Instructions For Form 1099-R - Distributions From Pensions, Annuities, Retirement Or Profit-Sharing Plans, Iras, Insurance Contracts, Etc
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1
2Guide to understanding your 1099-R
This is an example of a 1099-R tax form. The contents of many of the form’s boxes are described below. If you have
questions regarding your 1099-R, contact your tax advisor or the IRS at 800-829-1040. If you have questions about your
retirement benefits, contact us at 800-547-6657 or visit
Distributions From
1
Gross distribution
OMB No. 1545-0119
Pensions, Annuities,
1
Retirement or
Gross distribution – The total amount we
XX
$
Profit-Sharing
paid you during the tax year.
Plans, IRAs,
2a Taxable amount
Insurance
2a
Contracts, etc.
Taxable amount – The taxable portion of
1099-R
$
Form
Box 1. If this box is empty, see explanation of 2b.
2b
Taxable amount
Total
Copy C
not determined
distribution
For Recipient’s
2b
4
Federal income tax
Records
3
Capital gain (included
Taxable amount not determined –
withheld
in box 2a)
If this box is checked, we did not have all of the
information needed to calculate your taxable amount.
$
$
Refer to IRS publication 575, Pension and Annuity
5
Employee contributions
6
Net unrealized
Income for assistance.
/Designated Roth
appreciation in
contributions or
employer’s securities
insurance premiums
Total distribution – If this box is checked, the
$
$
distribution you received closed your account.
7
Distribution
8
Other
IRA/
code(s)
SEP/
SIMPLE
4
This information
Federal income tax withheld – The total
is being
$
%
furnished to the
9b
amount of federal income tax withheld during the tax
9a
Your percentage of total
Total employee contributions
Internal
distribution
Revenue Service.
%
$
year.
5
Employee contributions – The after-tax (non-taxable) contributions, if any, that you recovered tax free during the
tax year. DRS most commonly uses Box 5 for basis recovery which is calculated using any post-tax retirement contributions
you paid in. This is usually for work done prior to 1984 before retirement contributions switched to pre-tax. See the IRS
website for a full explanation of basis recovery.
7
Distribution code – The code identifying the type of benefit (retirement, disability, beneficiary, etc.) you received in
the tax year. The codes are listed on the back of this page.
9b
Total employee contributions – The total amount of after-tax contributions you paid to your retirement
system while working. We use this to determine the after-tax contribution amount shown in Box 5. This amount is only
shown during your first year of retirement.
You may receive more than one 1099-R if you:
• Retired from more than one retirement system.
• Reached age 59½ during the tax year.
• Are receiving your own retirement benefit and a survivor benefit from someone else.
• Are receiving your own retirement benefit and a payment resulting from a divorce.
• Received a retirement benefit and a refund of contributions within the same tax year.
Washington State Department of Retirement Systems
PO Box 48380 • Olympia WA 98504-0931 • • 800.547.6657
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