OMB No. 1545-1007

Form 8606 Nondeductible IRAs

 See separate instructions.

Department of the Treasury

Internal Revenue Service

Attachment

 Attach to Form 1040, Form 1040A, or Form 1040NR. Sequence No. 48

Name. If married, file a separate form for each spouse required to file Form 8606. See page 5 of the instructions. Your social security number

Home address (number and street, or P.O. box if mail is not delivered to your home) Apt. no. Fill in Your Address Only

if You Are Filing This

Form by Itself and Not

With Your Tax Return

City, town or post office, state, and ZIP code

1

1 Enter your nondeductible contributions to traditional IRAs for 2003, including those made for

2003 from January 1, 2004, through April 15, 2004 (see page 5 of the instructions)

2 Enter your total basis in traditional IRAs (see page 6 of the instructions) 2

3 Add lines 1 and 2

4

3

Enter those contributions included on line 1 that were made from January 1, 2004, through April

15, 2004

5

4

Subtract line 4 from line 3 5

6 Enter the value of all your traditional, SEP, and SIMPLE IRAs as of

December 31, 2003, plus any outstanding rollovers (see page 6 of

the instructions)

8

7

Enter the net amount you converted from traditional, SEP, and SIMPLE

IRAs to Roth IRAs in 2003. Do not include amounts converted that

you later recharacterized (see page 6 of the instructions). Also enter

this amount on line 16

9 9

10

Add lines 6, 7, and 8

10

 .

11

Divide line 5 by line 9. Enter the result as a decimal rounded to at

least 3 places. If the result is 1.000 or more, enter “1.000”

11 Multiply line 8 by line 10. This is the nontaxable portion of the amount

you converted to Roth IRAs. Also enter this amount on line 17

12

12

13

Multiply line 7 by line 10. This is the nontaxable portion of your

distributions that you did not convert to a Roth IRA

13

14

15

Subtract line 13 from line 3. This is your total basis in traditional IRAs for 2003 and earlier

years

Cat. No. 63966F Form 8606 (2003)



In 2003, did you take a

distribution from traditional,

SEP, or SIMPLE IRAs or

make a Roth IRA conversion?

No

Yes

Enter the amount from line 3 on

line 14. Do not complete the rest

of Part I.

Go to line 4.

Taxable amount. Subtract line 12 from line 7. Also include this amount on Form 1040, line 15b;

Form 1040A, line 11b; or Form 1040NR, line 16b





6

For Paperwork Reduction Act Notice, see page 8 of the instructions.

Part I Nondeductible Contributions to Traditional IRAs and Distributions From Traditional, SEP, and SIMPLE IRAs

Complete this part only if:

● You made nondeductible contributions to a traditional IRA for 2003,

● You took distributions from a traditional, SEP, or SIMPLE IRA in 2003 (other than a rollover, conversion,

recharacterization, or return of certain contributions) and you made nondeductible contributions to a traditional IRA

in 2003 or an earlier year, or

● You converted part, but not all, of your traditional, SEP, and SIMPLE IRAs to Roth IRAs in 2003 (excluding any portion

you recharacterized) and you made nondeductible contributions to a traditional IRA in 2003 or an earlier year.

Enter your distributions from traditional, SEP, and SIMPLE IRAs in

2003. Do not include rollovers, conversions to a Roth IRA, certain

returned contributions, or recharacterizations of traditional IRA

contributions (see page 6 of the instructions)

7

Add lines 11 and 12. This is the nontaxable portion of all your distributions

14

8

15

Note: You may be subject to an additional 10% tax on the amount on line 15 if you were under

age 591⁄2 at the time of the distribution (see page 7 of the instructions).

2003
Form 8606 (2003) Page 2

Under penalties of perjury, I declare that I have examined this form, including accompanying attachments, and to the best of my

knowledge and belief, it is true, correct, and complete. Sign Here Only if You

Are Filing This Form

by Itself and Not With

Your Tax Return  Your signature  Date

Part III

Complete this part if you converted part or all of your traditional, SEP, and SIMPLE IRAs to a Roth IRA in 2003 (excluding

any portion you recharacterized).

17

18

If you completed Part I, enter the amount from line 11. Otherwise, enter your basis in the amount

on line 16 (see page 7 of the instructions)

16

19 Enter your total nonqualified distributions from Roth IRAs in 2003 including any qualified first-time

homebuyer distributions (see page 7 of the instructions)

20 Enter your basis in Roth IRA contributions (see page 7 of the instructions)

21 Subtract line 20 from line 19. If zero or less, enter -0- and skip lines 22 through 25. But if you have a

qualified first-time homebuyer distribution, complete line 23. If more than zero, you may be subject to

an additional tax (see page 8 of the instructions)

22 Enter your basis in Roth IRA conversions (see page 8 of the instructions)

19

Taxable amount. Subtract line 17 from line 16. Also include this amount on Form 1040,

line 15b; Form 1040A, line 11b; or Form 1040NR, line 16b

Form 8606 (2003)

Caution: If your modified adjusted gross income is over $100,000 or you are married filing separately and you lived

with your spouse at any time in 2003, you cannot convert any amount from traditional, SEP, or SIMPLE IRAs to Roth

IRAs for 2003. If you erroneously made a conversion, you must recharacterize (correct) it (see page 7 of the instructions).

Part II

16 If you completed Part I, enter the amount from line 8. Otherwise, enter the net amount you

converted from traditional, SEP, and SIMPLE IRAs to Roth IRAs in 2003. Do not include amounts

you later recharacterized back to traditional, SEP, or SIMPLE IRAs in 2003 or 2004 (see page 7

of the instructions)

17

18

Distributions From Roth IRAs

Complete this part only if you took a distribution from a Roth IRA in 2003 (other than a rollover, recharacterization, or

return of certain contributions—see page 7 of the instructions).

25 Taxable amount. Subtract line 24 from line 21. If zero or less, enter -0-. Also include this amount

on Form 1040, line 15b; Form 1040A, line 11b; or Form 1040NR, line 16b

20

21

25

2003 Conversions From Traditional, SEP, or SIMPLE IRAs to Roth IRAs

22

24 Add lines 22 and 23

23 Qualified first-time homebuyer expenses (see page 8 of the

instructions). Do not enter more than $10,000

24

23