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1 CORRECTE (if checked) - PAYER'S name. street address. city or town, state or province, country, and Gross distribution OMB No istributions From ZP or foreign postal code Pensions, Annuities, 3, CHARLES SCHWAB & CO., NC. $ Retirement or!2 4 2 MAN STREET 2a Taxable amount Profit-Sharing Plans, RAs, nsurance SAN FRANCSCO CA 9405 $ 3, Form 099-R Contracts etc b Taxable amount [X] Total not determined distribution 0 Copy B PAYER'S federal identification number RECPENT'S identification number 3 Capital gain (included 4 Federal income tax Report this income in box2a) ***-* withheld on your federal tax $ $, return. f this form RECPENT'S name, street address (including apt. no.), city or town, state or province. 6 Net unrealizad appreciation shows federal country, and ZP or foreign postal code 5.i.'::&t:r,;, n employefs securities income tax withheld s $ in box 4, attach this CHARLES SCHWAB & CO NC CUST 7 istribution. rrnsep/ 8 Other copy to your return RA ROLLOVER code(s) SKJLE $ % This information is being furnished to 9a Your percentage of total 9b Total employee the nternal WALORF, M distribution contributions % $ Revenue Service. 0 Amount allocable to RR st year of desig. Roth conlrib. 2 Stale tax withheld 3 State/Payes state no. 4 Slate distribution within 5 years.!... J,n?..,QQ......MPJ..?? $ s s Account number (see instructions) 5 local tax withheld 6 Name of locality 7 Local distribution $... G J '"w'"'''''''''''''''''''"''''''''''''''''''"''w'''''''"'''''''"'"'_'_,, Form 099-R 099r epartment of the Treasury - nternal Revenue Service,

2 2/27/ R Codes for Box R Codes for Box 7 Answer ocument 0 0/23/204 07:52AM,,.!'Used Published 02/07/204 0:54 AM Updated p...,..., r,.,,...,...,,, CJ,-----, se Code only if the employee/taxpayer has not reached age 59 /2, and arly distribution, o known xception rou do not know if any of the exceptions under Code 2, 3, or 4 apply. Use pode even if the distribution is made for medical expenses, health -- with )applicable) 'nsurance premiums, qualified higher education expenses, a first-time home L purchase, or a qualified reservist distribution under section 72(t)(2)(B), (), ' ' ' ' ' r P E), (F), or (G). Code must also be used even if a taxpayer is 59 /2 or older! nd he or she modifies a series of substantially equal periodic payments nder section 72(q), (t), or (v) prior to the end of the 5-year period which began! L j ith the first payment.,-----, Use Code 2 only if the employee/taxpayer has not reached age 59 /2 and :=== ou know the distribution is: 2 arly distribution, xception applies A Roth RA conversion (an RA converted to a Roth RA). A distribution made from a qualified retirement plan or RA because of an RS levy under section 633. A section 457(b) plan distribution that is not subject to the additional 0% tax. See Section 457(b) plan distributions on page 2 of the RS instructions for Form 099-R for information on distributions that may be subject to the 0% additional tax. A distribution from a qualified retirement plan after separation from service in or after the year the taxpayer has reached age 55. A distribution from a governmental defined benefit plan to a public safety employee after separation from service in or after the year the employee has reached age 50. A distribution that is part of a series of substantially equal periodic payments as described in section 72(q), (t), (u), or (v). A distribution that is a permissible withdrawal under an eligible automatic contribution arrangement (EACA). Any other distribution subject to an exception under section 72(q), (t), (u), or (v) that is not required to be reported using Code, 3, or 4. t 8 8,, or L j===i=================;:== pisability \for these purposes, see section 72(m)(7). i p Code 4 regardless of the age of the employee/taxpayer to indicate ayment to a decedent's beneficiary, including an estate or trust. Also use it eath. or death benefit payments made by an employer but not made as part of a ension, profit-sharing, or retirement plan. :== se A, 8,, H, L, or rohibited se Code 5 if there was a prohibited transaction involving the account. Code one means the account is no longer an RA. ection 035 se Code 6 to indicate the tax-free exchange of life insurance, annuity, longerm care insurance, or endowment contracts under section 035.,,-----, se Code 7: (a) for a normal distribution from a plan, including a traditional ormal RA, section 40(k), or section 403(b) plan, if the employee/ taxpayer is at east age 59 /2, (b) for a Roth RA conversion if the participant is at least ge 59 /2, and (c) to report a distribution from a life insurance, annuity, or ndowment contract and for reporting income from a failed life insurance ontract under sections 7702(g) and (h). See Rev. Proc , /4

3 : 227/ R Codes for Box 7 " 7 istribution.r.b. 60, available at RB/ar9.html. Generally, la B, or se Code 7 if no other code applies. o not use Code 7 for a Roth RA. ote: Code must be used even if a taxpayer is 59 2 or older and he or he modifies a series of substantially equal periodic payments under section 72(q), (t). or (v) prior to the end of the 5-year period which began with the first ==================================================== 8 '----J xcess.. se Code 8 for an RA distribution under section 408(d)(4), unless Code P ontnbutlons plus :. pplies. Also use this code for corrective distributions of excess deferrals, amingslexcess, 2, 4, B, xcess contributions, and excess aggregate contributions, unless Code P, eferrals (and/or r J pplies. See Corrective istributions and RA Revocation or Account Closure amings) taxable n the RS instructions for Form 099-R for more information. n 203.;ost of current se Code 9 to report premiums paid by a trustee or custodian for current life E ife insurance pr other insurance protection. See the instructions for box 2a in the RS one protection nstructions for Form 099-R for more information. r,---, i se Code A only for participants born before January 2, 936, or their ;====; A '----J neficiaries to indicate the distribution may be eligible for the 0-year tax ay be eligible fo pption method of computing the tax on lump-sum distributions (on Form 4972, la J'f or 7 0-year tax option ax on Lump-Sum istributions). To determine whether the distribution may, eligible for the tax option, you need not consider whether the recipient usedl his method (or capital gain treatment) in the past. Roth se Code B for a distribution from a designated Roth account. But use Code. 2, 4, 7, esignated account for a section 45 distribution under EPCRS (see Code E) or Code H for a. G, L, P, distribution irect rollover to a Roth RA. pr U,---, Annuity payments rom nonqualified nnuities and istributions from.. se Code for a distribution from any plan or arrangement not described in fe nsurance actions 40(a). 403(a), 403(b), 408, 408A. or457(b). pontracts that may be subject to ax under section 4 i!, 2, 3, 4, jor7 E nder Employee. ee istributions under Employee Plans Compliance Resolutions System lans Compliance EPCRS) in the RS instructions for Form 099-R for more information. esolution ystem (EPCRS) ============================= haritable gift ee Charitable gift annuities in the RS instructions for Form 099-R for more nformation. =====::; se Code G for a direct rollover from a qualified plan, section 403(b) plan or a one ovemmental section 457(b) plan to an eligible retirement plan (another ualified plan, a section 403(b) plan, a governmental section 457(b) plan, or an pirect rollover and RA). See irect Rollovers in the RS instructions for Form 099-R for more G rollover nformation. Also use Code G for RA rollover contributions to an accepting or 8 ontribution mployer plan and for RRs. ote: o not use Code G for a direct rollover from a designated Roth account o a Roth RA. Use Code H. L. j - ==:::;,---, pirect rollover of H designated Roth ccount istribution to a se Code H for a direct rollover of a distribution from a designated Roth ccount to a Roth RA. i se.custhel p. com /applanswers/detai /a _i d/489/-/ 099-r-codes-for-box-7 :r 2/4

4 2/27/ R Codes for Box 7 t= UfothiRA J se Code J for a distribution from a Roth RA when Code Q or Code T does arty distribution B ot apply. But use Code 2 for an RS levy and Code 5 for a prohibited or P rom a Roth RA ransaction. :::se;eated as po not use Code L to report a loan offset. See Loans Treated as istributions 4 8 distributions unde n the RS instructions for Form 099-R for more information. : ' ' or ection 72(p) i echaracterized se CodeN for a recharacterization of an RA contribution made for 203 andl ' '===== RA contribution echaracterized in 203 to another type of RA by a trustee-to-trustee transfer one made for 2o3 lor with the same trustee.,...---,excess p ee the explanation for Code 8. The RS suggests that anyone using Code P r-----, pontributions plus or the refund of an RA contribution under section 408(d)(4), including excess L. ' 2, 4, B, ramings/excess oth RA contributions, advise payees, at the time the distribution is made, jorj eferrals taxable hat the earnings are taxable in the year in which the contributions were n 202 ad e. :====== se Code Q for a distribution from a Roth RA if you know that the participant:== eets the 5-year holding period and: Q ualified stribution from a oth RA The participant has reached age 59 /2, The participant died, or The participant is disabled. ote: f any other code, such as 8 or P, applies, use Code J Recharacterized se CodeR for a recharacterization of an RA contribution made for 202 and! RA contribution echaracterized in 203 to another type of RA by a trustee-to-trustee transfer i one made for 202 pr with the same trustee.,...---, arty distribution! f.jse Code S only if the distribution is from a SMPLE RA in the first 2 years, F"'-'-"'-'-"--' rom a SMPLE he employee/taxpayer has not reached age 59 /2, and none of the s RAin first 2 xceptions under section 72(t) are known to apply when the distribution is ears, no known ade. The 2-year period begins on the day contributions are first deposited in.., xception he individual's SMPLE RA. o not use CodeS if Code 3 or 4 applies.,...---, se Code T for a distribution from a Roth RA if you do not know if the 5-year olding period has been met but: T oth RA stribution, xception applies The participant has reached age 59 /2, The participant died, or The participant is disabled. ote: f any other code, such as 8 or P, applies, use Code J. ========================================,...---, se Code U for a distribution of dividends from an employee stock ownership ividends plan (ESOP) under section 404(k). These are not eligible rollover distributions.j istributed from u ote: o not report dividends paid by the corporation directly to plan i n ESOP under articipants or their beneficiaries. Continue to report those dividends on Form action 404(k) 099-V. w '---- === harges or ayments for urchasing long- se Code W for charges or payments for purchasing qualified long-term care : erm care nsurance ontracts under ombined rrangements nsurance contracts under combined arrangements which are excludible underj action 72(e)() against the cash value of an annuity contract or the cash urrender value of a life insurance contract. 34

5 2/27/ R Codes for Box 7 se.custhel p.com/applanswers/detai /a _i d/489/-/ 099-r- codes-for- box-7 4/4

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