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beneficiary, without any intervening distribution or

Recipient's Name and Social Security Number

deemed distribution to the designated beneficiary.

(SSN)

List the designated beneficiary as the recipient unless you

Specific Instructions for Form

are reporting a returned excess contribution to the

1099-QA

contributor. In that case, list the contributor as the

recipient. Enter the SSN of the applicable recipient.

Who Must File

Account Number

Any State or its agency or instrumentality that establishes

The IRS encourages you to designate an account number

and maintains a qualified ABLE program must file a Form

for all Forms 1099-QA that you file. See part L in the 2016

1099-QA, Distributions from ABLE Accounts, with the IRS

General Instructions for Certain Information Returns.

on or before February 28, 2017, for each ABLE account

from which any distribution was made or which was

Box 1. Gross Distribution

terminated during 2016. The filing may be done by either

Enter the gross distribution from the ABLE account in

an officer or employee of the State or its agency or

2016. The gross distribution includes amounts distributed

instrumentality having control of the qualified ABLE

that the designated beneficiary intends to roll over to

program, or the officer’s or employee’s designee.

another ABLE account, but does not include

Do not file Form 1099-QA for a change in the name of

program-to-program transfers. See Rollovers and

the designated beneficiary on an ABLE account if the new

program-to-program transfers, earlier. A gross distribution

designated beneficiary is an eligible individual and a

also includes a withdrawal of excess contributions plus

member of the family of the former designated

earnings.

beneficiary. For these purposes, a “member of the family”

Box 2. Earnings

means a sibling, whether by blood or by adoption, and

includes a brother, sister, stepbrother, stepsister,

To determine the earnings on the gross distribution

half-brother, or half-sister. If the new designated

reported in box 1, see Proposed Regulations section

beneficiary is not an eligible individual for the tax year or is

1.529A-3(c).

not a member of the family of the former beneficiary, the

Box 3. Basis

Form 1099-QA filed with respect to the former designated

beneficiary should include in Box 1 the fair market value of

Enter the portion of the distribution that constitutes the

the assets in the ABLE account on the date on which the

return of investment in the account. The amount of the

change is made to the new designated beneficiary.

gross distribution minus the earnings portion of that

distribution is the portion of the distribution that constitutes

Statements to Recipients

the return of investment in the account. This amount is

If you are required to file Form 1099-QA, you also must

computed by subtracting the amount in box 2 from the

furnish a statement to the designated beneficiary of the

amount in box 1.

ABLE account reporting their distribution, and to each

Box 4. Program-to-Program Transfer Checkbox

contributor who received a returned contribution (plus

earnings) attributable to the calendar year. Furnish a copy

Check this box if a program-to-program transfer was

of Form 1099-QA or an acceptable substitute statement to

made from this ABLE account to another ABLE account in

each recipient. See part M in the 2016 General

2016. See Rollovers and program-to-program transfers,

Instructions for Certain Information Returns.

earlier.

Truncating recipient’s identification number on pay-

Box 5.

ee statements. Pursuant to Treasury Regulations

Check the box if the ABLE account terminated in 2016.

section 301.6109-4, all filers of this form may truncate a

recipient’s identification number (social security number

Box 6. Other Than Designated Beneficiary

(SSN), individual taxpayer identification number (ITIN),

Checkbox

adoption taxpayer identification number (ATIN), or

Check this box if this form is being filed with respect to a

employer identification number (EIN)) on recipient

distribution to or for the benefit of someone other than the

statements. Truncation is not allowed on any documents

designated beneficiary of the ABLE account, for example,

the filer files with the IRS. A payer's identification number

a distribution of an excess contribution to the contributor.

may not be truncated on any form. See part J in the 2016

General Instructions for Certain Information Returns.

Specific Instructions for Form

Payer's Name and Federal Identification

5498-QA

Number

For the payer's name and federal identification number,

Who Must File

enter the name, address, and taxpayer identification

Any State or its agency or instrumentality that establishes

number (TIN). For a program established and maintained

and maintains a qualified ABLE program must file, for

by a state that uses the EIN of the state, enter the name of

each ABLE account, a Form 5498-QA, ABLE Account

the state on the first name line and the name of the

Contribution Information, with the IRS on or before May

program on the second name line.

31, 2017. The filing may be done by either an officer or

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Instructions for Forms 1099-QA and 5498-QA (2016)

Instructions For Forms 1099-Qa And 5498-Qa - Distributions From Able Accounts And Able Account Contribution Information - 2016 Page 4

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