form, which appear in black, may be downloaded and printed and used to satisfy the requirement to provide the information to the recipient. If you have 10 or more information returns to file, you may be required to file e-file. Go to IRS.gov/InfoReturn for e-file options. If you have fewer than 10 information returns to file, we strongly encourage you to e-file. If you want to file them on paper, you can place an order for the official IRS information returns, which include a scannable Copy A for filing with the IRS and all other applicable copies of the form, at IRS.gov/EmployerForms. We’ll mail you the forms you request and their instructions, as well as any publications you may order. See Publications 1141,1167 , and 1179 for more information about printing these forms. |
9898 VOID CORRECTED PAYER’S name, street address, city or town, state or province, 1 Gross distribution OMB No. 1545-0119 Distributions From country, ZIP or foreign postal code, and telephone no. Pensions, Annuities, Retirement or $ Profit-Sharing Plans, 2a Taxable amount 2024 IRAs, Insurance Contracts, etc. $ Form 1099-R 2b Taxable amount Total Copy A not determined distribution For PAYER’S TIN RECIPIENT’S TIN 3 Capital gain (included in 4 Federal income tax Internal Revenue box 2a) withheld Service Center $ $ File with Form 1096. RECIPIENT’S name 5 Employee contributions/ 6 Net unrealized Designated Roth appreciation in For Privacy Act contributions or employer’s securities and Paperwork insurance premiums Reduction Act $ $ Notice, see the Street address (including apt. no.) 7 Distribution IRA/ 8 Other 2024 General code(s) SEP/ Instructions for SIMPLE $ % Certain Information City or town, state or province, country, and ZIP or foreign postal code 9a Your percentage of total 9b Total employee contributions Returns. distribution % $ 10 Amount allocable to IRR 11 1st year of desig. 12 FATCA filing 14 State tax withheld 15 State/Payer’s state no. 16 State distribution within 5 years Roth contrib. requirement $ $ $ $ $ Account number (see instructions) 13 Date of 17 Local tax withheld 18 Name of locality 19 Local distribution payment $ $ $ $ Form 1099-R Cat. No. 14436Q www.irs.gov/Form1099R 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 |
VOID CORRECTED PAYER’S name, street address, city or town, state or province, 1 Gross distribution OMB No. 1545-0119 Distributions From country, ZIP or foreign postal code, and telephone no. Pensions, Annuities, Retirement or $ Profit-Sharing Plans, 2a Taxable amount 2024 IRAs, Insurance Contracts, etc. $ Form 1099-R 2b Taxable amount Total Copy 1 not determined distribution For PAYER’S TIN RECIPIENT’S TIN 3 Capital gain (included in 4 Federal income tax State, City, box 2a) withheld or Local Tax Department $ $ RECIPIENT’S name 5 Employee contributions/ 6 Net unrealized Designated Roth appreciation in contributions or employer’s securities insurance premiums $ $ Street address (including apt. no.) 7 Distribution IRA/ 8 Other code(s) SEP/ SIMPLE $ % City or town, state or province, country, and ZIP or foreign postal code 9a Your percentage of total 9b Total employee contributions distribution % $ 10 Amount allocable to IRR 11 1st year of desig. 12 FATCA filing 14 State tax withheld 15 State/Payer’s state no. 16 State distribution within 5 years Roth contrib. requirement $ $ $ $ $ Account number (see instructions) 13 Date of 17 Local tax withheld 18 Name of locality 19 Local distribution payment $ $ $ $ Form 1099-R www.irs.gov/Form1099R Department of the Treasury - Internal Revenue Service |
CORRECTED (if checked) PAYER’S name, street address, city or town, state or province, 1 Gross distribution OMB No. 1545-0119 Distributions From country, ZIP or foreign postal code, and telephone no. Pensions, Annuities, Retirement or $ Profit-Sharing Plans, 2a Taxable amount 2024 IRAs, Insurance Contracts, etc. $ Form 1099-R 2b Taxable amount Total Copy B not determined distribution Report this PAYER’S TIN RECIPIENT’S TIN 3 Capital gain (included in 4 Federal income tax income on your box 2a) withheld federal tax return. If this $ $ form shows RECIPIENT’S name 5 Employee contributions/ 6 Net unrealized federal income Designated Roth appreciation in tax withheld in contributions or employer’s securities box 4, attach insurance premiums $ $ this copy to IRA/ 8 Other your return. Street address (including apt. no.) 7 Distribution code(s) SEP/ SIMPLE This information is $ % being furnished to City or town, state or province, country, and ZIP or foreign postal code 9a Your percentage of total 9b Total employee contributions the IRS. distribution % $ 10 Amount allocable to IRR 11 1st year of desig. 12 FATCA filing 14 State tax withheld 15 State/Payer’s state no. 16 State distribution within 5 years Roth contrib. requirement $ $ $ $ $ Account number (see instructions) 13 Date of 17 Local tax withheld 18 Name of locality 19 Local distribution payment $ $ $ $ Form 1099-R www.irs.gov/Form1099R Department of the Treasury - Internal Revenue Service |
Instructions for Recipient as periodic payments, nonperiodic payments, or a total distribution. Generally, distributions from retirement plans (IRAs, qualified plans, Report the amount on Form 1040, 1040-SR, or 1040-NR on the line section 403(b) plans, and governmental section 457(b) plans), for “IRA distributions” or “Pensions and annuities” (or the line for insurance contracts, etc., are reported to recipients on Form 1099-R. “Taxable amount”) and on Form 8606, as applicable. However, if this Qualified plans and section 403(b) plans. If your annuity starting is a lump-sum distribution, see Form 4972. If you haven’t reached date is after 1997, you must use the simplified method to figure your minimum retirement age, report your disability payments on the line taxable amount if your payer didn’t show the taxable amount in box for “Wages, salaries, tips, etc.” on your tax return. Also report on that 2a. See the instructions for your tax return. line permissible withdrawals from eligible automatic contribution IRAs. For distributions from a traditional individual retirement arrangements and corrective distributions of excess deferrals, excess arrangement (IRA), simplified employee pension (SEP), or savings contributions, or excess aggregate contributions except if the incentive match plan for employees (SIMPLE), generally the payer isn’t distribution is of designated Roth contributions or your after-tax required to compute the taxable amount. See the instructions for your contributions or if you’re self-employed. tax return to determine the taxable amount. If you’re at least age 73, If a life insurance, annuity, qualified long-term care, or endowment you must take minimum distributions from your IRA (other than a Roth contract was transferred tax free to another trustee or contract issuer, IRA). If you don’t, you’re subject to an excise tax on the amount that an amount will be shown in this box and code 6 will be shown in box should’ve been distributed. See Pub. 590-A and Pub. 590-B for more 7. If a charge or payment was made against the cash value of an information on IRAs. annuity contract or the cash surrender value of a life insurance Roth IRAs. For distributions from a Roth IRA, generally the payer isn’t contract for the purchase of qualified long-term care insurance, an required to compute the taxable amount. You must compute any amount will be shown in this box and code W will be shown in box 7. taxable amount on Form 8606. An amount shown in box 2a may be You need not report these amounts on your tax return. If code C is taxable earnings on an excess contribution. shown in box 7, the amount shown in box 1 is a receipt of reportable Loans treated as distributions. If you borrow money from a qualified death benefits that is taxable in part. plan, section 403(b) plan, or governmental section 457(b) plan, you Box 2a. This part of the distribution is generally taxable. If there is no may have to treat the loan as a distribution and include all or part of entry in this box, the payer may not have all the facts needed to figure the amount borrowed in your income. There are exceptions to this the taxable amount. In that case, the first box in box 2b should be rule. If your loan is taxable, code L will be shown in box 7. See Pub. checked. You may want to get one of the free publications from the 575. IRS to help you figure the taxable amount. See Additional information Recipient’s taxpayer identification number (TIN). For your on the back of Copy 2. For an IRA distribution, seeIRAs and Roth protection, this form may show only the last four digits of your TIN IRAs, earlier. For a direct rollover, other than from a qualified plan, (SSN, ITIN, ATIN, or EIN). However, the payer has reported your section 403(b) plan, or governmental section 457(b) plan to a complete TIN to the IRS. designated Roth account in the same plan or to a Roth IRA, zero Account number. May show an account, policy, or other unique should be shown and you must enter zero (-0-) on the “Taxable number the payer assigned to distinguish your account. amount” line of your tax return. If you roll over a distribution (other Box 1. Shows the total amount distributed this year. The amount may than a distribution from a designated Roth account) from a qualified have been a direct rollover, a transfer or conversion to a Roth IRA, a plan, section 403(b) plan, or governmental section 457(b) plan to a recharacterized IRA contribution; or you may have received it designated Roth account in the same plan or to a Roth IRA, you must (Continued on the back of Copy C) |
CORRECTED (if checked) PAYER’S name, street address, city or town, state or province, 1 Gross distribution OMB No. 1545-0119 Distributions From country, ZIP or foreign postal code, and telephone no. Pensions, Annuities, Retirement or $ Profit-Sharing Plans, 2a Taxable amount 2024 IRAs, Insurance Contracts, etc. $ Form 1099-R 2b Taxable amount Total Copy C not determined distribution For Recipient’s PAYER’S TIN RECIPIENT’S TIN 3 Capital gain (included in 4 Federal income tax box 2a) withheld Records $ $ RECIPIENT’S name 5 Employee contributions/ 6 Net unrealized Designated Roth appreciation in contributions or employer’s securities insurance premiums $ $ Street address (including apt. no.) 7 Distribution IRA/ 8 Other code(s) SEP/ This information is SIMPLE $ % being furnished to City or town, state or province, country, and ZIP or foreign postal code 9a Your percentage of total 9b Total employee contributions the IRS. distribution % $ 10 Amount allocable to IRR 11 1st year of desig. 12 FATCA filing 14 State tax withheld 15 State/Payer’s state no. 16 State distribution within 5 years Roth contrib. requirement $ $ $ $ $ Account number (see instructions) 13 Date of 17 Local tax withheld 18 Name of locality 19 Local distribution payment $ $ $ $ Form 1099-R (keep for your records) www.irs.gov/Form1099R Department of the Treasury - Internal Revenue Service |
Instructions for Recipient (continued) Box 6. If you received a lump-sum distribution from a qualified plan include on the “Taxable amount” line of your tax return the amount that includes securities of the employer’s company, the net unrealized shown in this box plus the amount in box 6, if any. appreciation (NUA) (any increase in value of such securities while in If this is a total distribution from a qualified plan and you were born the trust) is taxed only when you sell the securities unless you choose before January 2, 1936 (or you’re the beneficiary of someone born to include it in your gross income this year. See Pub. 575 and before January 2, 1936), you may be eligible for the 10-year tax Form 4972. If you roll over the distribution to a designated Roth option. See the Form 4972 instructions for more information. account in the same plan or to a Roth IRA, see the instructions for box If you’re an eligible retired public safety officer who elected to 2a. For a direct rollover to a designated Roth account in the same plan exclude from income distributions from your eligible plan used to pay or to a Roth IRA, the NUA is included in box 2a. If you didn’t receive a certain insurance premiums, the amount shown in box 2a hasn’t been lump-sum distribution, the amount shown is the NUA attributable to reduced by the exclusion amount. See the instructions for your tax employee contributions, which isn’t taxed until you sell the securities. return for more information. Box 7.The following codes identify the distribution you received. For Box 2b. If the first box is checked, the payer was unable to determine more information on these distributions, see the instructions for your the taxable amount and box 2a should be blank, except for an IRA. tax return. Also, certain distributions may be subject to an additional It’s your responsibility to determine the taxable amount. If the second 10% tax. See the Instructions for Form 5329. box is checked, the distribution was a total distribution that closed out 1—Early distribution, no known exception (in most cases, under age your account. 59½). Box 3. If you received a lump-sum distribution from a qualified plan 2—Early distribution, exception applies (under age 59½). and were born before January 2, 1936 (or you’re the beneficiary of 3—Disability. someone born before January 2, 1936), you may be able to elect to 4—Death. treat this amount as a capital gain on Form 4972 (not on Schedule D 5—Prohibited transaction. (Form 1040)). See the Form 4972 instructions. For a charitable gift 6—Section 1035 exchange (a tax-free exchange of life insurance, annuity, report as a long-term capital gain as explained in the annuity, qualified long-term care insurance, or endowment Instructions for Form 8949. contracts). Box 4. Shows federal income tax withheld. Include this amount on 7—Normal distribution. your income tax return as tax withheld. Generally, if you receive 8—Excess contributions plus earnings/excess deferrals (and/or payments that aren’t eligible rollover distributions, you can change earnings) taxable in 2024. your withholding or elect not to have income tax withheld by giving 9—Cost of current life insurance protection. the payer Form W-4P or Form W-4R, as applicable. A—May be eligible for 10-year tax option (see Form 4972). Box 5. Generally, this shows the employee’s investment in the B—Designated Roth account distribution. contract (after-tax contributions), if any, recovered tax free this year; Note: If code B is in box 7 and an amount is reported in box 10, the portion that’s your basis in a designated Roth account; the part of see the Instructions for Form 5329. premiums paid on commercial annuities or insurance contracts C—Reportable death benefits under section 6050Y. recovered tax free; the nontaxable part of a charitable gift annuity; or D—Annuity payments from nonqualified annuities that may be subject the investment in a life insurance contract reportable under section to tax under section 1411. 6050Y. This box doesn’t show any IRA contributions. If the amount E—Distributions under Employee Plans Compliance Resolution shown is your basis in a designated Roth account, the year you first System (EPCRS). made contributions to that account may be entered in box 11. (Continued on the back of Copy 2) |
CORRECTED (if checked) PAYER’S name, street address, city or town, state or province, 1 Gross distribution OMB No. 1545-0119 Distributions From country, ZIP or foreign postal code, and telephone no. Pensions, Annuities, Retirement or $ Profit-Sharing Plans, 2a Taxable amount 2024 IRAs, Insurance Contracts, etc. $ Form 1099-R 2b Taxable amount Total Copy 2 not determined distribution File this copy PAYER’S TIN RECIPIENT’S TIN 3 Capital gain (included in 4 Federal income tax with your state, box 2a) withheld city, or local income tax $ $ return, when RECIPIENT’S name 5 Employee contributions/ 6 Net unrealized required. Designated Roth appreciation in contributions or employer’s securities insurance premiums $ $ Street address (including apt. no.) 7 Distribution IRA/ 8 Other code(s) SEP/ SIMPLE $ % City or town, state or province, country, and ZIP or foreign postal code 9a Your percentage of total 9b Total employee contributions distribution % $ 10 Amount allocable to IRR 11 1st year of desig. 12 FATCA filing 14 State tax withheld 15 State/Payer’s state no. 16 State distribution within 5 years Roth contrib. requirement $ $ $ $ $ Account number (see instructions) 13 Date of 17 Local tax withheld 18 Name of locality 19 Local distribution payment $ $ $ $ Form 1099-R www.irs.gov/Form1099R Department of the Treasury - Internal Revenue Service |
Instructions for Recipient (continued) were made for qualified long-term care insurance contracts under F—Charitable gift annuity. combined arrangements, the amount of the reduction in the G—Direct rollover of a distribution to a qualified plan, a section 403(b) investment (but not below zero) in the annuity or life insurance plan, a governmental section 457(b) plan, or an IRA. contract is reported here. H—Direct rollover of a designated Roth account distribution to a Roth Box 9a. If a total distribution was made to more than one person, the IRA. percentage you received is shown. J—Early distribution from a Roth IRA, no known exception (in most Box 9b. For a life annuity from a qualified plan or from a section cases, under age 59½). 403(b) plan (with after-tax contributions), an amount may be shown for K—Distribution of traditional IRA assets not having a readily available the employee’s total investment in the contract. It is used to compute FMV. the taxable part of the distribution. See Pub. 575. L—Loans treated as distributions. Box 10. If an amount is reported in this box, see the Instructions for M—Qualified plan loan offset. Form 5329 and Pub. 575. N—Recharacterized IRA contribution made for 2024 and Box 11. The first year you made a contribution to the designated Roth recharacterized in 2024. account reported on this form is shown in this box. P—Excess contributions plus earnings/excess deferrals (and/or Box 12. If checked, the payer is reporting on this Form 1099 to satisfy earnings) taxable in 2023. its Internal Revenue Code chapter 4 account reporting requirement Q—Qualified distribution from a Roth IRA. under FATCA. You may also have a filing requirement. See the R—Recharacterized IRA contribution made for 2023 and Instructions for Form 8938. recharacterized in 2024. Box 13. Shows the date of payment for reportable death benefits S—Early distribution from a SIMPLE IRA in first 2 years, no known under section 6050Y. exception (under age 59½). Boxes 14–19. If state or local income tax was withheld from the T—Roth IRA distribution, exception applies. distribution, boxes 16 and 19 may show the part of the distribution U—Dividend distribution from ESOP under section 404(k). subject to state and/or local tax. Note: This distribution isn’t eligible for rollover. Additional information. You may want to see: W—Charges or payments for purchasing qualified long-term care Form W-4P, Form 4972, Form 5329, Form 8606 insurance contracts under combined arrangements. Pub. 525, Taxable and Nontaxable Income If the IRA/SEP/SIMPLE box is checked, you’ve received a traditional Pub. 560, Retirement Plans for Small Business IRA, SEP, or SIMPLE distribution. Box 8. If you received an annuity contract as part of a distribution, the Pub. 571, Tax-Sheltered Annuity Plans value of the contract is shown. It isn’t taxable when you receive it and Pub. 575, Pension and Annuity Income shouldn’t be included in boxes 1 and 2a. When you receive periodic Pub. 590-A, Contributions to IRAs payments from the annuity contract, they’re taxable at that time. If the Pub. 590-B, Distributions from IRAs distribution is made to more than one person, the percentage of the Pub. 721, U.S. Civil Service Retirement Benefits annuity contract distributed to you is also shown. You’ll need this Pub. 939, General Rule for Pensions and Annuities information if you use the 10-year tax option (Form 4972). If charges Pub. 969, HSAs and Other Tax-Favored Health Plans |