EFTA01222730.pdf

Additional Taxes on Qualified Plans Fom5329 (Including IRAs) and Other Tax-Favored Accounts OMB No. 1545-0074 2017 Department of the Treasury ► Attach to Form 1040 or Form 1040NR. Attachment Internal Revenue Service (99) ► Go to wwwirs.gov/Form5329 for instructions and the latest Information Sequence No. 29 Name of nelividual subject to additional tax. If mailed filing jointly. see instructions. Your social Beastly number Home address (number and street). or S box if mail is not delivered to your home Apt. no. Fill in Your Address Only City. town or post office. state, and ZIP code. If you have a foreign address. also complete If You Are Filing This the spaces below (see instructions). Form by Itself and Not If this Is an amended With Your Tax Return return, check here ► Foreign country name Foreign province/statakounty Foreign postal code If you only owe the additional 10% tax on early distributions, you may be able to report this tax direct y on Form 1040, line 59, or Form 1040NR, line 57, without fi ing Form 5329. See the instructions for Form 1040, line 59, or for Form 1040NR, line 57. Part I Additional Tax on Early Distributions. Complete this part if you took a taxable distribution (other than a qualified disaster distribution) before you reached age 59% from a qualified retirement plan (including an IRA) or modified endowment contract (unless you are reporting this tax directly on Form 1040 or Form 1040NR-see above). You may also have to complete this part to indicate that you qualify for an exception to the additional tax on early distributions or for certain Roth IRA distributions (see instructions). 1 Early distributions included in income. For Roth IRA distributions, see instructions 1 2 Early distributions included on line 1 that are not subject to the additional tax (see instructions). Enter the appropriate exception number from the instructions: 2 3 Amount subject to additional tax. Subtract line 2 from line 1 3 4 Additional tax. Enter 10% (0.10) of line 3. Include this amount on Form 1040, Ire 59, or Form 1040NR, line 57 4 Caution: If any part of the amount on line 3 was a distribution from a SIMPLE IRA, you may have to include 25% of that amount on line 4 instead of 10% (see instructions). Part II Additional Tax on Certain Distributions From Education Accounts and ABLE Accounts. Complete this part if you included an amount in income, on Form 1040 or Form 1040NR, line 21, from a Coverdell education savings account (ESA), a qualified tuition program (QTP), or an ABLE account. 5 Distributions included in income from a Coverdell ESA, a QTP, or an ABLE account 5 6 Distributions included on line 5 that are not subject to the additional tax (see instructions) 6 7 Amount subject to additional tax. Subtract line 6 from line 5 7 8 Additional tax. Enter 10% (0.10) of line 7. Include this amount on Form 1040, line 59, or Form 1040NR, line 57 8 Part III Additional Tax on Excess Contributions to Traditional IRAs. Complete this part if you contributed more to your traditional IRAs for 2017 than is allowable or you had an amount on line 17 of your 2016 Form 5329. 9 Enter your excess contributions from line 16 of your 2016 Form 5329 (see instructions . If zero, go to line 15 9 10 If your traditional IRA contributions for 2017 are less than your maximum allowable contribution, see instructions. Otherwise, enter -0- 10 11 2017 traditional IRA distributions included in income (see instructions) . 12 2017 distributions of prior year excess contributions (see instructions) . 12 13 Add lines 10, 11, and 12 14 Prior year excess contributions. Subtract line 13 from line 9. If zero or less, enter -0- 15 Excess contributions for 2017 (see instructions) 16 Total excess contributions. Add lines 14 and 15 17 Additional tax. Enter 6% (0.06) of the smaller of line 16 or the value of your traditional IRAs on December 31, 2017 (including 2017 contributions made in 2018). Include this amount on Form 1040, line 59, or Form 1040NR, line 57 . 17 Part IV Additional Tax on Excess Contributions to Roth IRAs. Complete this part if you contributed more to your Roth IRAs for 2017 than is allowable or you had an amount on line 25 of your 2016 Form 5329. 18 Enter your excess contributions from line 24 of your 2018 Form 5329 (see instructions . If zero, go to line 23 18 19 If your Roth IRA contributions for 2017 are less than your maximum allowable contribution, see instructions. Otherwise, enter -0- . . . 19 20 2017 distributions from your Roth IRAs (see instructions) 20 21 Add lines 19 and 20 21 22 Prior year excess contributions. Subtract line 21 from line 18. If zero or less, en er -0- 22 23 Excess contributions for 2017 (see instructions) 23 24 Total excess contributions. Add lines 22 and 23 24 25 Additional tax. Enter 6% (0.06) of the smaller of kne 24 or the value of your Roth IRAs on December 31, 2017 (including 2017 contributions made in 2018). Include this amount on Form 1040, line 59, or Form 1040NR, line 57 25 For Privacy Act and Paperwork Reduction Act Notice, see your tax return Instructions. Form 5329 (2017) EFTA01222730 Form 5329(2017) Page 2 LIM Additional Tax on Excess Contributions to Coverdell ESAs. Complete this part if the contributions to your Coverdell ESAs for 2017 were more than is allowable or you had an amount on line 33 of your 2016 Form 5329. 26 Enter the excess contributions from line 32 of your 2016 Form 5329 (see instructions . If zero, go to line 31 26 27 If the contributions to your Coverdell ESAs for 2017 were less than the maximum allowable contribution, see instructions. Otherwise, enter -0- 27 28 2017 distributions from your Coverdell ESAs (see instructions) 28 29 Add lines 27 and 28 29 30 Prior year excess contributions. Subtract line 29 from line 26. If zero or less, en er -0- 30 31 Excess contributions for 2017 (see instructions) 31 32 Total excess contributions. Add lines 30 and 31 32 33 Additional tax. Enter 6% (0.06) of the smaller of line 32 or the value of your Coverdell ESAs on December 31, 2017 (including 2017 contributions made in 2018). Include this amount on Form 1040, line 59, or Form 1040NR, line 57 33 Part VI Additional Tax on Excess Contributions to Archer MSAs. Complete this part if you or your employer contributed more to your Archer MSAs for 2017 than is allowable or you had an amount on line 41 of your 20 6 Form 5329. 34 Enter the excess contributions from line 40 of your 2016 Form 5329 (see Instructions If zero, go to line 39 34 35 If the contributions to your Archer MSAs for 2017 are less than the maximum allowable contribution, see instructions. Otherwise, enter -0- 35 36 2017 distributions from your Archer MSAs from Form 8853, line 8 . . 36 37 Add lines 35 and 36 38 Prior year excess contributions. Subtract line 37 from line 34. If zero or less, en er -0- 39 Excess contributions for 2017 (see instructions) 40 Total excess contributions. Add lines 38 and 39 41 Additional tax. Enter 6% (0.06) of the smaller of line 40 or the value of your Archer MSAs on December 31, 2017 (including 2017 contributions made in 2018). Include this amount on Form 1040, line 59, or Form 1040NR, line 57 41 Part VII Additional Tax on Excess Contributions to Health Savings Accounts (HSAs). Complete this part if you, someone on your behalf, or your employer contributed more to your HSAs for 2017 than is allowable or you had an amount on line 49 of your 2016 Form 5329. 42 Enter the excess contributions from line 48 of your 2016 Form 5329. If zero, go to line 47 42 43 If the contributions to your HSAs for 2017 are less than the maximum allowable contribution, see instructions. Otherwise, enter -0- . . . . 43 44 2017 distributions from your HSAs from Form 8889, line 16 . . . . 44 45 Add lines 43 and 44 46 Prior year excess contributions. Subtract line 45 from line 42. If zero or less, enter -0- 46 47 Excess contributions for 2017 (see instructions) 47 48 Total excess contributions. Add lines 46 and 47 48 49 Additional tax. Enter 6% (0.06) of the smaller of line 48 or the value of your HSAs on December 31, 2017 (inducing 2017 contributions made in 2018). Include this amount on Form 1040, line 59, or Form 1040NR, line 57 49 Part VIII Additional Tax on Excess Contributions to an ABLE Account. Complete this part if contributions to your ABLE account for 2017 were more than is allowable. 50 Excess contributions for 2017 (see instructions) 50 51 Additional tax. Enter 6% (0.06) of the smaller of line 50 or the value of your ABLE account on December 31, 2017. Include this amount on Form 1040, line 59, or Form 1040NR, line 57 . . . 51 Part IX Additional Tax on Excess Accumulation in Qualified Retirement Plans (Including IRAs). Complete this part if you did not receive the minimum required distribution from your qualified retirement plan. 62 Minimum required distribution for 2017 (see instructions) 52 53 Amount actually distributed to you in 2017 53 54 Subtract line 53 from line 52. If zero or less, enter -0- 54 55 Additional tax. Enter 50% (0.50) of line 54. Include this amount on Form 1040, line 59, or Form 1040NR, line 57 55 Under penalties of penury. I declare that I have examined this form. including accompanying attachments. and to the best of m Sign Here Only If You knowledge and belief. it is true. correct. and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Are Filing This Form by Itself and Not With Your Tax Return Your signature Date Print/Type preparers name Preparers signature Date Pl1N Paid Check D if self-employed Preparer Firrn's name ► Fam's EIN ► Use Only Fkrn's address ► Phone no. Form 5329 (2017) EFTA01222731