Publication 721 - Tax Guide To U.s. Civil Service Retirement Benefits - 2002 Page 19
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28Filled-In Worksheet A. Simplified Method for Diane Greene
Keep for Your Records
See the instructions in Part II of this publication under Simplified Method.
1. Enter the total annuity payments received this year. Also, add this amount to the total for Form
1040, line 16a, or Form 1040A, line 12a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1. $
15,000
2. Enter your cost in the plan at the annuity starting date plus any death benefit exclusion
*
. . . . . . . . .
2.
36,000
Note: If your annuity starting date was before this year and you completed this worksheet last
year, skip line 3 and enter the amount from line 4 of last year’s worksheet on line 4 below.
Otherwise, go to line 3.
3. Enter the appropriate number from Table 1 or 2 below. Use Table 2 if your annuity starting date is
after 1997 and payments are for your life and the life of your beneficiary. Otherwise use Table 1 . .
3.
360
4. Divide line 2 by line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.
100
5. Multiply line 4 by the number of months for which this year’s payments were made. If your annuity
starting date was before 1987, enter this amount on line 8 below and skip lines 6, 7, 10, and 11.
Otherwise go to line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.
1,000
6. Enter any amounts previously recovered tax free in years after 1986 . . . . . . . . . . . . . . . . . . . . . . .
6.
0
7. Subtract line 6 from line 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7.
36,000
8. Enter the smaller of line 5 or line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8.
1,000
9. Taxable amount for year. Subtract line 8 from line 1. Enter the result, but not less than zero. Also
add this amount to the total for Form 1040, line 16b, or Form 1040A, line 12b. If your Form CSA
1099R or Form CSF 1099R shows a larger amount, use the amount on this line instead . . . . . . . . .
9. $
14,000
10. Add lines 6 and 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.
1,000
11. Balance of cost to be recovered. Subtract line 10 from line 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. $
35,000
Table 1 for Line 3 Above
AND your
annuity starting date was —
IF the age at
before November 19, 1996,
after November 18, 1996,
annuity starting date was . .
enter on line 3 . . . . . . . . . .
enter on line 3 . . . . . . . . . . . .
55 or under
300
360
56 – 60
260
310
61 – 65
240
260
66 – 70
170
210
71 or over
120
160
Table 2 for Line 3 Above
IF the combined ages at
annuity starting date were . .
THEN enter on line 3 . . . .
110 or under
410
111 – 120
360
121 – 130
310
131 – 140
260
141 or over
210
*
A death benefit exclusion up to $5,000 applied to certain benefits received by survivors of employees who died before August 21, 1996.
Page 19
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