Form 5329 Additional Taxes on Qualified Plans (Including IRAs) and Other Tax-Favored Accounts 2004. Summary: This is an example of Form 5329 (2004) as pertains to the description in the text. The line items completed are:
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“Name of individual subject to additional tax. If married filing jointly, see page 1 of the instructions.” field contains Tom
Jones
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“Your social security number” field contains 004-00-0000
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Under
“Part I: Additional Tax on Early Distributions”:
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“1. Early distributions included in income. For Roth IRA. distributions, see instructions” field contains 3,000
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“2. Early distributions included on line 1 that are not subject to the additional tax (see instructions).” field contains 0
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“3. Amount subject to additional tax. Subtract line 2 from line 1” field contains 3,000
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“4. Additional tax. Enter 10% (.10) of line 3. Include this amount on Form 1040, line 59” field contains
300
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