Tax on Lump-Sum Distributions

Tax on Lump-Sum Distributions OMB No. 1545-0193 Form 4972 Deparhnent of the Treasury Interrol Revenue Service (99) Name of recipient of distribution (From Qualified Plans of Participants Born Before January 2, 1936) P Go to wtvw.irs.gov/Form4,972 for the latest Information. P. Attach to Form 1040, Form 1040NR, or Form 1041. 2018 Attachment Sequence No. 28 Corn • lete this rt to see if ou can use Form 4972 1 Was this a distribution of a plan participant's entire balance (excluding deductible voluntary employee contributions and certain forfeited amounts) from all of an employer's qualified plans of one kind (for example, pension, profit-sharing, or stock bonus)? If "No," don't use this form 2 Did you roll over any part of the distribution? If "Yes," don't use this form 3 Was this distribution paid to you as a beneficiary of a plan participant who was born before January 2, 1936? 3 4 Were you (a) a plan participant who received this distribution, (b) born before January 2, 1936, and (c) a participant in the plan for at least 5 years before the year of the distribution? If you answered "No" to both questions 3 and 4, don't use this form. 5a Did you use Form 4972 after 1986 for a previous distribution from your own plan? If "Yes," don't use this form for a 2018 distribution from your own plan b If you are receiving this distribution as a beneficiary of a plan participant who died, did you use Form 4972 for a previous distribution received as a beneficiary of that participant after 1986? If "Yes," don't use this form for this distribution Identifying number Yes No 1 2 Part II 5a 5b Complete this part to choose the 20% capital gain election (see instructions) 8 Capital gain part 7 Multiply line 6 by 20% (0.20) ► 6 7 from Form 1099-R, box 3 If you also choose to use Part III, go to line 8. Otherwise, include the amount from line 7 in the total on Form 1040, line 11; Form 1040NR, line 42; or Form 1041, Schedule G, line 1b. Be sure to check box 2 on Form 1040, line 11, or check box b on Form 1040NR, line 42. Part III Complete this part to choose the 10-year tax option (see instructions) 8 If you completed Part II, enter the amount from Form 1099-R, box 2a, minus box 3. If you didn't complete Part II, enter the amount from box 2a. Multiple recipients (and recipients who elect to include net unrealized appreciation (NUA) in taxable income), see instructions 9 Death benefit exclusion for a beneficiary of a plan participant who died before August 21, 1996 10 Total taxable amount. Subtract line 9 from line 8 11 Current actuarial value of annuity from Form 1099-R, box 8. If none, enter -0- 12 Adjusted total taxable amount. Add lines 10 and 11. If this amount is $70,000 or more, skip lines 13 through 16, enter this amount on line 17, and go to line 18 13 Multiply line 12 by 50% (0.50), but don't enter more than $10,000 13 14 Subtract $20,000 from line 12. If line 12 is $20,000 or less, enter -0- 14 15 Multiply line 14 by 20% (0.20) 15 16 Minimum distribution allowance. Subtract line 15 from line 13 17 Subtract line 16 from line 12 18 Federal estate tax attributable to lump-sum distribution 19 Subtract line 18 from line 17. If line 11 is zero, skip lines 20 through 22 and go to line 23 20 Divide line 11 by line 12 and enter the result as a decimal (rounded to at least three places) 21 Multiply line 16 by the decimal on line 20 22 Subtract line 21 from line 11 23 Multiply line 19 by 10% (0.10) 24 Tax on amount on line 23. Use the Tax Rate Schedule in the instructions 25 Multiply line 24 by 10.0. If line 11 is zero, skip lines 26 through 28, enter this amount on line 29, and go to line 30 26 Multiply line 22 by 10% (0.10) 27 Tax on amount on line 26. Use the Tax Rate Schedule in the instructions 26 27 28 Multiply line 27 by 10.0 29 Subtract line 28 from line 25. Multiple recipients, see instructions ► 30 Tax on lump-sum distribution. Add lines 7 and 29. Also include this amount in the total on Form 1040, line 11 (check box 2); Form 1040NR, line 42 (check box b); or Form 1041, Schedule G, line lb ► 20 21 22 • 8 9 10 11 12 1 16 17 18 19 23 24 25 P I 28 29 30 For Paperwork Reduction Act Notice, see instructions. Form 4972 (2018) EFTA01222729