: 5329 Return for Individual OMB No. 1545-0203
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Retirement Arrangement Taxes 19 86
Department of the Treasury (Under Sections 408(f), 4973, and 4974 of the Internal Revenue Code) Attachment
Internal Revenue Service > Attach to Form 1040. Sequence No. 28,

Name Your social security number

Address (number and street)

City or town, state, and ZIP code

Excess Contributions Tax for Individual Retirement Arrangements

Complete this part if, either in this year or in earlier years, you have contributed more to your IRA
than is or was allowable as a deduction and you have an excess contribution subject to tax.

”

Excess contributions for 1986 (see Instructions for line 1). Do not include this amount on Form 1040, line 26
Earlier year excess contributions not previously eliminated (see Instructions for line 2) . | 2
3 Contribution credit. (If your maximum allowable deduction for 1986 is more than your
actual contribution, see instructions for line 3; otherwise, enter zero.) 3
1986 distributions out of your account that are taxable income . 4a

b 1985 tax year excess contributions (if any) withdrawn after the due date (including
extensions) of your 1985 income tax return, and 1984 and earlier tax year excess
contributions withdrawn in 1986. 4b

Do not enter any withdrawn excess contributions on line 4b if in the tax year that ‘the
excess contributions were made:

your total IRA contributions (other than rollover contributions) were more than
$2,250 (or if the total contributions for the year include employer contributions to
a SEP, $2,250 increased by the lesser of the amount of the employer
contributions to the SEP or $30,000); or
@ you took a deduction for the excess contributions on your Form 1040
Instead, enter these withdrawn excess contributions on line 4a of Form 5329 and also
on line 16 of Form 1040. 7)
¢ Add lines 3 through 4b. oe 4c
5 Adjusted earlier year excess contributions (line 2n minus line 4c but not less than zero) woe ee LS
6 Total excess contributions (add lines 1 and 5) :
7_ Tax (6% of line 6 or 6% of the value of your IRA on the last day of 1986, whichever is smaller). Enter taxo on Form 1040, line 54
Tax on Premature Distributions
Complete this part if you received a distribution from your IRA before you reached age 59¥2. Also, enter the
amount of the distribution on Form 1040, line 16.

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4

a

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8a If you entered into a prohibited transaction as described in the Instructions, borrowed any amount from one
of your individual retirement annuities, or pledged any part of your individual retirement annuity contracts,

enter 10% of the value of the account or annuity at the beginning of the year. . _ (Ba

b If in 1986 any part of your arrangement was invested in collectibles (see Instructions for line 8b), include
10% of the cost of the collectibles here... . [Bb

9 Enter 10% of the amount of the premature distributions from your arrangement during the year r (see
Instructions for line 9 for items that are not considered taxable distributions) rr)

10 Enter 10% of the amount from your individual retirement savings accounts that you pledged as security foraloan |10

11 Total tax (add lines 8a through 10). Enter here and on Form 1040, line 54 : : 11
Tax on Excess Accumulation in Individual Retirement Accounts and Annuities
12 Tax based on current year distribution method (see worksheet in Instructions). . . . . . . . . . . 2
13 Tax based on aggregate distribution method (see worksheet in Instructions)... 13
14 Tax due. Enter amount from line 12 or, if aggregate distribution method is applicable, ‘enter ‘the smaller of line
12 or line 13. Also include this amount on Form 1040, line 54 a 14
Under penalties of perjury, | declare that | have examined this return, including ‘accompanying Schedules and statements, and to the best of my knowledge and
Please belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge,
Sign
Here » Your signature > Date
. Preparer's Date Check if self- Preparer's social security no.
Paid signature employed > (] :
Preparer’s :
Firm's name (or
Use Only | yours, itself-employed) El. No.
and address ZIP code >

For Paperwork Reduction Act Notice, see page 1 of Instructions. UrS- GPO 2986-493-259 Form 5329 (1986)