2012 Department of the Treasury
Internal Revenue Service
Instructions for Form 5329
Additional Taxes on Qualified Plans (Including IRAs)
and Other Tax-Favored Accounts
Section references are to the Internal Revenue owe the additional tax on each Form 1040 or Form 1040NR. Be sure to
Code unless otherwise noted. 1099-R, you do not have to file Form include your address on page 1 of the
5329. Instead, see the instructions for form and your signature and the date on
General Instructions Form 1040, line 58, or Form 1040NR, page 2 of the form. Enclose, but do not
line 56, for how to report the 10% attach, a check or money order payable
additional tax directly on that line. to “United States Treasury” for any
Future Developments You received an early distribution taxes due. Write your SSN and “2012
For the latest information about subject to the tax on early distributions Form 5329” on the check. For
developments related to Form 5329 and from a qualified retirement plan (other information on other payment options,
its instructions, such as legislation than a Roth IRA), you meet an including credit or debit card payments,
enacted after they were published, go to exception to the tax on early see the instructions for Form 1040 or
www.irs.gov/form5329. distributions, and distribution code 1 is Form 1040NR, or go to IRS.gov.
shown in box 7 of Form 1099-R.
What's New You received an early distribution
Prior tax years. If you are filing Form
You can elect to treat a qualified 5329 for a prior year, you must use the
subject to the tax on early distributions prior year's version of the form. If you do
charitable distribution (QCD) made in from a qualified retirement plan (other
January 2013 as if it was made in 2012. not have any other changes and have
than a Roth IRA), you meet an not previously filed a federal income tax
Additionally, any portion of a distribution exception to the tax on early
from an IRA in December 2012 return for the prior year, file the prior
distributions from the list on page 3, but year's version of Form 5329 by itself
contributed as cash (or cash equivalent) box 7 of your Form 1099-R does not
to a charity before February 1, 2013 can (discussed earlier). If you have other
indicate an exception or the exception changes, file Form 5329 for the prior
be treated as a QCD if it meets certain does not apply to the entire distribution.
requirements. Both these transactions year with Form 1040X, Amended U.S.
You received taxable distributions Individual Income Tax Return.
can count towards your minimum from Coverdell ESAs or QTPs.
required distributions for 2012. See
Pub. 590, Individual Retirement
The contributions for 2012 to your Definitions
traditional IRAs, Roth IRAs, Coverdell
Arrangements (IRAs), for more ESAs, Archer MSAs, or HSAs exceed Qualified retirement plan. A qualified
information. your maximum contribution limit, or you retirement plan includes:
had a tax due from an excess A qualified pension, profit-sharing, or
Purpose of Form contribution on line 17, 25, 33, 41, or 49 stock bonus plan (including a 401(k)
Use Form 5329 to report additional of your 2011 Form 5329. plan),
taxes on: You did not receive the minimum A tax-sheltered annuity contract,
IRAs, required distribution from your qualified A qualified annuity plan, and
Other qualified retirement plans, retirement plan. An IRA.
Modified endowment contracts,
If you rolled over part or all of a Note. Modified endowment contracts
TIP distribution from a qualified are not qualified retirement plans.
QTPs, retirement plan, the part rolled
Archer MSAs, or over is not subject to the 10% additional Traditional IRAs. For purposes of
HSAs. tax on early distributions. See the Form 5329, a traditional IRA is any IRA,
instructions for Form 1040, lines 15a including a simplified employee pension
Who Must File and 15b or lines 16a and 16b; Form (SEP) IRA, other than a SIMPLE IRA or
You must file Form 5329 if any of the 1040A, lines 11a and 11b or 12a and Roth IRA.
following apply. 12b; or Form 1040NR, lines 16a and Early distribution. Generally, any
You received an early distribution 16b or 17a and 17b, for how to report distribution from your IRA, other
from a Roth IRA, the amount on line 23 the rollover. qualified retirement plan, or modified
of Form 8606, Nondeductible IRAs, is endowment contract before you reach
more than zero, and you are required to
enter an amount that is more than zero
When and Where To File age 591 2 is an early distribution.
on Form 5329, line 1 (see Distributions File Form 5329 with your 2012 Form Rollover. Generally, a rollover is a
from Roth IRAs, later). 1040 or Form 1040NR by the due date, tax-free distribution of assets from one
You received an early distribution including extensions, of your Form 1040 qualified retirement plan that is
subject to the tax on early distributions or Form 1040NR. reinvested in another plan or the same
from a qualified retirement plan (other plan. Generally, you must complete the
If you do not have to file a 2012
than a Roth IRA). However, if rollover within 60 days of receiving the
income tax return, complete and file
distribution code 1 is correctly shown in distribution. Any taxable amount not
Form 5329 by itself at the time and
box 7 of all your Forms 1099-R, and you rolled over must be included in income
place you would be required to file Form
Jan 06, 2013 Cat. No. 13330R
and may be subject to the 10% Additional Information Note. Any related IRA earnings
additional tax on early distributions. See Pub. 590, Individual Retirement withdrawn with excess IRA contributions
You can roll over (convert) amounts Arrangements; Pub. 560, Retirement are subject to the 10% additional tax on
from a qualified retirement plan to a Plans for Small Business; Pub. 575, early distributions if you were under age
Roth IRA. Any amount rolled over to a Pension and Annuity Income; Pub. 969, 591 2 at the time of the distribution.
Roth IRA is subject to the same rules for Health Savings Accounts and Other
converting a traditional IRA to a Roth Tax-Favored Health Plans; Pub. 970, A distribution of excess contributions
IRA. You must include in your gross Tax Benefits for Education; and Pub. from a qualified cash or deferred
income distributions from a qualified 4492-B, Information for Affected arrangement.
retirement plan that you would have had Taxpayers in the Midwestern Disaster A distribution of excess aggregate
to include in income if you had not rolled Areas. contributions to meet nondiscrimination
them into a Roth IRA. Generally, the requirements for employee
10% additional tax on early distributions contributions and matching employer
does not apply. For more information, Specific Instructions contributions.
see chapter 2 of Pub. 590. A distribution of excess deferrals.
Joint returns. If both you and your A distribution from an eligible
The IRS may waive the 60-day spouse are required to file Form 5329,
requirement if failing to waive it would governmental section 457 deferred
complete a separate form for each of compensation plan to the extent the
be against equity or good conscience, you. Include the combined tax on Form
such as situations where a casualty, distribution is not attributable to an
1040, line 58. amount transferred from a qualified
disaster, or other events beyond your
reasonable control prevented you from Amended returns. If you are filing an retirement plan.
meeting the 60-day requirement. Also, amended 2012 Form 5329, check the See the instructions for line 2, later,
the 60-day period may be extended if box at the top of page 1 of the form. Do for other distributions that are not
you had a frozen deposit. See Pub. 590 not use the 2012 Form 5329 to amend subject to the tax.
for details. your return for any other year. For
information about amending a Form Line 1
In-plan Roth rollover. If you are a 5329 for a prior year, see Prior tax Enter the amount of early distributions
participant in a 401(k), 403(b), or years, earlier. included in income that you received
governmental 457(b) plan, your plan
may now permit you to roll over Part I—Additional Tax on A qualified retirement plan, including
amounts from those plans to a
designated Roth account within the Early Distributions earnings on withdrawn excess
In general, if you receive an early contributions to your IRAs included in
same plan. The rollover of any untaxed
distribution (including an involuntary income in 2012, or
amounts must be included in income.
Generally, the 10% additional tax on cashout) from an IRA, other qualified A modified endowment contract
early distributions does not apply. For retirement plan, or modified endowment entered into after June 20, 1988.
more information, see Pub. 575. contract, the part of the distribution Certain prohibited transactions, such
included in income generally is subject as borrowing from your IRA or pledging
Compensation. Compensation to the 10% additional tax. But see
includes wages, salaries, tips, bonuses, your IRA assets as security for a loan,
Distributions from a designated Roth are considered to be distributions and
and other pay you receive for services account and Distributions from Roth
you perform. It also includes sales may also cause you to owe the
IRAs, later. additional tax on early distributions. See
commissions, commissions on
insurance premiums, and pay based on The additional tax on early Pub. 590 for details.
a percentage of profits. It includes net distributions does not apply to any of the Distributions from a designated
earnings from self-employment, but only following: Roth account. If you received an early
for a trade or business in which your A qualified HSA funding distribution distribution from your designated Roth
personal services are a material from an IRA (other than a SEP or account, include on line 1 the amount of
income-producing factor. SIMPLE IRA). See Pub. 969 for details. the distribution that you must include in
For IRAs, treat nontaxable combat A distribution from a traditional or your income. You will find this amount in
pay and any differential wage payments, SIMPLE IRA that was converted to a box 2a of your 2012 Form 1099-R. You
and all taxable alimony received under a Roth IRA. may also need to include a recapture
decree of divorce or separate A rollover from a qualified retirement amount on line 1 if you have ever made
maintenance as compensation. plan to a Roth IRA. an in-plan Roth rollover (discussed
In-plan rollover to a designated Roth next).
Compensation does not include any
amounts received as a pension or If you never made an in-plan
A distribution of certain excess IRA
annuity and does not include any Roth rollover, you only need to
contributions (see the instructions for TIP
amount received as deferred include on line 1 of this form the
line 15, later, and the instructions for
compensation. amount from box 2a of your 2012 Form
line 23, later).
Taxable compensation is your 1099-R reporting the early distribution.
compensation that is included in gross
income reduced by any deductions on
Form 1040 or Form 1040NR, lines 27
and 28, but not by any loss from
-2- Instructions for Form 5329 (2012)
Recapture amount subject to the The recapture amount that you must
additional tax on early distributions. include on line 1 will not exceed the
If you have ever made an in-plan Roth amount of your early distribution; and,
rollover and you received an early for purposes of determining this 01 Qualified retirement plan distributions
distribution for 2012, the recapture recapture amount, a contribution, (does not apply to IRAs) you receive
amount to include on line 1 is a portion conversion, or rollover amount (or after separation from service in or
of amounts you rolled over. portion thereof) will only be allocated to after the year you reach age 55 (age
an early distribution once. 50 for qualified public safety
The recapture amount that you must
include on line 1 will not exceed the For more information about the
amount of your early distribution; and, recapture amount for distributions from 02 Distributions made as part of a series
for purposes of determining this a Roth IRA, including how to calculate it, of substantially equal periodic
recapture amount, a rollover amount (or see Pub. 590. Also, see the Example payments (made at least annually) for
portion of a rollover) will only be below that illustrates a situation where a your life (or life expectancy) or the
allocated to an early distribution once. taxpayer must include a recapture joint lives (or joint life expectancies)
amount on line 1. of you and your designated
For more information about the
beneficiary (if from an employer plan,
recapture amount for distributions from Example. You converted $20,000 payments must begin after separation
a designated Roth account, including from a traditional IRA to a Roth IRA in from service).
how to calculate it, see Pub. 575. 2008 and converted $10,000 in 2009.
Your 2008 Form 8606 had $5,000 on 03 Distributions due to total and
Distributions from Roth IRAs. If you permanent disability.
received an early distribution from your line 17 and $15,000 on line 18 and your
Roth IRAs, include on line 1 the part of 2009 Form 8606 had $3,000 on line 17 04 Distributions due to death (does not
the distribution that you must include in and $7,000 on line 18. You made Roth apply to modified endowment
your income. You will find this amount IRA contributions of $2,000 for 2008 contracts).
on line 25 of your 2012 Form 8606. You and 2009. You did not make any Roth
05 Qualified retirement plan distributions
will also need to include on line 1 the IRA conversions or contributions for up to (1) the amount you paid for
following amounts. 2010 through 2012, or take any Roth unreimbursed medical expenses
A qualified first-time homebuyer IRA distributions before 2012. during the year minus (2) 7.5% of
distribution from line 20 of your 2012 On July 9, 2012, at age 53, you took your adjusted gross income for the
Form 8606. Also include this amount on a $33,000 distribution from your Roth year.
line 2 and enter exception number 09. IRA. Your 2012 Form 8606 shows
06 Qualified retirement plan distributions
Recapture amounts attributable to $33,000 on line 19; $29,000 on line 23 made to an alternate payee under a
any conversions or rollovers to your ($33,000 minus $4,000 for your qualified domestic relations order
Roth IRAs in 2008 through 2012. See contributions on line 22) and $0 on (does not apply to IRAs).
Recapture amount subject to the line 25 ($29,000 minus your basis in
conversions of $30,000). 07 IRA distributions made to
additional tax on early distributions next.
unemployed individuals for health
First, $4,000 of the $33,000 is
If you did not convert or roll insurance premiums.
allocated to your 2012 Form 8606,
TIP over an amount to your Roth 08 IRA distributions made for higher
line 22; then $15,000 to your 2008 Form
IRAs in 2008 through 2012, or education expenses.
8606, line 18; $5,000 to your 2008 Form
have a first-time homebuyer distribution,
8606, line 17; and $7,000 to your 2009 09 IRA distributions made for purchase
you only need to include the amount
Form 8606, line 18. The remaining of a first home, up to $10,000.
from line 25 of your 2012 Form 8606 on
$2,000 is allocated to the $3,000 on
line 1 of this form. 10 Distributions due to an IRS levy on
your 2009 Form 8606, line 17. On line 1,
the qualified retirement plan.
Recapture amount subject to the enter $22,000 ($15,000 allocated to
additional tax on early distributions. your 2008 Form 8606, line 18, plus the 11 Qualified distributions to reservists
If you converted or rolled over an $7,000 that was allocated to your 2009 while serving on active duty for at
Form 8606, line 18). least 180 days.
amount to your Roth IRAs in 2008
through 2012 and you received an early If you take a Roth IRA distribution in 12 Other (see Other below). Also, enter
distribution for 2012, the recapture 2013, the first $1,000 will be allocated to this code if more than one exception
amount to include on line 1 is the the $1,000 remaining from your 2009 applies.
amount, if any, of the early distribution Form 8606, line 17, and will not be
allocated to the taxable portion of your subject to the additional tax on early
2008 through 2012 conversions or distributions. Other. The following exceptions also
rollovers. Additional information. For more apply.
Generally, an early distribution is details, see Are Distributions Taxable? Distributions incorrectly indicated as
allocated to your Roth IRA contributions in Pub. 590. early distributions by code 1, J, or S in
first, then to your conversions and box 7 of Form 1099-R. Include on line 2
rollovers on a first-in, first-out basis. The Line 2 the amount you received when you
recapture amount is the amount of the The additional tax on early distributions were age 591 2 or older.
conversion or rollover that was subject does not apply to the distributions Distributions from a section 457 plan,
to tax in the year of the conversion or described below. Enter on line 2 the which are not from a rollover from a
the rollover. An early distribution amount that can be excluded. In the qualified retirement plan.
allocated to a conversion or rollover is space provided, enter the applicable Distributions from a plan maintained
first allocated to the taxable portion. exception number (01-12). by an employer if:
Instructions for Form 5329 (2012) -3-
1. You separated from service by to avoid the tax on any 2012 excess which the excess contributions were
March 1, 1986; contributions (see the instructions for made were not more than the amounts
2. As of March 1, 1986, your entire line 15, later). shown in the following table.
interest was in pay status under a Line 9 Year(s) Contribution Contribution
written election that provides a specific
schedule for distribution of your entire Enter the amount from line 16 of your limit limit if age
2011 Form 5329 only if the amount on 50 or older at
interest; and the end of
line 17 of your 2011 Form 5329 is more
3. The distribution is actually being than zero. the year
made under the written election.
Line 10 2008 $5,000 $6,000
Distributions that are dividends paid through
If you contributed less to your traditional 2011
with respect to stock described in
IRAs for 2012 than your contribution
section 404(k). 2006 or $4,000 $5,000
limit for traditional IRAs, enter the
Distributions from annuity contracts to 2007
the extent that the distributions are 2005 $4,000 $4,500
allocable to the investment in the If you are not married filing jointly,
contract before August 14, 1982. your contribution limit for traditional 2002 $3,000 $3,500
For additional exceptions that apply IRAs is the smaller of your taxable
to annuities, see Pub. 575. compensation ( defined earlier) or
$5,000 ($6,000 if age 50 or older at the 1997 $2,000 —
Line 4 end of 2012). If you are married filing through
If any amount on line 3 was a jointly, your contribution limit is generally 2001
distribution from a SIMPLE IRA received $5,000 ($6,000 if age 50 or older at the before 1997 $2,250 —
within 2 years from the date you first end of 2012) and your spouse's
participated in the SIMPLE IRA plan, contribution limit is $5,000 ($6,000 if If the total contributions for the year
you must multiply that amount by 25% age 50 or older at the end of 2012). But included employer contributions to a
instead of 10%. These distributions are if the combined taxable compensation SEP, increase that amount by the
included in boxes 1 and 2a of Form for you and your spouse is less than smaller of the amount of the employer
1099-R and are designated with code S $10,000 ($11,000 if one spouse is 50 or contributions or:
in box 7. older at the end of 2012; $12,000 if both
spouses are 50 or older at the end of
Part II—Additional Tax on 2012), see How Much Can Be 2009 or 2010 $49,000
Certain Distributions From Contributed? in Pub. 590 for special 2008 $46,000
Education Accounts 2007 $45,000
Also include on line 11a or 11b 2006 $44,000
Line 6 (line 11 for Form 1040NR) of the IRA
This tax does not apply to distributions Deduction Worksheet in the instructions 2005 $42,000
that are includible in income if: for Form 1040 or Form 1040NR, line 32, 2004 $41,000
Made due to the death or disability of the smaller of (a) Form 5329, line 10, or 2002 or 2003 $40,000
the beneficiary; (b) the excess, if any, of Form 5329,
Made on account of a tax-free line 9, over the sum of Form 5329, lines 2001 $35,000
scholarship, allowance, or payment 11 and 12. before 2001 $30,000
described in section 25A(g)(2);
Made because of attendance by the
Enter on line 11 any withdrawals from Line 15
beneficiary at a U.S. military academy.
This exception applies only to the extent your traditional IRAs that are included in Enter the excess of your contributions to
that the distribution does not exceed the your income. Do not include any traditional IRAs for 2012 (unless
costs of advanced education (as withdrawn contributions reported on withdrawn—see below) over your
defined in title 10 of the U.S. Code) at line 12. contribution limit for traditional IRAs.
the academy; or See the instructions for line 10, earlier,
Line 12 to figure your contribution limit for
Included in income because you used
Enter any excess contributions to your traditional IRAs. Any amount you
the qualified education expenses to
traditional IRAs for 1976 through 2010 contribute for the year in which you
figure the American opportunity and
that you had returned to you in 2012 reach age 701 2 or a later year is an
lifetime learning credits.
and any 2011 excess contributions that excess contribution because your
Enter on line 6 the portion of line 5 you had returned to you in 2012 after contribution limit is zero. Do not include
that is excluded. the due date (including extensions) of rollovers in figuring your excess
your 2011 income tax return, that are contributions.
Part III—Additional Tax on included on line 9, if:
You can withdraw some or all of your
You did not claim a deduction for the
Excess Contributions to excess contributions and no traditional excess contributions for 2012 and they
Traditional IRAs IRA deduction was allowable (without will not be treated as having been
If you contributed more for 2012 than is regard to the modified AGI limitation) for contributed if:
allowable or you had an amount on the excess contributions, and You make the withdrawal by the due
line 17 of your 2011 Form 5329, you The total contributions to your date, including extensions, of your 2012
may owe this tax. But you may be able traditional IRAs for the tax year for tax return,
-4- Instructions for Form 5329 (2012)
You do not claim a traditional IRA $0 if married filing separately and you “Filed pursuant to section 301.9100-2”
deduction for the withdrawn lived with your spouse at any time in written at the top. Report any related
contributions, and 2012, or earnings for 2012 on the amended
You withdraw any earnings on the $110,000 for any other taxpayer. return and include an explanation of the
withdrawn contribution and include the withdrawal. Make any other necessary
earnings in gross income (see the See Pub. 590 for details. changes on the amended return (for
Instructions for Form 8606 for details). Line 20 example, if you reported the
Also, if you had not reached age 591 2 at contributions as excess contributions on
Generally, enter the amount from Form your original return, include an amended
the time of the withdrawal, include the
8606, line 19, plus any qualified Form 5329 reflecting that the withdrawn
earnings as an early distribution on
distributions. But if you withdrew the contributions are no longer treated as
line 1 of Form 5329 for the year in which
entire balance of all your Roth IRAs, do having been contributed).
you report the earnings.
not enter less than the amount on Form
If you timely filed your return without 5329, line 18 (see Example below).
withdrawing the excess contributions,
Part V—Additional Tax on
you can still make the withdrawal no
Example. You contributed $1,000 to Excess Contributions to
a Roth IRA in 2010, your only
later than 6 months after the due date of contribution to Roth IRAs. In 2012, you Coverdell ESAs
your tax return, excluding extensions. If discovered you were not eligible to If the contributions to your Coverdell
you do, file an amended return with contribute to a Roth IRA in 2010. On ESAs for 2012 were more than is
“Filed pursuant to section 301.9100-2” September 9, 2012, you withdrew $800, allowable or you had an amount on
written at the top. Report any related the entire balance in the Roth IRA. You line 33 of your 2011 Form 5329, you
earnings for 2012 on the amended must file Form 5329 for 2010 and 2011 may owe this tax. But you may be able
return and include an explanation of the to pay the additional taxes for those to avoid the tax on any 2012 excess
withdrawal. Make any other necessary years. When you complete Form 5329 contributions (see the instructions for
changes on the amended return (for for 2012, you enter $1,000 (not $800) line 31, later).
example, if you reported the on line 20, because you withdrew the
contributions as excess contributions on Line 26
your original return, include an amended Enter the amount from line 32 of your
Form 5329 reflecting that the withdrawn Line 23 2011 Form 5329 only if the amount on
contributions are no longer treated as Enter the excess of your contributions to line 33 of your 2011 Form 5329 is more
having been contributed). Roth IRAs for 2012 (unless than zero.
withdrawn—see below) over your
Part IV—Additional Tax on Line 27
contribution limit for Roth IRAs (see the
Enter the excess, if any, of the
Excess Contributions to instructions for line 19, earlier).
maximum amount that can be
Roth IRAs Do not include rollovers from another contributed to your Coverdell ESAs for
If you contributed more to your Roth IRA Roth IRA or designated Roth account in 2012 (see the instructions for line 31
for 2012 than is allowable or you had an figuring your excess contributions. below) over the amount actually
amount on line 25 of your 2011 Form contributed for 2012.
5329, you may owe this tax. But you You can withdraw some or all of your
may be able to avoid the tax on any excess contributions for 2012 and they Line 28
2012 excess contributions (see the will not be treated as having been Enter your total distributions from
instructions for line 23, later). contributed if: Coverdell ESAs in 2012. Do not include
You make the withdrawal by the due rollovers or returned excess
date, including extensions, of your 2012 contributions.
Line 18 tax return, and
Enter the amount from line 24 of your You withdraw any earnings on the Line 31
2011 Form 5329 only if the amount on withdrawn contributions and include the Enter the excess of the contributions to
line 25 of your 2011 Form 5329 is more earnings in gross income (see the your Coverdell ESAs for 2012 (not
than zero. Instructions for Form 8606 for details). including rollovers) over your
Also, if you had not reached age 591 2 at contribution limit for Coverdell ESAs.
Line 19 the time of the withdrawal, include the Your contribution limit is the smaller of
If you contributed less to your Roth IRAs earnings as an early distribution on $2,000 or the sum of the maximum
for 2012 than your contribution limit for line 1 of Form 5329 for the year in which amounts allowed to be contributed by
Roth IRAs, enter the difference. Your you report the earnings. the contributor(s) to your Coverdell
contribution limit for Roth IRAs is ESAs. The maximum contribution may
generally your contribution limit for Note. A Form 5329 is not required if the be limited based on the contributor's
traditional IRAs (see the instructions for excess Roth IRA contributions are not modified AGI. See Pub. 970 for details.
line 10, earlier) reduced by the amount treated as having been contributed and
you do not have any earnings to report You can withdraw some or all of the
you contributed to traditional IRAs. But
as early distributions on the form. excess contributions for 2012 and they
your contribution limit for Roth IRAs may
will not be treated as having been
be further reduced or eliminated if your
If you timely filed your return without contributed if:
modified AGI for Roth IRA purposes is
withdrawing the excess contributions, You make the withdrawal before June
you can still make the withdrawal no 1, 2013, and
$173,000 if married filing jointly or
later than 6 months after the due date of You also withdraw any income
your tax return, excluding extensions. If earned on the withdrawn contributions
you do, file an amended return with and include the earnings in gross
Instructions for Form 5329 (2012) -5-
income for the year in which the You make the withdrawal by the due However, you can withdraw some or
contribution was made. date, including extensions, of your 2012 all of the excess contributions for 2012
tax return, and and they will not be treated as having
If you filed your return without been contributed if:
You withdraw any income earned on
withdrawing the excess contributions,
the withdrawn contributions and include You make the withdrawal by the due
you can still make the withdrawal, but it
the earnings in gross income for the date, including extensions, of your 2012
must be made before June 1, 2013. If
year in which you receive the withdrawn return, and
you do, file an amended return. Report
contributions and earnings. You withdraw any income earned on
any related earnings for 2012 on the
Include the withdrawn contributions the withdrawn contributions and include
amended return and include an
and related earnings on Form 8853, the earnings in gross income for the
explanation of the withdrawal. Make any
lines 6a and 6b. year in which you receive the withdrawn
other necessary changes on the
contributions and earnings.
amended return (for example, if you If you timely filed your return without
reported the contributions as excess withdrawing the excess contributions, Include the withdrawn contributions
contributions on your original return, you can still make the withdrawal no and related earnings on Form 8889,
include an amended Form 5329 later than 6 months after the due date of lines 14a and 14b.
reflecting that the withdrawn your tax return, excluding extensions. If
contributions are no longer treated as you do, file an amended return with If you timely filed your return without
having been contributed). “Filed pursuant to section 301.9100-2” withdrawing the excess contributions,
written at the top. Report any related you can still make the withdrawal no
Part VI—Additional Tax on earnings for 2012 on the amended later than 6 months after the due date of
Excess Contributions to return and include an explanation of the your tax return, excluding extensions. If
withdrawal. Make any other necessary you do, file an amended return with
Archer MSAs changes on the amended return (for “Filed pursuant to section 301.9100-2”
If you or your employer contributed example, if you reported the written at the top. Report any related
more to your Archer MSA for 2012 than contributions as excess contributions on earnings for 2012 on the amended
is allowable or you had an amount on your original return, include an amended return and include an explanation of the
line 41 of your 2011 Form 5329, you Form 5329 reflecting that the withdrawn withdrawal. Make any other necessary
may owe this tax. But you may be able contributions are no longer treated as changes on the amended return (for
to avoid the tax on any 2012 excess having been contributed). example, if you reported the
contributions (see the instructions for contributions as excess contributions on
line 39, later). your original return, include an amended
Part VII—Additional Tax on Form 5329 reflecting that the withdrawn
Line 34 Excess Contributions to contributions are no longer treated as
Enter the amount from line 40 of your Health Savings Accounts having been contributed).
2011 Form 5329 only if the amount on
line 41 of your 2011 Form 5329 is more
If you, someone on your behalf, or your Part VIII—Additional Tax
employer contributed more to your on Excess Accumulation
Line 35 HSAs for 2012 than is allowable or you in Qualified Retirement
If your contribution limit for your Archer had an amount on line 49 of your 2011
MSAs (the smaller of line 3 or line 4 of Form 5329, you may owe this tax. But
Plans (Including IRAs)
Form 8853, Archer MSAs and you may be able to avoid the tax on any You owe this tax if you do not receive
Long-Term Care Insurance Contracts) 2012 excess contributions (see the the required minimum distribution from
is greater than the contributions to your instructions for line 47, later). your qualified retirement plan, including
Archer MSAs for 2012, enter the an IRA or an eligible section 457
difference on line 35. Also include on
Line 43 deferred compensation plan. The
your 2012 Form 8853, line 5, the smaller If your contribution limit for your HSAs additional tax is 50% of the excess
of: (line 12 of Form 8889, Health Savings accumulation—the difference between
Accounts (HSAs)) is greater than the the amount that was required to be
Form 5329, line 35, or
contributions you made to your HSAs distributed and the amount that was
The excess, if any, of Form 5329,
(or those made on your behalf) for 2012 actually distributed. The tax is due for
line 34, over Form 5329, line 36.
(Form 8889, line 2), enter the difference the tax year that includes the last day by
Line 39 on line 43. Also include on your 2012 which the minimum required distribution
Enter the excess of your contributions to Form 8889, line 13, the smaller of: is required to be taken.
your Archer MSA for 2012 (from Form Form 5329, line 43, or Required Distributions
8853, line 2) over your contribution limit The excess, if any, of Form 5329,
(the smaller of line 3 or line 4 of Form line 42, over Form 5329, line 44. IRA (other than a Roth IRA). You
8853). Also include on line 39 any must start receiving distributions from
excess contributions your employer
Line 47 your IRA by April 1 of the year following
made. See the Instructions for Form Enter the excess of your contributions the year in which you reach age 701 2. At
8853 for details. (including those made on your behalf) to that time, you can receive your entire
your HSAs for 2012 (Form 8889, line 2) interest in the IRA or begin receiving
However, you can withdraw some or over your contribution limit (Form 8889, periodic distributions. If you choose to
all of the excess contributions for 2012 line 12). Also include on line 47 any receive periodic distributions, you must
and they will not be treated as having excess contributions your employer receive a minimum required distribution
been contributed if: made. See the Instructions for Form each year. You can figure the minimum
8889 for details. required distribution by dividing the
-6- Instructions for Form 5329 (2012)
account balance of your IRAs (other Exception. If you owned more than certain distributions from qualified plans,
than Roth IRAs) on December 31 of the 5% of the employer maintaining the including IRAs, and other tax-favored
year preceding the distribution by the plan, you must begin receiving accounts. Our legal right to ask for the
applicable life expectancy. For distributions no later than April 1 of the information requested on this form is
applicable life expectancies, see Pub. year following the year in which you sections 6001, 6011, 6012(a), and 6109
590. reach age 701 2, regardless of when you and their regulations. If you do not
If the trustee, custodian, or issuer of retire. provide this information, or you provide
your IRA informs you of the minimum Your plan administrator should figure incomplete or false information, you
required distribution, you can use that the amount that must be distributed may be subject to penalties
amount. each year. You are not required to provide the
If you have more than one IRA, you Waiver of tax. The IRS can waive part information requested on a form that is
can take the minimum required or all of this tax if you can show that any subject to the Paperwork Reduction Act
distribution from any one or more of the shortfall in the amount of distributions unless the form displays a valid OMB
individual IRAs. was due to reasonable error and you control number. Books or records
For more details on the minimum are taking reasonable steps to remedy relating to a form or its instructions must
distribution rules (including examples), the shortfall. If you believe you qualify be retained as long as their contents
see Pub. 590. for this relief, attach a statement of may become material in the
explanation and file Form 5329 as administration of any Internal Revenue
You may count the following follows. law. Generally, tax returns and return
TIP transactions towards your information are confidential, as required
minimum required distributions 1. Complete lines 50 and 51 as
by section 6103. However, we may give
for 2012, which is entered on line 51: instructed.
this information to the Department of
You elect to treat a QCD made in 2. Enter “RC” and the amount you Justice for civil and criminal litigation,
January 2013 as if it was made in 2012. want waived in parentheses on the and to cities, states, the District of
Any portion of your distribution in dotted line next to line 52. Subtract this Columbia, and U.S. commonwealths
December 2012 that you contributed as amount from the total shortfall you and possessions to carry out their tax
cash (or cash equivalent) to a charity figured without regard to the waiver, and laws. We may also disclose this
before February 1, 2013, and that enter the result on line 52. information to other countries under a
contribution meets the requirements of a 3. Complete line 53 as instructed. tax treaty, to federal and state agencies
QCD. You must pay any tax due that is to enforce federal nontax criminal laws,
See Pub. 590 for more information. reported on line 53. or to federal law enforcement and
intelligence agencies to combat
Roth IRA. There are no minimum The IRS will review the information terrorism.
required distributions during the lifetime you provide and decide whether to grant
of the owner of a Roth IRA. Following your request for a waiver. The average time and expenses
the death of the Roth IRA owner, required to complete and file this form
required distribution rules apply to the Privacy Act and Paperwork Reduc- will vary depending on individual
beneficiary. See Pub. 590 for details. tion Act Notice. We ask for the circumstances. For the estimated
information on this form to carry out the averages, see the instructions for your
Qualified retirement plans (other Internal Revenue laws of the United income tax return.
than IRAs) and eligible section 457 States. We need this information to
deferred compensation plans. In ensure that you are complying with If you have suggestions for making
general, you must begin receiving these laws and to allow us to figure and this form simpler, we would be happy to
distributions from your plan no later than collect the right amount of tax. You are hear from you. See the instructions for
April 1 following the later of (a) the year required to give us this information if you your income tax return.
in which you reach age 701 2 or (b) the made certain contributions or received
year in which you retire.
Instructions for Form 5329 (2012) -7-