Publication 575 - Pension And Annuity Income - 2004 Page 6
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362004
PAYERS’ NAME, STREET ADDRESS, CITY, STATE, AND ZIP CODE
ANNUITIES OR PENSIONS BY THE
RAILROAD RETIREMENT BOARD
UNITED STATES RAILROAD RETIREMENT BOARD
844 N RUSH ST CHICAGO IL 60611-2092
3.
Employee Contributions
PAYER’S FEDERAL IDENTIFYING NO. 36-3314600
1.
Claim Number and Payee Code
4.
Contributory Amount Paid
COPY B -
2.
Recipient’s Identification Number
5.
Vested Dual Benefit
REPORT THIS INCOME ON
YOUR
FEDERAL
TAX
Recipient’s Name, Street Address, City, State, and ZIP Code
6.
Supplemental Annuity
RETURN. IF THIS FORM
SHOWS FEDERAL INCOME
TAX WITHHELD IN BOX 9
7.
Total Gross Paid
ATTACH THIS COPY TO
YOUR RETURN.
8.
Repayments
THIS
INFORMATION
IS
BEING
FURNISHED TO THE INTERNAL
9.
Federal Income Tax
REVENUE SERVICE.
Withheld
10.
Rate of Tax
11.
Country
12. Medicare Premium Total
FORM RRB-1099-R
•
Recovery of a prior year overpayment of an NSSEB,
Each beneficiary will receive his or her own Form
TIP
RRB-1099-R. If you receive benefits on more
tier 2 benefit, VDB, or supplemental annuity benefit,
than one railroad retirement record, you may get
or
more than one Form RRB-1099-R. So that you get your
•
Recovery of Railroad Unemployment Insurance Act
form timely, make sure the RRB always has your current
benefits received while awaiting payment of your
mailing address.
railroad retirement annuity.
The amounts shown on this form are after any offset for:
Box 1 — Claim Number and Payee Code. Your claim
number is a six- or nine-digit number preceded by an
•
Social Security benefits,
alphabetical prefix. This is the number under which the
•
RRB paid your benefits. Your payee code follows your
Age reduction,
claim number and is the last number in this box. It is used
•
Public Service pensions or public disability benefits,
by the RRB to identify you under your claim number. In all
•
your correspondence with the RRB, be sure to use the
Dual railroad retirement entitlement under another
claim number and payee code shown in this box.
RRB claim number,
•
Box 2 — Recipient’s Identification Number. This is
Work deductions,
the recipient’s U.S. taxpayer identification number. It is the
•
Legal process partition deductions,
social security number (SSN), individual taxpayer identifi-
•
cation number (ITIN), or employer identification number
Actuarial adjustment,
(EIN), if known, for the person or estate listed as the
•
Annuity waiver, or
recipient.
•
Recovery of a current-year overpayment of NSSEB,
If you are a resident or nonresident alien who
tier 2, VDB, or supplemental annuity benefits.
TIP
must furnish a taxpayer identification number to
the IRS and are not eligible to obtain an SSN, use
The amounts shown on Form RRB-1099-R do not reflect
Form W-7, Application for IRS Individual Taxpayer Identifi-
any special rules, such as capital gain treatment or the
cation Number, to apply for an ITIN. The instructions for
special 10-year tax option for lump-sum payments, or
Form W-7 explain how and when to apply.
tax-free rollovers. To determine if any of these rules apply
Box 3 —Employee Contributions. This is the amount
to your benefits, see the discussions about them later.
of taxes withheld from the railroad employee’s earnings
Generally, amounts shown on your Form RRB-1099-R
that exceeds the amount of taxes that would have been
are considered a normal distribution. Use distribution code
withheld had the earnings been covered under the social
“7” if you are asked for a distribution code.
security system. This amount is the employee’s cost (in-
There are three copies of this form. Copy B is to be
vestment in the contract) that you use to figure the tax-free
included with your income tax return if federal income tax is
part of the NSSEB and tier 2 benefit you received (the
witheld. Copy C is for your own records. Copy 2 is filed with
amount shown in box 4). (For information on how to figure
your state, city, or local income tax return, when required.
the tax-free part, see Partly Taxable Payments under Tax-
See the illustrated Copy B (Form RRB-1099-R) above.
ation of Periodic Payments, later.) The amount shown is
Page 6
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