Countries and Languages
| Countries | Languages |
|---|---|
| USA | English |
Extracted Fields
Basic Form Information
| Field | Description |
|---|---|
| Void | Specifies that the processed form should be annulled. |
| Corrected | Specifies that the processed form is being submitted to correct data provided earlier. |
| Year | The reporting fiscal year. |
Payer Details
| Field | Description |
|---|---|
| Name | The name, address, and phone number of the payer. |
| Street | The name, address, and phone number of the payer. |
| City | The name, address, and phone number of the payer. |
| State | The name, address, and phone number of the payer. |
| ZIP Code | The name, address, and phone number of the payer. |
| Country | The name, address, and phone number of the payer. |
| Phone | The name, address, and phone number of the payer. |
Tax Identification Numbers
| Field | Description |
|---|---|
| Payer’s TIN | The tax identification number assigned to the payer. |
| Recipient’s TIN | The tax identification number assigned to the recipient of the payments. |
Recipient Details
| Field | Description |
|---|---|
| Name | The name and address of the payment recipient. |
| Street | The name and address of the payment recipient. |
| City | The name and address of the payment recipient. |
| State | The name and address of the payment recipient. |
| ZIP Code | The name and address of the payment recipient. |
| Country | The name and address of the payment recipient. |
Account Information
| Field | Description |
|---|---|
| Account Number | The unique number used by the payer to identify the payment recipient. |
Distribution Information
| Field | Description |
|---|---|
| Gross Distribution | The total amount distributed (before taxes and other deductions). |
| Taxable Amount | The amount distributed that is subject to taxation (if the data required to calculate this amount can be obtained). |
| Taxable Amount Not Determined | Specifies that the data required to calculate an amount for box 2a (Taxable Amount) cannot be obtained. |
| Total Distribution | Specifies that the amount specified in box 1 (Gross Distribution) was either a once-off payment, or that the payment received in the specified fiscal year was the last in a series of periodic or partial payments. |
| Capital Gain | The amount taxable as capital gains. |
| Federal Income Tax Withheld | The total amount withheld as federal income tax. |
Employee Contributions and Securities
| Field | Description |
|---|---|
| Employee Contributions or Insurance Premiums | The amount paid by the recipient as employee contributions or insurance premiums (eligible for tax deductions in the reporting fiscal year). |
| Net Unrealized Appreciation in Employer’s Securities | The net unrealized appreciation of employer’s securities received by the payment recipient. |
Distribution Codes and Account Types
| Field | Description |
|---|---|
| Distribution Code | The distribution code or codes. The payer may specify up to two codes, which are then used by the IRS to determine whether the payment recipient has provided the correct information about the payments. The following symbols are allowed: numbers 1-9 and Latin letters A-W. |
| IRA SEP SIMPLE | Specifies that the payments were made from either an individual retirement account (IRA), a SEP IRA account, or a SIMPLE IRA account. |
Annuity and Distribution Details
| Field | Description |
|---|---|
| Other | The distribution amount received from an annuity contract. If the distribution is made to more than one recipient, the share distributed to the recipient specified in the form is also shown. |
| Other (%) | The distribution amount received from an annuity contract. If the distribution is made to more than one recipient, the share distributed to the recipient specified in the form is also shown. |
| Your Percentage of Total Distribution | The percentage of the distribution received by the recipient (if the distribution was made to more than one recipient). |
Employee Contribution History
| Field | Description |
|---|---|
| Total Employee Contributions | The total amount of employee contributions paid by the recipient. Contributions that were already subject to tax deductions during any previous fiscal year are not specified. |
Roth Account Information
| Field | Description |
|---|---|
| Amount Allocable to IRR within 5 Years | The total amount that can be allocated as an in-plan Roth rollover made within 5 years from the date of the first contribution to the Roth account. |
| First Year of Designated Roth Contributions | The first year the recipient made a contribution to the designated Roth account. |
Compliance and Payment Information
| Field | Description |
|---|---|
| FATCA Filing Requirement | Specifies that the Foreign Account Tax Compliance Act (FATCA) filing requirement is satisfied. |
| Date of Payment | Specifies the date of payment for reportable death benefits in the following format: MM/DD/YYYY. |
State and Local Tax Information
| Field | Description |
|---|---|
| State Tax Withheld 1 | State- and locality-specific payment and tax information. Contains the payment amounts, the withheld tax, the names of the states and localities, as well as the taxpayer identification numbers assigned to the payer in the corresponding states. |
| State Tax Withheld 2 | State- and locality-specific payment and tax information. Contains the payment amounts, the withheld tax, the names of the states and localities, as well as the taxpayer identification numbers assigned to the payer in the corresponding states. |
| State and Payer State Number 1 | State- and locality-specific payment and tax information. Contains the payment amounts, the withheld tax, the names of the states and localities, as well as the taxpayer identification numbers assigned to the payer in the corresponding states. |
| State and Payer State Number 2 | State- and locality-specific payment and tax information. Contains the payment amounts, the withheld tax, the names of the states and localities, as well as the taxpayer identification numbers assigned to the payer in the corresponding states. |
| State Distribution 1 | State- and locality-specific payment and tax information. Contains the payment amounts, the withheld tax, the names of the states and localities, as well as the taxpayer identification numbers assigned to the payer in the corresponding states. |
| State Distribution 2 | State- and locality-specific payment and tax information. Contains the payment amounts, the withheld tax, the names of the states and localities, as well as the taxpayer identification numbers assigned to the payer in the corresponding states. |
| Local Tax Withheld 1 | State- and locality-specific payment and tax information. Contains the payment amounts, the withheld tax, the names of the states and localities, as well as the taxpayer identification numbers assigned to the payer in the corresponding states. |
| Local Tax Withheld 2 | State- and locality-specific payment and tax information. Contains the payment amounts, the withheld tax, the names of the states and localities, as well as the taxpayer identification numbers assigned to the payer in the corresponding states. |
| Name of Locality 1 | State- and locality-specific payment and tax information. Contains the payment amounts, the withheld tax, the names of the states and localities, as well as the taxpayer identification numbers assigned to the payer in the corresponding states. |
| Name of Locality 2 | State- and locality-specific payment and tax information. Contains the payment amounts, the withheld tax, the names of the states and localities, as well as the taxpayer identification numbers assigned to the payer in the corresponding states. |
| Local Distribution 1 | State- and locality-specific payment and tax information. Contains the payment amounts, the withheld tax, the names of the states and localities, as well as the taxpayer identification numbers assigned to the payer in the corresponding states. |
| Local Distribution 2 | State- and locality-specific payment and tax information. Contains the payment amounts, the withheld tax, the names of the states and localities, as well as the taxpayer identification numbers assigned to the payer in the corresponding states. |
Key Fields
- Year
- Payer Details/Name
- Payer’s TIN
- Recipient’s TIN
- Recipient Details/Name
- Account Number
- Gross Distribution
- Taxable Amount
Validation Rules
| Rule | Description |
|---|---|
| Complete Form Year | Checks the value in the Year field. It removes any white spaces and converts a 2-digit year into a 4-digit format. If the last two digits are numeric and start with 9, it converts the value to the 1900’s (for example, 99 converts to 1999). Otherwise, it assumes the date is from the 2000’s (for example, 24 converts to 2024). |