Schedule J (Form N-11/n-15/n-40) - Supplemental Annuities Schedule - 2015 Page 2
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3SCHEDULE J (FORM N-11/N-15/N-40) INSTRUCTIONS
Page 2
Note: Section 18-235-7-03(c), Hawaii Administrative Rules, clarifies
4. A pension plan to which NO employee contributions were made
that pension plan distributions received after 1997 are exempt from the
(i.e. the employer paid for the entire cost of the pension) if distribu-
Hawaii income tax when the distributions are attributable to certain em-
tions are made for any reason other than because of retirement
ployer contributions. The purpose of the rule is to exempt distributions
or the attainment of age 70-1/2 (e.g., you quit, were laid off or
attributable to employer contributions, notwithstanding the employer’s
fired, the plan was terminated, etc.). The full amount received is
choice of entity for doing business (i.e., sole proprietorship, S corpora-
taxable and must be reported on Form N-15, line 16, Column A. If
tions, partnerships, and limited liability companies).
you are filing Form N-11, the taxable amount should have already
been included in the amount reported as federal adjusted gross
WHO MUST USE THIS FORM
income on line 7.
You MUST use this form if you received payment from any of the
5. The state retirement system or any other public retirement system.
following:
These amounts are not subject to Hawaii’s personal net income
tax. If you are filing Form N-11, the amount reported as taxable
1. A privately purchased annuity. The portion of your cost included
pension for federal should be included on Form N-11, line 13.
in each distribution may be excluded.
If you have received a lump-sum distribution, also see Form N-152,
2. A profit-sharing plan to which employee contributions were made.
Tax on Lump-Sum Distributions.
Only the increase in the value of the plan attributable to your con-
tributions is taxable.
See Administrative Rules section 18-235-7-01 through 18-235-7-03
for further information.
3. A death benefit as a beneficiary of a deceased employee.
LINE-BY-LINE INSTRUCTIONS
4. A pension plan to which employee contributions were made (i.e.
both the employee and the employer contributed towards the cost
PART I — COMPUTATION OF THE ANNUAL PENSION
of the pension). Only the increase in the value of the plan attribut-
EXCLUSION —
Use this part to compute the amount of the
able to your contributions is taxable.
nontaxable portion of pension or annuity payments received each
5. A qualified retirement plan in the form of a lump-sum and you are
year.
using Form N-152 to make a capital gain election or to use the
This Part must be completed only in the first year a distribution is
10-year averaging method to report the lump-sum distribution.
received. The computations made in this Part will not change from
6. A hybrid plan which is partly pension and partly deferred com-
year to year. Keep a copy of this Part since you will need the informa-
pensation, such as a 401(k) plan with a profit-sharing component
tion each year a distribution is received to compute the taxable portion
or employer matching program, an SEP plan with employer con-
of the distribution.
tributions as well as salary reduction option, or any similar hybrid
Line 1. Annual annuity — Enter the amount you will receive each
plan.
year. If you received a distribution for only part of a year, report an
If you did not contribute to the cost of your annuity that is not a part
amount that reflects what you would have received had distributions
of an employer’s pension plan or you recovered your entire cost before
been made for a 12 month period.
July 1, 1989, under the prior three year recovery rule, report your total
Include on this line only amounts that are fixed and definite. Any
annuity received this year on Form N-15, line 16, Column A. If you are
indefinite or varying amounts should be included in Part II, line 15.
filing Form N-11, the taxable amount should have already been includ-
ed in the amount reported as federal adjusted gross income on line 7.
If you are using this form to determine the taxable amount of a lump-
sum distribution to be reported on Form N-152, enter on line 1 the total
If you receive benefits from more than one plan, a separate Sched-
amount of the distribution. If you are electing to include in taxable in-
ule J must be completed for each plan.
come this year the net unrealized appreciation (NUA) of your employ-
er’s securities received as part of the distribution, include on this line
WHO SHOULD NOT USE THIS FORM
the appropriate amount from the box which is your NUA in employer’s
DO NOT use this form if you received a payment from any of the
securities on federal Form 1099-R.
following:
Line 2. Multiple — Enter the multiple used for federal purposes to de-
1. An annuity you receive which is NOT part of your employer’s pen-
termine the expected return on the contract. This number represents
sion plan AND to which no employee contributions were made.
the expected number of years that the annuity will be paid based on
The full amount received is taxable and must be reported on
your age and other factors. See the discussion regarding Expected Re-
Form N-15, line 16, column A. If you are filing Form N-11, the
turn and actuarial tables in Internal Revenue Service Publication 939.
taxable amount should have already been included in the amount
If you are using this form to determine the taxable amount of a lump-
reported as federal adjusted gross income on line 7.
sum distribution to be reported on Form N-152, enter “1” on this line.
2. An annuity you receive which is NOT part of your employer’s pen-
Line 4a. Employee’s contributions which were previously taxed
sion plan in which the cost to you was recovered before July 1,
— This includes premiums, contributions, or other amounts paid includ-
1989, under the three year recovery rule formerly permitted. The
ing amounts your employer contributed if you were required to include
full amount received is taxable and must be reported on Form
these amounts in income.
N-15, line 16, Column A. If you are filing Form N-11, the tax-
able amount should have already been included in the amount
Do NOT include amounts paid for health and accident benefits or
reported as federal adjusted gross income on line 7.
deductible voluntary employee contributions. Also do NOT include
any refunded premiums, rebates, dividends, or unrepaid loans (any of
3. A pension plan to which NO employee contributions were made
which were not included in your income) that you received before the
(i.e. the employer paid for the entire cost of the pension) if distribu-
later of the annuity starting date or the date on which you received your
tions are made after retiring or after attaining the age of 70-1/2.
first payment. Finally, do NOT include any additional premiums paid for
The entire amount is NOT subject to Hawaii taxation and need
double indemnity or disability benefits and any other amounts received
not be reported. If you are filing Form N-11, the amount reported
under the contract or plan before the later of the above dates that you
as taxable for federal should be included on Form N-11, line 13.
did not have to include in your income.
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