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Form 1040—Lines 15b Through 16b You cannot claim a charitable in a Midwestern disaster area. For details, Insurance Premiums for Retired contribution deduction for any see Pub. 4492-B. Public Safety Officers QCD not included in your in- If you are an eligible retired public safety CAUTION ! You should receive a Form 1099-R come. officer (law enforcement officer, showing the amount of your pension and firefighter, chaplain, or member of a rescue Exception 4. If the distribution is a quali- annuity payments, including distributions squad or ambulance crew), you can elect to fied health savings account (HSA) funding from 401(k), 403(b), and governmental exclude from income distributions made distribution (HFD), enter the total distribu- 457(b) plans. See page 27 for details on from your eligible retirement plan that are tion on line 15a. If the total amount distrib- rollovers and lump-sum distributions. Do used to pay the premiums for coverage by uted is an HFD and you elect to exclude it not include the following payments on lines an accident or health plan or a long-term from income, enter -0- on line 15b. If only 16a and 16b. Instead, report them on line 7. care insurance contract. You can do this part of the distribution is an HFD and you • Disability pensions received before only if you retired because of disability or elect to exclude that part from income, you reach the minimum retirement age set because you reached normal retirement enter the part that is not an HFD on line 15b by your employer. age. The premiums can be for coverage for unless Exception 2 applies to that part. • Corrective distributions (including you, your spouse, or dependents. The dis- Enter “HFD” next to line 15b. any earnings) of excess salary deferrals or tribution must be from a plan maintained An HFD is a distribution made directly excess contributions to retirement plans. by the employer from which you retired as by the trustee of your IRA (other than an The plan must advise you of the year(s) the a public safety officer. Also, the distribu- ongoing SEP or SIMPLE IRA) to your distributions are includible in income. tion must be made directly from the plan to HSA. If eligible, you generally can elect to the provider of the accident or health plan exclude an HFD from your income once in or long-term care insurance contract. You Attach Form(s) 1099-R to your lifetime. You cannot exclude more can exclude from income the smaller of the Form 1040 if any federal than the limit on HSA contributions or amount of the premiums or $3,000. You income tax was withheld. more than the amount that would otherwise TIP can only make this election for amounts be included in your income. If your IRA that would otherwise be included in your includes nondeductible contributions, the Fully Taxable Pensions and income. HFD is first considered to be paid out of Annuities otherwise taxable income. See Pub. 969 for An eligible retirement plan is a govern- If your pension or annuity is fully taxable, details. mental plan that is: enter it on line 16b; do not make an entry • A qualified trust, The amount of an HFD reduces on line 16a. Your payments are fully tax- • A section 403(a) plan, the amount you can contribute able if (a) you did not contribute to the cost to your HSA for the year. If you • A section 403(b) plan, or (see page 27) of your pension or annuity, or CAUTION ! fail to maintain eligibility for an (b) you got your entire cost back tax free • A section 457(b) plan. HSA for the 12 months following the before 2009. But see Insurance Premiums month of the HFD, you may have to report If you make this election, reduce the for Retired Public Safety Officers on this the HFD as income and pay an additional otherwise taxable amount of your pension page. tax. See Form 8889, Part III. or annuity by the amount excluded. The Fully taxable pensions and annuities amount shown in box 2a of Form 1099-R See Pub. 590 for details. also include military retirement pay shown does not reflect the exclusion. Report your More than one exception applies. If more on Form 1099-R. For details on military total distributions on line 16a and the tax- than one exception applies, attach a state- disability pensions, see Pub. 525. If you able amount on line 16b. Enter “PSO” next ment showing the amount of each excep- received a Form RRB-1099-R, see to line 16b. tion, instead of making an entry next to line Pub. 575 to find out how to report your If you are retired on disability and re- 15b. For example: “Line 15b – $1,000 benefits. porting your disability pension on line 7, Rollover and $500 HFD.” include only the taxable amount on that line Partially Taxable Pensions and More than one distribution. If you (or and enter “PSO” and the amount excluded Annuities your spouse if filing jointly) received more on the dotted line next to line 7. Enter the total pension or annuity payments than one distribution, figure the taxable you received in 2009 on line 16a. If your Annuity Starting Date amount of each distribution and enter the Form 1099-R does not show the taxable total of the taxable amounts on line 15b. Your annuity starting date is the later of the amount, you must use the General Rule Enter the total amount of those distribu- first day of the first period for which you explained in Pub. 939 to figure the taxable tions on line 15a. received a payment or the date the plan’s part to enter on line 16b. But if your annu- obligations became fixed. You may have to pay an addi- ity starting date (defined on this page) was tional tax if you received an after July 1, 1986, see Simplified Method Simplified Method early distribution from your on this page to find out if you must use that CAUTION ! You must use the Simplified Method if ei- IRA and the total was not rolled method to figure the taxable part. ther of the following applies. over. See the instructions for line 58 on page 45 for details. You can ask the IRS to figure the tax- 1. Your annuity starting date (defined able part for you for a $500 fee. For details, above) was after July 1, 1986, and you used see Pub. 939. this method last year to figure the taxable part. Lines 16a and 16b If your Form 1099-R shows a taxable 2. Your annuity starting date was after amount, you can report that amount on Pensions and Annuities November 18, 1996, and both of the fol- line 16b. But you may be able to report a lowing apply. Special rules may apply if you lower taxable amount by using the General received a distribution from a Rule or the Simplified Method or if the a. The payments are from a qualified profit-sharing or retirement exclusion for retired public safety officers, employee plan, a qualified employee annu- TIP plan and your main home was discussed next, applies. ity, or a tax-sheltered annuity. - 25 - Need more information or forms? See page 96.