C)voio

{_] CORRECTED

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

1 Regular IRA contributions
made in 1988 and 1989 for
1988

OMB No. 1545:0747

Individual

$
mmo | I9DBB | acstcement
: Information
$
TRUSTEE'S or ISSUER'S Federal identification no] PARTICIPANT'S social security number | 3 Life insurance cost included in Box 1 Copy C
$ For Trustee or
Issuer

PARTICIPANT'S name (first, middie, last)

Street address

City, state, ard ZIP code

4 Fair market value of account

For Paperwork
Reduction Act

Notice and
instructions for
completing this

form, see
Instructions for

‘Account number (optional)

Forms 1099,
1098, 5498, 1096,
and W-2G.

Form 5498

CJvoi

[CORRECTED

Department of the Treasury

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

T Regular IRA contributions
mgggm 1988 and 1989 for

(OMB No, 1545-0747

Internal Revenue Service

PARTICIPANT'S name (first, middie, last)

Street address,

City, state, and ZIP code

4 Fair market value of account

Individual
$ 1988 Retirement
2 Rollover IRA contributions Arrangement
Information
$
TRUSTEE'S or ISSUER'S Federal identification no] PARTICIPANT'S social security number | 3 Life insurance cost included in Box 1 Copy C
$ For Trustee or
Issuer

For Paperwork
Reduction Act

Notice and
instructions for
completing this

form, see
Instructions for

‘Account number (optional)

Forms 1099,
1098, 5498, 1096,

and W-2G

Form 5498

CJ] voip

[-] CORRECTED

Department of the Treasury

Internal Revenue Service

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

1 Regular IRA contributions
made in 1988 and 1989 for
1988

$

OMB No. 1545-0747

1988

2 Rollover IRA contributions Arrangement
Information
$
TRUSTEE’S or ISSUER'S Federal identification no] PARTICIPANT'S social security number | 3 Life insurance cost included in Box 1 Copy C
$ For Trustee or
Issuer

PARTICIPANT'S name (first, middie, last)

Street address

City, state, and ZIP code

4 Fair market value of account

$

For Paperwork
Reduction Act

Notice and
instructions for
completing this

form, see
instructions for

‘Account number (optional)

Forms 1099,
1098, 5498, 1096,

and W-2G.

Form 5498

Department of the Treasury -

Internal Revenue Service


Instructions to Participant

The information in Boxes 1, 2, 3, and 4 has been submitted
to the Internal Revenue Service by the trustee or issuer of
your individual retirement arrangement (IRA) to report
regular or rollover contributions made to your IRA and the
value of your IRA or simplified employee pension (SEP)
account.

If you or your spouse were an active participant in an
employer's pension plan, your IRA contributions may not be
deductible. See Publication 590, Individual Retirement
Arrangements (IRAs).

Box 1.—The amount shown is the contributions for 1988
made in 1988 and through April 17, 1989, to an IRA.

Box 2.—This is the amount of any rollover you made in
1988. You must report any distribution you received from a
plan on the appropriate line of your income tax return.

Instructions to Participant

The information in Boxes 1, 2, 3, and 4 has been submitted
to the Internal Revenue Service by the trustee or issuer of
your individuai retirement arrangement (IRA) to report
regular or rollover contributions made to your IRA and the
value of your IRA or simplified employee pension (SEP)
account.

If you or your spouse were an active participant in an
employer's pension plan, your !RA contributions may not be
deductible. See Publication 590, Individual Retirement
Arrangements (IRAs).

Box 1.—The amount shown is the contributions for 1988
made in 1988 and through April 17, 1989, to an IRA.

Box 2.—This is the amount of any rollover you made in
1988. You must report any distribution you received from a
plan on the appropriate line of your income tax return.

Instructions to Participant

The information in Boxes 1, 2, 3, and 4 has been submitted
to the Internal Revenue Service by the trustee or issuer of
your individual retirement arrangement (IRA) to report
regular or rollover contributions made to your !RA and the
value of your IRA or simplified employee pension (SEP)
account.

If you or your spouse were an active participant in an
employer’s pension plan, your IRA contributions may not be
deductible. See Publication 590, Individual Retirement
Arrangements (IRAs).

Box 1.—The amount shown is the contributions for 1988
made in 1988 and through April 17, 1989, to an IRA.

Box 2.—This is the amount of any rollover you made in
1988. You must report any distribution you received from a
plan on the appropriate line of your income tax return.

Subtract the part of the distribution that was rolled over and
enter the taxable remainder on the appropriate line of your
income tax return. If you have ever made any nondeductible
contributions to your IRA, see the instructions for Form
1040. If property was rolled over, see Publication 590.

Box 3.—For endowment contracts only, this is the amount
allocable to the cost of life insurance. Subtract this amount
from your allowable IRA contribution included in Box 1 to
compute the amount allowable for your IRA deduction.

Box 4.—This is the fair market value of your account at the
end of the year.

The trustee or issuer of the plan may use the other boxes on
this form to give you more information about your IRA.

You are not required to attach a copy of Form 5498 to your
income tax return. Keep this form for your records.

Subtract the part of the distribution that was rolled over and
enter the taxable remainder on the appropriate line of your
income tax return. If you have ever made any nondeductible
contributions to your IRA, see the instructions for Form
1040. If property was rolled over, see Publication 590.

Box 3.—For endowment contracts only, this is the amount
allocable to the cost of life insurance. Subtract this amount
from your allowable IRA contribution included in Box 1 to
compute the amount allowable for your IRA deduction.

Box 4.—This is the fair market value of your account at the
end of the year.

The trustee or issuer of the plan may use the other boxes on
this form to give you more information about your IRA.

You are not required to attach a copy of Form 5498 to your
income tax return. Keep this form for your records.

Subtract the part of the distribution that was rolled over and
enter the taxable remainder on the appropriate line of your
income tax return. If you have ever made any nondeductible
contributions to your IRA, see the instructions for Form
1040. If property was rolled over, see Publication 590.

Box 3.—For endowment contracts only, this is the amount
allocable to the cost of life insurance. Subtract this amount
from your allowable IRA contribution included in Box 1 to
compute the amount allowable for your IRA deduction.

Box 4.—This is the fair market value of your account at the
end of the year.

The trustee or issuer of the plan may use the other boxes on
this form to give you more information about your IRA.

You are not required to attach a copy of Form 5498 to your
income tax return. Keep this form for your records.


2a28  [Jvoio

{_] CORRECTED

For Official Use Only

“Type or machine print TRUSTEE’S or ISSUER'S name, street addréss, city, state,
and ZIP code

1 Regular IRA contributions
made in 1988 and 1989 for

OMB No. 1545-0747

Individual
$ 1988 Retirement
2 Rollover IRA contributions Arrangement
Information
$
TRUSTEE'S or ISSUER'S Federal identification no) PARTICIPANT'S social security number | 3 Life insurance cost included in Box 1 Copy A
$ For Internal
Revenue

‘Type or machine print PARTICIPANT'S name (first, middle, last)

4 Fair market value of account

$

Service Center
For Paperwork
Reduction Act

Street address

City, state, and ZIP code

Account number (optional)

Notice and
instructions for
completing this

form, see
Instructions for
Forms 1099,
11098, 5498, 1096,
and W-2G.

Form 5498 Do NOT Cut or Se

2828 Clvoiw

parate Forms on This Page

(J) correcTED

Department of the Treasury -

For Official Use Only

Type or machine print TRUSTEE'S or ISSUER'S name, street address, city, state,
and ZIP code

1. Regular IRA contributions
made in 1988 and 1989 for

$

2 Rollover IRA contributions

$

(OMB No. 1545:0747

1988

Internal Revenue Service

Individual
Retirement
Arrangement
Information

"TRUSTEE'S or ISSUER'S Federal identification no] PARTICIPANT'S social security number

3 Life insurance cost included in Box 1

$

Type or machine print PARTICIPANT'S name (first, middle, last)

4 Fair market value of account

$

Street address

CopyA

For Internal
Revenue
Service Center
For Paperwork
Reduction Act
Notice and
instructions for
completing this

City, state, and ZIP code

‘Account number (optional)

form, see
Instructions for
Forms 1099,
1098, 5498, 1096,
and W-2G.

Form 5498 Do NOT Cut or Se,

2828 (voi

Department of the Treasury

parate Forms on This Page

[| corRECTED

For Official Use Only

Type or machine print TRUSTEE’S or ISSUER'S name, street addréss, city, state,
and ZIP code

1 Regular IRA contributions
mage in 1988 and 1989 for

OMB No. 1545-0747

Internal Revenue Service

Individual
$ 1988 Retirement
2 Rollover IRA contributions Arrangement
Information
$
TTRUSTEE'S or ISSUER'S Federal identification no) PARTICIPANT'S social security number | 3 Life insurance cost included in Box 1 Copy A
$ For Internal
Revenue

Type or machine print PARTICIPANT'S name (first, middle, last)

4 Fair market value of account

$

Street address

City, state, and ZIP code

Account number (optional)

Service Center
For Paperwork
Reduction Act

Notice and
instructions for
completing this

form, see
Instructions for
Forms 1099,
11098, 5498, 1096,

and W-2G.

Form 5498

Department of the Treasury - Internal Revenue Service




{_] CORRECTED (if checked)

TRUSTEE'S or ISSUER'S name, street address, city, state, and ZIP code 1 Regular IRA contributions OMB No. 1545-0747
made in 1988 and 1989 for an
1988 Individual
$ 4 Retirement
2 Rollover IRA contributions Arrangement
Information
$
TRUSTEE’S or ISSUER'S Federal identification no) PARTICIPANT'S social security number | 3 Life insurance cost included in Box L
$ Copy B
PARTICIPANT'S name (first, middle, last) 4 Fair market value of account For
Participant
$ The information in
Street address Boxes 1, 2,3, and
4 is being
furnished to the
City, state, and ZIP code Internal Revenue
Service.
Account number (optional)
Form 5498 Department of the Treasury - Internal Revenue Service
{_] CORRECTED (if checked)
TRUSTEE’S or ISSUER’S name, street address, city, state, and ZIP code 1 Regular IRA contributions OMB No. 1545-0747
made in 1988 and 1989 for a
+988 Individual
$ | 988 Retirement
2 Rollover IRA contributions Arrangement
Information
$
‘TRUSTEE'S or ISSUER'S Federal identification no] PARTICIPANT'S social security number | 3 Life insurance cost Included in Box 1
$ Copy B
PARTICIPANT'S name (first, middle, last) 4 Fair market value of account For
Participant
$ The information in
Street address Boxes 1, 2, 3, and
4is being
furnished to the
City, state, and ZIP code Internal Revenue
Service.
‘Account number (optional)
Form 5498 Department of the Treasury - internal Revenue Service
[_] CORRECTED (if checked)
TRUSTEE'S or ISSUER'S name, street address, city, state, and ZIP coce 1 Regular IRA contributions OMB No. 1545-0747
made in 1988 and 1989 for .
1988 Individual

$ 1988 Retirement
2 Rollover IRA contributions Arrangement

Information

$

TRUSTEE'S or ISSUER'S Federal dentification no] PARTICIPANT'S social security number | 3 Life insurance cost included in Box 1
$ Copy B
PARTICIPANT'S name (first, middle, last) 4 Fair market value of account For
Participant
$ The information in
Street address Boxes 1, 2, 3, and
4is being
furnished to the
City, state, and ZIP code Internal Revenue
Service.

‘Account number (optional)

Form 5498 Department of the Treasury - Internal Revenue Service