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Phil retired in January 2021 at age 63. His pension is $1,500 per month and this year he received eleven payments. Phils life expectancy is

Phil retired in January 2021 at age 63. His pension is $1,500 per month and this year he received eleven payments. Phil’s life expectancy is 21 years. He received the following 1099-R.

◻ CORRECTED (if checked)
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.

Pierce Corporation Pension Plan
6200 Winnetka Avenue
Woodland Hills, CA 91371
1Gross distributionOMB No. 1545-0119

2021

Form 1099-R
Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc.
$16,500.00
2aTaxable amount
$
2bTaxable amount
not determined ☒

Total
distribution ◻
Copy B

Report this income on your federal tax return. If this form shows federal income tax withheld in box 4, attach this copy to your return.



This information is being furnished to the IRS.
PAYER'S TINRECIPIENT'S TIN3Capital gain (included in box 2a)4Federal income tax withheld
24-7654567120-66-4377$
$0.00
RECIPIENT’S name

Phil Ventura

Street address (including apt. no.)
1001 Chawareewong Blvd

City or town, state or province, country, and ZIP or foreign postal code
Sherman Oaks, CA 91403
5Employee contributions/Designated Roth contributions or insurance premiums6Net unrealized appreciation in employer’s securities
$
$
7Distribution code(s)IRA/SEP/ SIMPLE8Other

     7$
%

9aYour percentage of total distribution %9bTotal employee contributions
$42,500.00
10Amount allocable to IRR within 5 years111st year of desig. Roth contrib.12 FATCA filing
     requirement
14State tax withheld15State/Payer’s state no.16State distribution
$

$
$$

$
Account number (see instructions)13 Date of
     payment
17Local tax withheld18Name of locality19Local distribution
$




$


$

$
Form 1099-Rwww.irs.gov/Form1099RDepartment of the Treasury - Internal Revenue Service

a.  Calculate Phil's taxable income from the annuity in the current year, using the general rule.

In your computations round any division to five decimal places. Round your final answer to the nearest dollar.

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