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on or before May 31, 2016, for each ABLE account from

transfer of the entire balance of an ABLE account into an

which any distribution was made or which was terminated

ABLE account of the same designated beneficiary, or of

during 2015. The filing may be done by either an officer or

part or all of the balance to an ABLE account of another

employee of the State or its agency or instrumentality

eligible individual who is a member of the family of the

having control of the qualified ABLE program, or the

former designated beneficiary.

officer’s or employee’s designee.

Box 2. Earnings

Statements to Recipients

Enter the earnings portion on the distribution reported in

DRAFT AS OF

If you are required to file Form 1099-QA, you also must

box 1. The earnings portion of the distribution is equal to

furnish a statement to the to the designated beneficiary of

the product of the amount of the distributions and the

the ABLE account and to each contributor who received a

earnings ratio. The earnings ratio means the amount of

returned contribution attributable to the calendar year.

earnings attributable to the account as of the last day of

Furnish a copy of Form 1099-QA or an acceptable

the calendar year in which the designated beneficiary’s

substitute statement to each recipient. See part M in the

taxable year begins, divided by the total account balance

July 2, 2015

2015 General Instructions for Certain Information Returns.

on that same date, after taking into account all

distributions made during that calendar year and all

Truncating recipient’s identification number on pay-

contributions received during that same year (other than

ee statements. Pursuant to Treasury Regulations

those contributions returned to the contributor).

section 301.6109-4, all filers of this form may truncate a

recipient’s identification number (social security number

Box 3. Basis

(SSN), individual taxpayer identification number (ITIN),

Enter portion of the distribution that constitutes the return

adoption taxpayer identification number (ATIN), or

of investment in the account. This amount is computed by

employer identification number (EIN)) on payee

subtracting the amount in box 2 from the amount in box 1.

statements. Truncation is not allowed on any documents

The amount of the gross distribution minus the earnings

the filer files with the IRS. A payer's identification number

portion of that distribution is the portion of the distribution

may not be truncated on any form. See part J in the 2015

that constitutes the return of investment in the account.

General Instructions for Certain Information Returns.

Box 4. Program-to-Program Transfer Checkbox

Payer's Name and Federal Identification

Check this box if the transfer was made directly

Number

(program-to-program transfer) of the entire balance of an

For the payer's name and federal identification number,

ABLE account for the same designated beneficiary in

enter the name, address, and taxpayer identification

which the transferor ABLE account is closed upon the

number (TIN). For a program established and maintained

completion of the transfer, or of part or all of the balance

by a state that uses the EIN of the state, enter the name of

of an ABLE account of another eligible individual who is a

the state on the first name line and the name of the

member of the family of the former designated individual,

program on the second name line.

without any intervening distribution to the designated

beneficiary.

Recipient's Name and Social Security Number

(SSN)

Box 5.

List the designated beneficiary as the recipient unless you

Check the box if the ABLE account terminated in 2015.

are reporting a returned excess contribution to the

contributor. In that case, list the contributor as the

Box 6. Designated Beneficiary Checkbox

recipient. Enter the SSN of the applicable recipient.

Check the box if the form is being furnished to a

contributor and not the designated beneficiary of the

Account Number

qualified ABLE program. The term designated beneficiary

The IRS encourages you to designate an account number

in connection with an ABLE account established under a

for all Forms 1099-QA that you file. See part L in the 2015

qualified ABLE program means the eligible individual who

General Instructions for Certain Information Returns.

established an ABLE account and is the owner of such

account.

Box 1. Gross Distribution

Enter the gross distribution from the ABLE account. For

Specific Instructions for Form

this purpose, all amounts distributed from an ABLE

5498-QA

account to or for the benefit of the designated beneficiary

during his or her tax year are treated as one distribution.

Any excess contributions (along with any net attributable

Who Must File

income) that are being returned should be reported here.

Any State or its agency or instrumentality that establishes

and maintains a qualified ABLE program must file, for

Any change in the designated beneficiary of an interest

each ABLE account, a Form 5498-QA, ABLE Account

in a qualified ABLE program during a tax year shall not be

Contribution Information, with the IRS on or before May

treated as a distribution if the new beneficiary is an eligible

31, 2016. The filing may be done by either an officer or

individual for such tax year and a member of the family of

employee of the State or its agency or instrumentality

the former beneficiary.

having control of the qualified ABLE program, or the

A program-to-program transfer shall not be treated as a

officer’s or employee’s designee.

distribution. A program-to-program transfer is the direct

-2-

Instructions for Forms 1099-QA and 5498-QA (2015)

Instructions For Forms 1099-Qa And 5498-Qa Draft - Department Of The Treasury - 2015 Page 3

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