. 5329 _ Return for Individual | OMS No. 1545-0203
om Retirement Arrangement Taxes 1982
Department of the Treasuy | (Under Sections 408(f), 409(c), 4973 and 4974 of the Internal Revenue Code)

Internal Revenue Service b> Attach to Form 1040.

Name | Your social security number

Address (Number and street)

City or town, State and ZIP code

(EEE Excess Contributions Tax for Individual Retirement Arrangements

If you have contributed either this year or in earlier years more to your IRA than is or was allow-
able as a deduction, and you have an excess contribution subject to tax, complete the following.

1 Excess contributions for 1982 (see instructions for line 1). Do NOT include this amount on Form 1040, line 25 .

2 Earlier year excess contributions not previously eliminated (see instructions for line 2) .

3 Contribution credit. (If your maximum allowable deduction for 1982 is more than your actual
contribution, enter the difference; otherwise enter zero. See instructions for line 3) .

4 (a) 1982 distributions out of your account that are taxable. ©. 6. 6 + ee

(b) 1981 tax year excess contributions (if any) withdrawn after the due date (including
extensions) of your 1981 income tax return, and 1980 and earlier tax year excess
contributions withdrawn in 1982. Enter -O— and include the amount of your withdrawal
on line 4(a) if the excess contributions you withdrew: (i) occurred in a tax year (other
than 1976 or 1977) for which your total IRA contributions (other than rollover contribu-
tions) were more than $1,750 ($7,500 if there is an employer contribution toa SEP) o} or

(ii) were taken as a deduction on your Form 1040. . . . es

(c) Add lines 3 through 4(b). . . - ee ee ee LN
5 Adjusted earlier year excess contributions line 2 minus line 4(c) but not less than zero). . sone
6 Total excess contributions (add linesland5). . 2. 2. 6 6 ee ee ee ee ee

7 Tax (6% of line 6 or 6% of the value of your IRA on the last day of 1982, whichever is smaller.) Enter tax on Form 1040, line 57 .

WEE Tax on Premature Distributions
If you received a distribution from your arrangement before you reached 59/2, complete lines 8, 9, 10, and 11.
Also, enter the amount of the distribution on Form 1040, line 21.

8 (a) If you entered into a prohibited transaction as described in definition C, borrowed any amount from one of
your individual retirement annuities, or pledged any part of one of your individual retirement annuity ¢ con-
tracts, enter 10% of the value of the account or annuity at the beginning of the year .

(b) If in 1982 any part of your arrangement was invested in collectibles (see instructions for line 8(b)) include
10% of the cost of the collectible here. . . . - rear soe ee

9 Enter 10% of the amount of the distributions from your arrangement during the year (see instruction for line 9
for items that are not considered taxable distributions). 2. 2... 6 ee ee ee ee
10 Enter 10% of the amount from your individual retirement savings accounts that you pledged as security foraloan. . . . «

11 Total tax (add lines 8(a) through 10). Enter here and on Form 1040, line 57. (See instructions for line 11 for credits against tax) .

MEETS Tax on Excess Accumulation in Individual Retirement Accounts and Annuities

12 Tax based on current year distribution method (See worksheet in Instructions) . . . . ss + eo + &
13 Tax based on aggregate distribution method (See worksheet in Instructions) . . oe
14 Tax due. Enter amount from line 12 or, if aggregate distribution method is applicable, enter the smaller of tine

12 or line 13. Also include this amount on Form 1040, line 57 .

Under penalties of perjury, | declare that | have examined this return, including accompanying schedules and statements, and to the best
Please ‘of my knowledge and 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 Pua signature Dons

. Preparer’s Date check if Preparer’s social security no.
Paid signature Sioyed” CI fl Hl
Preparer's | rms name (or E. a :
Use Only | yours, if self-employed) -l._No. > H

and address ZIP code >

For Paperwork Reduction Act Notice, see page 1 of Instructions. Form 5329 (1982)

363-202-1 ‘Ye US, GOVERNMENT PRINTING OFFICE : 198—O-363-202