2b. Taxable amount not determined = An X means the non taxable could not be determined (NOT used by PSPRS).

Transcription

1 Box # Title Attachment (Example) 1. Gross Distribution = Total of benefit amount. (A) 2a. Taxable amount = Taxable benefit amount. 2b. Taxable amount not determined = An X means the non taxable could not be determined (NOT used by PSPRS). Total Distribution = An X means the payment in box 1 is the member s entire balance in the plan. 3. Capital gain (included in box 2a) = The taxable amount of a capital gain (NOT used by PSPRS). 4. Federal income tax withheld = Total federal income taxes paid (B) 5. Employee contributions/designated Roth contribution or insurance premiums = The total non taxable benefit amount only. PSPRS does NOT have Roth contributions. See Attachments #1 D and #2 D about year to date insurance premiums. Check your December Direct Deposit Notice on our website at Members Only for your insurance information. (D)

2 6. Net unrealized appreciation in employer s securities = Net unrealized appreciation from a qualified plan which includes securities of the employer corporation (NOT used by PSPRS). 7. Distribution code(s) = Type of benefit paid. See Attachment #3 IRA/SEP SIMPLE = An X means the distribution is from a IRA, SEP IRA, or Simple IRA (NOT used by PSPRS). 8. Other $ = Current actuarial value of an annuity contract that is part of a lump sum distribution. % = Percentage amount of reduction in the investment. 9a. Your percentage of total distribution = If distribution was made to multiple people, this is the member s percentage. 9b. Total employee contributions = Total employee contributions. This is not a required field (NOT used by PSPRS). 10. Amount allocable to IRR within 5 years = Distribution amount that can be allocated to an IRR made within the 5 year period beginning the first day the rollover was made (NOT used by PSPRS) st year of design. Roth contrib.. = First year of the 5 taxable year period Roth account was established (NOT used by PSPRS). 12. State tax withheld = Total Arizona state income taxes. (C) 13. State/Payer state no. = Taxpayer ID for state (NOT used by PSPRS Fed ID is same as state). 14. State distribution = Distribution code for state (NOT used by PSPRS). 15. Local tax withheld = Local taxes withheld (NOT used by PSPRS). 16. Name of locality = Name of locality for local taxes withheld (NOT used by PSPRS). 17. Local Distribution = Local distribution code for local taxes withheld (NOT Used by PSPRS). 18. Payer s name, street address, city, state, and Zip Code = System name and complete address from where the benefit was paid. (E) 19. Payer s Federal Identification number = Federal tax ID from system where benefit was paid. 20. Recipient s Identification number = Social Security number of benefit recipient.

3 21. Recipient s address, city, state, ZIP Code = Address and recipient of benefit recipient. (F) 22. Account number = Member s System and ID provided by PSPRS, CORP or EORP. (G) Attachment #1 Direct Deposit Notice printed from

4 Attachment #2 Direct Deposit Notice sent from Wells Fargo

5 Attachment #3 Internal Revenue Service (IRS) Distribution Codes for box #7 NOTE: The IRS has many more codes, but the table below explains the codes used by PSPRS, CORP and EORP. If you would like to see all codes, visit the IRS website. Distribution Codes Explanations 1 Early Distribution, no known exception. Used when employee has reached age 59 ½ and there are no exceptions or known exceptions. 2 Early Distribution, exception applies Used if employee has not reached age 59 ½ and one of the following exceptions exist: A Roth IRA conversion (an IRA converted to a Roth IRA) A distribution made from a qualified retirement plan or IRA because of an IRS levy under section A section 457(b) plan distribution that is not subject to the additional 10% tax. A distribution from a qualified retirement plan after separation from service in or after the year the taxpayer has reached age 55. A distribution from a governmental defined benefit plan to a public safety employee after separation from service in or after the year the employee has reached age 50. A distribution made to an alternate payee under a qualified domestic relations order. 3 Disability Used when receiving a Temporary, Accidental or Catastrophic disability. 4 Death Used regardless of the age of the employee to indicate payment to a decedent s beneficiary, including an estate or trust. Also used for death benefit payments made by an employer, but not made as a part of a pension, profit-sharing or retirement plan. 7 Normal Distribution Used for a normal pension where employee is 59 ½ and over. G Direct rollover and rollover contributions Used when distribution is a rollover from a qualified plan to another qualified plan.