Publication 571 - Tax-Sheltered Annuity Plans (403(B) Plans) Page 16
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21Worksheet A. Cost of Incidental Life Insurance
Note. Use this worksheet to figure the cost of incidental life insurance included in your annuity contract. This amount will be used to
figure includible compensation for your most recent year of service.
1.
Enter the value of the contract (amount payable upon your death) . . . . . . . . . . . . . . . . . . . . .
1.
2.
Enter the cash value in the contract at the end of the year . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.
3.
3.
Subtract line 2 from line 1. This is the value of your current life insurance protection . . . . . . . . .
4.
4.
Enter your age on your birthday nearest the beginning of the policy year . . . . . . . . . . . . . . . . .
5.
Enter the 1-year term premium for $1,000 of life insurance based on your age. (From
Figure
3-1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.
6.
Divide line 3 by $1,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6.
7.
Multiply line 6 by line 5. This is the cost of your incidental life insurance . . . . . . . . . . . . . . . . . .
7.
Worksheet B. Includible Compensation for Your Most Recent Year of Service
1
Note. Use this worksheet to figure includible compensation for your most recent year of service.
1. Enter your includible wages from the employer maintaining your 403(b) account for your most
recent year of service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.
2. Enter elective deferrals excluded from your gross income for your most recent year of service
2.
2
3. Enter amounts contributed or deferred by your employer under a cafeteria plan for your most
3.
recent year of service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4. Enter amounts contributed or deferred by your employer according to your election to your 457
account (a nonqualified plan of a state or local government or of a tax-exempt organization) for
your most recent year of service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.
5. Enter pre-tax contributions (employer’s contributions made on your behalf according to your
5.
election) to a qualified transportation fringe benefit plan for your most recent year of service . .
6. Enter your foreign earned income exclusion for your most recent year of service . . . . . . . . . .
6.
7. Add lines 1, 2, 3, 4, 5, and 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7.
8. Enter the cost of incidental life insurance that is part of your annuity contract for your most
recent year of service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8.
9. Enter compensation that was both:
•
Earned during your most recent year of service, and
•
9.
Earned while your employer was not qualified to maintain a 403(b) plan . . . . . . . . . . . . .
10. Add lines 8 and 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10.
11. Subtract line 10 from line 7. This is your includible compensation for your most recent year of
service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11.
1
Use estimated amounts if figuring includible compensation before the end of the year.
2
Elective deferrals made to a designated Roth account are not excluded from your gross income and should not be included on this line.
Worksheet C. Limit on Catch-Up Contributions
Note. If you will be age 50 or older by the end of the year, use this worksheet to figure your limit on catch-up
contributions.
1. Maximum catch-up contributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.
$5,500
2. Enter your includible compensation for your most recent year of service . . . . . . . . . . . . . . . . .
2.
3. Enter your elective deferrals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.
4. Subtract line 3 from line 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.
5. Enter the lesser of line 1 or line 4. This is your limit on catch-up contributions . . . . . . . . . . . . .
5.
Chapter 9 Worksheets
Page 16
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