Form Sc4972 - Tax On Lump-Sum Distributions From Qualified Retirement Plans - 2012
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1
21350
STATE OF SOUTH CAROLINA
SC4972
DEPARTMENT OF REVENUE
(Rev. 3/21/12)
TAX ON LUMP-SUM DISTRIBUTIONS
3107
From Qualified Retirement Plans
2012
Attach to form SC1040 or form SC1041.
See federal instructions.
Name of recipient of distribution
Identifying number
Part I
Complete this part to choose capital gain election. (See federal instructions.)
1
1
Capital gain part from Box 3 of Form 1099-R...............................................................................
Multiply line 1 by 3.92% (.0392)
2
If you choose to use Part II, go to line 3. Otherwise, enter the amount from line 2 of this
form on SC1040, line 7; or SC1041, line 9............................................................................
2
Part II
Complete this part to choose the 10-year tax option. (See federal instructions.)
3
3
Amount from line 10 of federal Form 4972 .................................................................................
4
Caution: Retirement Deduction - (See instructions)
4a
a) Taxpayer: Date of Birth
4b
b) Spouse:
Date of Birth
4c
c) Surviving Spouse: Date of Birth of Deceased Spouse
5
Age 65 and older deduction - (See instructions )
5a
a) Taxpayer: Date of Birth
5b
b) Spouse:
Date of Birth
6
Add lines 4 and 5.........................................................................................................................
6
7
7
Total taxable amount (subtract line 6 from line 3) .......................................................................
Current actuarial value of annuity (from Form 1099-R, box 8) ....................................................
8
8
Adjusted total taxable amount. Add lines 7 and 8. If this amount is $70,000 or more, skip lines
9
10 through 13, and enter this amount on line 14 and go to line 15...............................................
9
10
10
Multiply line 9 by 50% (.50), but do not enter more than $10,000...
11
Subtract $20,000 from line 9. If the
11
result is less than zero, enter -0-....
12
12
Multiply line 11 by 20% (.20)...........................................................
13
Minimum distribution allowance. Subtract line 12 from line 10....................................................
13
14
Subtract line 13 from line 9 or enter the amount from line 9 if the amount is $70,000 or more....
14
South Carolina estate tax attributable to lump-sum distribution...................................................
15
15
Subtract line 15 from line 14
16
If line 8 is blank, skip lines 17 through 19 and go to line 20..................................................
16
17
Divide line 8 by line 9 and enter the results as a decimal (round to at least four places) .............
17
Multiply line 13 by the decimal on line 17.....................................................................................
18
18
19
Subtract line 18 from line 8...........................................................................................................
19
20
Multiply line 16 by 10% (.10).........................................................................................................
20
21
Tax on amount on line 20. Use the Tax Rate Schedule on back ................................................
21
22
Multiply line 21 by ten (10). If line 8 is blank, skip lines 23 through 25, and enter this amount
on line 26 and go to line 27...........................................................................................................
22
31071020
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