IRS Approved 1099-R Recipient State City or Local Copy C Tax Form - 100 Recipients

Perforation: Horizontal at 5 1/2"; Vertical at 1/2" from Right

File Form 1099-R, Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc., for each person to whom you have made a designated distribution or are treated as having made a distribution of $10 or more from profit-sharing or retirement plans, any individual retirement arrangements (IRAs), annuities, pensions, insurance contracts, survivor income benefit plans, permanent total disability payments under life insurance contracts, charitable gift annuities, etc. Also, report on Form 1099-R death benefit payments made by employers that are not made as part of a pension, profit-sharing, or retirement plan. Reportable disability payments made from a retirement plan must be reported on Form 1099-R. Generally, do not report payments subject to withholding of social security Medicare Taxes on this form. Report such payments on Form W-2, Wage Tax Statement. Generally, do not report amounts totally exempt from tax, such as workers compensation Department of Veterans Affairs (VA) payments. However, if part of the distribution is taxable part is non-taxable, report the entire distribution.

• 82641
• BRREC05