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Box 12. FATCA filing requirement

When FATCA is checked, an account number is required.

Box 2b. Taxable amount not determined Box 2b. Total distribution

Box 7a. Distribution code quick-select

Select up to two codes. The final PDF combines these selections with any code typed above.

1Early distribution, no known exception 2Early distribution, exception applies 3Disability 4Death 5Prohibited transaction 6Section 1035 exchange 7Normal distribution 8Excess contributions plus earnings/excess deferrals taxable in 2026 9Cost of current life insurance protection AMay be eligible for 10-year tax option BDesignated Roth account distribution CReportable death benefits under section 6050Y DAnnuity payments from nonqualified annuities EDistributions under EPCRS FCharitable gift annuity GDirect rollover and direct payment HDirect rollover of a designated Roth account distribution to a Roth IRA JEarly distribution from a Roth IRA KTraditional IRA assets without a readily available FMV MQualified plan loan offset NRecharacterized IRA contribution made for 2026 PExcess contributions/deferrals taxable in 2025 QQualified distribution from a Roth IRA RRecharacterized IRA contribution made for 2025 SEarly distribution from a SIMPLE IRA in the first 2 years TRoth IRA distribution, exception applies UDividends distributed from an ESOP under section 404(k) WQualified long-term care insurance charges/payments

Box 7b. IRA/SEP/SIMPLE Box 7c. Trump Account Add a second state reporting line Add a second locality reporting line

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