Form 1099-R Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, Individual Retirement Arrangements,
Insurance Contracts, etcetera. 2008
Summary: This is an example of Form 1099-R (2008) with information completed per the text. The line items are completed as
follows:
|
“PAYER'S name, street address, city, state, and ZIP code” field contains:
|
| Brown's Real Estate |
| Profit-Sharing Plan |
| 2101 Chelsea Court |
| Anytown, Nevada 89300 |
|
|
“PAYER'S federal identification number” field contains 10-0000000
|
|
“RECIPIENT'S identification number” field contains 005-00-6789
|
|
“RECIPIENT'S name” field contains Mary Brown
|
|
“Street address (including apt. number)” field contains 12 Mill Avenue
|
|
“City, state, and ZIP code” field contains Anytown, Nevada 89300
|
|
|
“1. Gross distribution” field contains $160000.00
|
|
“2a. Taxable amount” field contains $160000.00
|
|
“2b. Total distribution” checkbox checked
|
|
“4. Federal income tax withheld” field contains $32000.00
|
|
“7. Distribution code” field contains 7A
|
|
“8. Other” field contains $10000.00
|
