VOID CORRECTED

IRA contributions (other

than amounts in boxes

2–4 and 8–10)

TRUSTEE’S or ISSUER’S name, street address, city, state, and ZIP code 1

IRA

Contribution

Information

$

2 Rollover contributions

$

TRUSTEE’S or ISSUER’S federal identification no. PARTICIPANT’S social security number 3 Roth IRA conversion amount

$

PARTICIPANT’S name 5 Fair market value of account

$

Street address (including apt. no.)

City, state, and ZIP code

Account number (see instructions)

Form 5498 Department of the Treasury - Internal Revenue Service

2828

Cat. No. 50010C

Copy A

For

Internal Revenue

Service Center

File with Form 1096.

For Privacy Act

and Paperwork

Reduction Act

Notice, see the

2007 General

Instructions for

Forms 1099, 1098,

5498, and W-2G.

Form 5498

OMB No. 1545-0747

7 IRA SEP SIMPLE

8 SEP contributions 9 SIMPLE contributions

$ $

10 Roth IRA contributions

$

Roth IRA

Life insurance cost

included in box 1

6

$

Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page

4 Recharacterized contributions

$

11 Check if RMD

for 2008

2007
CORRECTED (if checked)

TRUSTEE’S or ISSUER’S name, street address, city, state, and ZIP code

TRUSTEE’S or ISSUER’S federal identification no. PARTICIPANT’S social security number

PARTICIPANT’S name

Street address (including apt. no.)

City, state, and ZIP code

Account number (see instructions)

Form 5498 Department of the Treasury - Internal Revenue Service

For

Participant

Copy B

(keep for your records)

IRA

Contribution

Information

This information

is being

furnished to

the Internal

Revenue

Service.

IRA contributions (other

than amounts in boxes

2–4 and 8–10)

1

$

2 Rollover contributions

$

3 Roth IRA conversion amount

$

5 Fair market value of account

$

Form 5498

OMB No. 1545-0747

7 IRA SEP SIMPLE

8 SEP contributions 9 SIMPLE contributions

$ $

10 Roth IRA contributions

$

Roth IRA

Life insurance cost

included in box 1

6

$

4 Recharacterized contributions

$

11 If checked, required

minimum distribution 

for 2008

2007
The information on Form 5498 is submitted to the Internal Revenue Service

by the trustee or issuer of your individual retirement arrangement (IRA) to

report contributions, including any catch-up contributions, and the fair market

value of the account. For information about IRAs, see Pub. 590, Individual

Retirement Arrangements (IRAs), and Pub. 560, Retirement Plans for Small

Business (SEP, SIMPLE, and Qualified Plans).

Box 6. For endowment contracts only, shows the amount allocable to the cost

of life insurance. Subtract this amount from your allowable IRA contribution

included in box 1 to compute your IRA deduction.

Box 5. Shows the fair market value of all investments in your account at year

end. However, if a decedent’s name is shown, the amount reported may be

the FMV on the date of death. If the FMV shown is zero for a decedent, the

executor or administrator of the estate may request a date-of-death value from

the financial institution.

Box 1. Shows traditional IRA contributions for 2007 you made in 2007 and

through April 15, 2008. These contributions may be deductible on your Form

1040 or 1040A. However, if you or your spouse was an active participant in an

employer’s pension plan, these contributions may not be deductible. This box

does not include amounts in boxes 2–4 and 8–10.

Box 2. Shows any rollover, including a direct rollover to a traditional IRA or

Roth IRA, you made in 2007. It does not show any amounts you converted

from your traditional IRA, SEP IRA, or SIMPLE IRA to a Roth IRA. They are

shown in box 3. See the Form 1040 or 1040A instructions for information on

how to report rollovers. If you have ever made any nondeductible contributions

to your traditional IRA or SEP IRA and you did not roll over the total

distribution, use Form 8606, Nondeductible IRAs, to figure the taxable amount.

If property was rolled over, see Pub. 590.

Box 7. May show the kind of IRA reported on this Form 5498.

Box 8. Shows SEP contributions made in 2007, including contributions made

in 2007 for 2006, but not including contributions made in 2008 for 2007. If

made by your employer, do not deduct on your income tax return. If you made

the contributions as a self-employed person (or partner), they may be

deductible. See Pub. 560.

Box 9. Shows SIMPLE contributions made in 2007. If made by your employer,

do not deduct on your income tax return. If you made the contributions as a

self-employed person (or partner), they may be deductible. See Pub. 560.

Box 10. Shows Roth IRA contributions you made in 2007 and through April 15,

2008. Do not deduct on your income tax return.

Box 3. Shows the amount converted from a traditional IRA, SEP IRA, or SIMPLE

IRA to a Roth IRA in 2007. Use Form 8606 to figure the taxable amount.

Instructions for Participant Box 4. Shows amounts recharacterized from transferring any part of the

contribution (plus earnings) from one type of IRA to another. See Pub. 590.

Box 11. If the box is checked, you must take a required minimum distribution

(RMD) for 2008. An RMD may be required even if the box is not checked. The

amount, or offer to compute the amount, and date of the RMD will be

furnished to you by January 31 either on Form 5498 (in the blank box to the

left of box 10) or in a separate statement. If you do not take the RMD for

2008, you are subject to a 50% excise tax on the amount not distributed. See

Pub. 590 for details.

Account number. May show an account or other unique number the trustee

assigned to distinguish your account.

Note. If you postponed making a contribution to your IRA or certain retirement

plans or repaid a qualified reservist distribution, the box to the left of box 10

should show a reason code, the amount of the contribution or repayment, and

the year to which the payment was credited, if applicable. Also, certain

catch-up contributions under a section 401(k) plan will be shown in the blank

box. See Form 8606 and its instructions for more information.
VOID CORRECTED

TRUSTEE’S or ISSUER’S name, street address, city, state, and ZIP code

TRUSTEE’S or ISSUER’S federal identification no. PARTICIPANT’S social security number

PARTICIPANT’S name

Street address (including apt. no.)

City, state, and ZIP code

Account number (see instructions)

Form 5498 Department of the Treasury - Internal Revenue Service

For

Trustee or Issuer

For Privacy Act

and Paperwork

Reduction Act

Notice, see the

2007 General

Instructions for

Forms 1099,

1098, 5498,

and W-2G.

Copy C

IRA

Contribution

Information

IRA contributions (other

than amounts in boxes

2–4 and 8–10)

1

$

2 Rollover contributions

$

3 Roth IRA conversion amount

$

5 Fair market value of account

$

Form 5498

OMB No. 1545-0747

7 IRA SEP SIMPLE

8 SEP contributions 9 SIMPLE contributions

$ $

10 Roth IRA contributions

$

Roth IRA

Life insurance cost

included in box 1

6

$

4 Recharacterized contributions

$

11 Check if RMD

for 2008

2007
Instructions for Trustees and Issuers

We provide general and specific form instructions

as separate products. The products you should

use for 2007 are the General Instructions for

Forms 1099, 1098, 5498, and W-2G and the 2007

Instructions for Forms 1099-R and 5498. To order

these instructions and additional forms, visit the

IRS website at www.irs.gov or call

1-800-TAX-FORM (1-800-829-3676).

Due dates. Furnish Copy B of this form to the

participant by June 2, 2008, but furnish fair

market value information and RMD if applicable

by January 31, 2008.

File Copy A of this form with the IRS by

June 2, 2008. If you file electronically, you must

have software that generates a file according to

the specifications in Pub. 1220, Specifications for

Filing Forms 1098, 1099, 5498, and W-2G

Electronically or Magnetically. IRS does not offer

a fill-in form option.

Caution: Because paper forms are scanned

during processing, you cannot file with the IRS

Forms 1096, 1098, 1099, or 5498 that you print

from the IRS website.

Need help? If you have questions about reporting

on Form 5498, call the information reporting

customer service site toll free at 1-866-455-7438

or 304-263-8700 (not toll free). For TTY/TDD

equipment, call 304-267-3367 (not toll free). The

hours of operation are Monday through Friday

from 8:30 a.m. to 4:30 p.m., Eastern time. The

service site can also be reached by email at

mccirp@irs.gov.