1099-R Excel Template

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Field Name	Notes	Example
Recipient's Identification number	This is a mandatory field. Text field, maximum 11 characters long.	652-45-7888
Recipient's Name (Line One)	This is a mandatory field. Text field, maximum 40 characters long.	John Doe
Recipient's Name (Line Two)	Text field, maximum 40 characters long.
Recipient's Address1	Text field, maximum 30 characters long.	South Orange Drive
Recipient's City	Text field, maximum 20 characters long.	Banana Town
Recipient's State	Must be one of the following: AA, AC, AE, AK, AL, AP, AR, AS, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MP, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY	IL
Recipient's Zip Code	Text field, maximum 11 characters long.	25201
Account Number	Text field, maximum 12 characters long.	652-999
Box 1:Gross distribution	Numeric field (shouldn’t include any non-numeric characters like a ",").	5666.26
Box 2a:Taxable amount	Numeric field (shouldn’t include any non-numeric characters like a ",").	5721.38
Box 2b:Taxable amount not determined	This field can either be 1 or 0. 1 means the check box is checked and 0, means it’s unchecked.	0
Box 2b: Total distribution	This field can either be 1 or 0. 1 means the check box is checked and 0, means it’s unchecked.	1
Box 3:Capital gain (included in box 2a)	Numeric field (shouldn’t include any non-numeric characters like a ",").	5886.74
Box 4:Federal income tax withheld	Numeric field (shouldn’t include any non-numeric characters like a ",").	5941.86
Box 5:Emp. contribs. /Des. Roth contribs. or ins. premiums	Numeric field (shouldn’t include any non-numeric characters like a ",").	100.2
Box 6:Net unrealized appreciation in employer’s securities	Numeric field (shouldn’t include any non-numeric characters like a ",").	10.23
Box 7:Distribution code(s)	Text field, maximum 6 characters long	B
Box 7:IRA/SEP/SIMPLE	This field can either be 1 or 0. 1 means the check box is checked and 0, means it’s unchecked.	0
Box 8:Other	Numeric field (shouldn’t include any non-numeric characters like a ",").	100.2
Box 8:%	A whole number between 1 and 99	10
Box 9a:Your percentage of total distribution	A whole number between 1 and 99	15
Box 9b:Total employee contributions	Numeric field (shouldn’t include any non-numeric characters like a ",").	455.63
Box 12:State tax withheld	Numeric field (shouldn’t include any non-numeric characters like a ",").	355.12
Box 13:State/Payer’s state no.	Text field, maximum 20 characters long. Must be formatted State Abbreviation/State ID such as IL/2851417 .	IL/1234-5678
Box 14:State distribution	Numeric field (shouldn’t include any non-numeric characters like a ",").	233.45
Box 15:Local tax withheld	Numeric field (shouldn’t include any non-numeric characters like a ",").	100.2
Box 16:Name of locality	Text field, maximum 12 characters long.	CLARKS
Box 17:Local distribution	Numeric field (shouldn’t include any non-numeric characters like a ",").	133.56
1st year of desig. Roth contrib.	Date field formatted as follows: MM/DD/YYYY	08/14/2009
Amount allocable to IRR within 5 years	Numeric field (shouldn’t include any non-numeric characters like a ",").	1000.18

1099-R Excel Template

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