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Simplified Method Worksheet—Lines 16a and 16b Keep for Your Records Form 1040—Lines 16a and 16b b. On your annuity starting date, either more details on the Simplified Method, see the taxable part of your annuity. Do not use you were under age 75 or the number of Pub. 575 or Pub. 721 for U.S. Civil Service the worksheet below. years of guaranteed payments was fewer retirement benefits. than 5. See Pub. 575 for the definition of Age (or Combined Ages) at If you received U.S. Civil Serv- guaranteed payments. Annuity Starting Date ice retirement benefits and you If you are the retiree, use your age on the chose the alternative annuity CAUTION ! If you must use the Simplified Method, annuity starting date. If you are the survivor option, see Pub. 721 to figure complete the worksheet below to figure the of a retiree, use the retiree’s age on his or taxable part of your pension or annuity. For her annuity starting date. But if your annu- Before you begin:  If you are the beneficiary of a deceased employee or former employee who died before August 21, 1996, include any death benefit exclusion that you are entitled to (up to $5,000) in the amount entered on line 2 below. Note. If you had more than one partially taxable pension or annuity, figure the taxable part of each separately. Enter the total of the taxable parts on Form 1040, line 16b. Enter the total pension or annuity payments received in 2009 on Form 1040, line 16a. 1. Enter the total pension or annuity payments received in 2009. Also, enter this amount on Form 1040, line 16a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 2. Enter your cost in the plan at the annuity starting date . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Note. If you completed this worksheet last year, skip line 3 and enter the amount from line 4 of last year’s worksheet on line 4 below (even if the amount of your pension or annuity has changed). Otherwise, go to line 3. 3. Enter the appropriate number from Table 1 below. But if your annuity starting date was after 1997 and the payments are for your life and that of your beneficiary, enter the appropriate number from Table 2 below . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. 4. Divide line 2 by the number on line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. 5. Multiply line 4 by the number of months for which this year’s payments were made. If your annuity starting date was before 1987, skip lines 6 and 7 and enter this amount on line 8. Otherwise, go to line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. 6. Enter the amount, if any, recovered tax free in years after 1986. If you completed this worksheet last year, enter the amount from line 10 of last year’s worksheet . . . . . . . . . . . . 6. 7. Subtract line 6 from line 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. 8. Enter the smaller of line 5 or line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 9. Taxable amount. Subtract line 8 from line 1. Enter the result, but not less than zero. Also, enter this amount on Form 1040, line 16b. If your Form 1099-R shows a larger amount, use the amount on this line instead of the amount from Form 1099-R. If you are a retired public safety officer, see Insurance Premiums for Retired Public Safety Officers on page 25 before entering an amount on line 16b. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. 10. Was your annuity starting date before 1987? Yes. STOP Leave line 10 blank. No. Add lines 6 and 8. This is the amount you have recovered tax free through 2009. You will need this number when you fill out this worksheet next year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. Table 1 for Line 3 Above AND your annuity starting date was— IF the age at annuity starting before November 19, 1996, after November 18, 1996, date (see page 25) was . . . enter on line 3 . . . enter on line 3 . . . 55 or under 300 360 56–60 260 310 61–65 240 260 66–70 170 210 71 or older 120 160 Table 2 for Line 3 Above IF the combined ages at annuity starting date (see page 25) were . . . THEN enter on line 3 . . . 110 or under 410 111–120 360 121–130 310 131–140 260 141 or older 210 Need more information or forms? See page 96. - 26 -