Understanding Your Form 1099-R Tour

Corrected Form 1099-SA:	[ close window ]
If this box is checked it indicates that a corrected Form 1099-R was filed with the IRS. Corrections must be filed with the IRS as soon as possible after errors are discovered.

Copy B:

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Indicates that this is Copy B of your Form 1099-SA and what should be attached to your Federal Income Tax Return. Additional copies include:

Copy A - Filed with IRS by Principal Trust/Delaware Charter
Copy 1 - Filed with your State, City, or Local Tax Department by Principal Trust/Delaware Charter
Copy B - To be attached to your Federal Income Tax Return
Copy C - To be kept for your personal records
Copy 2 - To be attached to your State, City, or Local Income Tax Return
Copy D - To be kept by Principal Trust/Delaware Charter

Recipient's Identification Number	[ close window ]
Shows your Social Security number used for tax identification purposes.

Trustee's Payer's name, Street Address, City, State, and Zip	[ close window ]
As trustee to your account, Principal Trust/Delaware Charter is the payer to your account. This field shows our legal name (Delaware Charter Guarantee & Trust Company) and our mailing address.

Payer's Federal Identification No.	[ close window ]
Shows Principal Trust/Delaware Charter's tax payers identification number.

Corrected From 1099-SA	[ close window ]
If this box is checked it indicates that a corrected Form 1099-SA was filed with the IRS. Corrections must be filed with the IRS as soon as possible after errors are discovered.

Box 2a: Taxable Amount	[ close window ]
Shows the total taxable amount of your gross distributions. This box may be blank if this is a distribution from an employer-sponsored plan or a Roth IRA.

Box 2b: Taxable Amount Not Determined	[ close window ]
This box is checked if we are unable to determine the taxable amount of the distribution. Total Distribution This box is checked if the payment shown in Box 1 is a total distribution. A total distribution is one or more distributions within one tax year in which the entire balance of the account is distributed.

Box 1: Gross Distributions	[ close window ]
Show the amount recieved this year. The amount may have been a direct payment to the medical service provider or distributed to you.

Box 2: Earnings on excess cont.

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Shows the earnings on any excess contributions you withdrew from an HSA or Archer MSA by the due date of your income tax return. If you withdrew excess, plus any earnings, by the due date of your income tax return, you must include the earnings in your income in the year you received the distribution even if you used it to pay qualified medical expenses. This amount is included in box 1. For an HSA, an excise tax of 6% for each taxable year is imposed on you for excess individual and employers contributions that remain in the account. See Form 5329.

Box 3: Distribution Code	[ close window ]
These codes identify the distrubiton you received: 1-Normal Distribution; 2-Excess Contributions; 3-Disability; 4-Death Distribution other than code 6; 5-Prohibited Transaction; 6-Death Distribution after year of death to a nonspouse beneficiary.

Box 4: Fair Market Value on date of death	[ close window ]
If the account holder died, shows the FMV of the account on the date of death.

Box 5: Account Type	[ close window ]
Shows the type of account that is reported on this Form 1099-SA.

IRA/SEP/SIMPLE Check box	[ close window ]
Indicates if the distribution is from a traditional IRA, SEP IRA, or SIMPLE IRA

Box 9a: Your Percentage of Total Distribution	[ close window ]
If the distribution was a total distribution and was made to more than one person, this box shows the percentage distributed to the individual named on this Form 1099-R.

Box 10: State Tax Withheld	[ close window ]
Shows the amount of state taxes withheld, if any.

Box 11: State and Payer's State Identification Number	[ close window ]
This box is intentionally left blank; the IRS does not require this information.

Box 12: State Distribution	[ close window ]
Shows the amount of State and Local distribution, if any.

Box 9b: Total employee contributions	[ close window ]
This box is left intentionally blank; the IRS does not require this information.