This form contains 73 fields organized into 11 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Calculations
494 45 Add lines 43 and 44 45 46 Prior year excess contributions. Subtract line 45 from line 42. If zero or less, enter -0-. 46 47 Excess contributions for 2023 (see instructions) 47 Text
Add lines 43 and 44. Enter the result here.
Distributions
Minimum required distribution for 2023 (see instructions) 52 Amount actually distributed to you in 2023 (see instructions) 53 235 Text
Enter the minimum required distribution for 2023 as per the instructions.
Minimum required distribution for 2023 (see instructions) 52 Amount actually distributed to you in 2023 (see instructions) 53 235 Text
Enter the amount actually distributed to you in 2023 as per the instructions.
Excess Contributions
42 Enter the excess contributions from line 48 of your 2022 Form 5329. If zero, go to line 47 Text
Enter the excess contributions from line 48 of your 2022 Form 5329. If zero, go to line 47.
494 45 Add lines 43 and 44 45 46 Prior year excess contributions. Subtract line 45 from line 42. If zero or less, enter -0-. 46 47 Excess contributions for 2023 (see instructions) 47 Text
Subtract line 45 from line 42. If zero or less, enter -0-.
494 45 Add lines 43 and 44 45 46 Prior year excess contributions. Subtract line 45 from line 42. If zero or less, enter -0-. 46 47 Excess contributions for 2023 (see instructions) 47 Text
Enter the excess contributions for 2023 as per the instructions.
48 Total excess contributions. Add lines 46 and 47 Text
Add lines 46 and 47 to get the total excess contributions.
Excess contributions for 2023 (see instructions) 50 Text
Enter the excess contributions for 2023 as per the instructions.
General
39 Excess contributions for 2023 (see instructions) 39 Text
Enter the excess contributions for 2023. Refer to the instructions for more details.
HSA Contributions
43 If the contributions to your HSAs for 2023 are less than the maximum allowable contribution, see instructions. Otherwise, enter -0--43 Text
If the contributions to your HSAs for 2023 are less than the maximum allowable contribution, see instructions. Otherwise, enter -0-.
HSA Distributions
44 2023 distributions from your HSAs from Form 8889, line 16 44 Text
Enter the 2023 distributions from your HSAs from Form 8889, line 16.
Miscellaneous
FEFF00630031005F0031005B0030005D CheckBox
Check this box if applicable.
FEFF00660031005F0039005B0030005D Text
Enter the relevant information as instructed.
FEFF00660031005F00310030005B0030005D Text
Enter the relevant information as instructed.
FEFF00660031005F00310031005B0030005D Text
Enter the relevant information as instructed.
FEFF00660031005F00310037005B0030005D Text
Enter the relevant information as instructed.
FEFF00660031005F00320030005B0030005D Text
Enter the relevant information as instructed.
FEFF00660031005F00320035005B0030005D Text
Enter the relevant information as instructed.
FEFF00660031005F00330032005B0030005D Text
Enter the relevant information as instructed.
FEFF00660032005F0033005B0030005D Text
Enter the relevant information as instructed.
FEFF00660032005F0034005B0030005D Text
Enter the relevant information as instructed.
FEFF00660032005F0035005B0030005D Text
Enter the relevant information as instructed.
FEFF00660032005F0039005B0030005D Text
Enter the relevant information as instructed.
FEFF00660032005F00310032005B0030005D Text
Enter the relevant information as instructed.
FEFF00660032005F00310033005B0030005D Text
Enter the relevant information as instructed.
FEFF00660032005F00310035005B0030005D Text
Enter the relevant information as instructed.
FEFF00660032005F00320039005B0030005D Text
This field appears to be a placeholder or incorrectly extracted. Please refer to the form for the correct field.
FEFF00630032005F0031005B0030005D CheckBox
This checkbox is likely used to indicate a specific condition or selection. Please refer to the form for the correct usage.
FEFF00630032005F0032005B0030005D CheckBox
This checkbox is likely used to indicate a specific condition or selection. Please refer to the form for the correct usage.
FEFF00660032005F00330034005B0030005D Text
This field appears to be a placeholder or incorrectly extracted. Please refer to the form for the correct field.
Personal Information
Name of individual subject to additional tax. If married filing jointly, see instructions Text
Enter the name of the individual who is subject to the additional tax. If you are filing jointly with your spouse, refer to the instructions for further guidance.
Your social security number Text
Enter your social security number. This should be a 9-digit number.
Max length: 11 characters
Home address (number and street), or P.O. box if mail is not delivered to your home Text
Enter your home address, including the street number and name. If mail is not delivered to your home, you can use a P.O. box.
Apt. no Text
Enter your apartment number, if applicable.
City, town or post office, state, and ZIP code. If you have a foreign address, also complete the spaces below. See instructions Text
Enter your city, state, and ZIP code. If you have a foreign address, complete the additional spaces provided for foreign addresses.
Foreign country name Text
Enter the name of your foreign country, if applicable.
Foreign province/state/county Text
Enter the name of your foreign province, state, or county, if applicable.
Foreign postal code Text
Enter your foreign postal code, if applicable.
Preparer Information
Print/Type preparer's name Text
Print or type the preparer's name.
PTIN Text
Enter the Preparer Tax Identification Number (PTIN). Maximum length is 11 characters.
Max length: 11 characters
Firm's name Text
Enter the name of the firm.
Firm's EIN Text
Enter the Employer Identification Number (EIN) of the firm. Maximum length is 10 characters.
Max length: 10 characters
Phone no Text
Enter the phone number.
Tax Calculation
Amount subject to additional tax. Subtract line 2 from line 1 Text
Enter the amount subject to additional tax by subtracting line 2 from line 1.
Additional tax. Enter 10% (0.10) of line 3. Include this amount on Schedule 2 (Form 1040), line 8 4 Text
Calculate and enter 10% (0.10) of the amount on line 3. Include this amount on Schedule 2 (Form 1040), line 8.
Distributions included in income from a Coverdell ESA, a QTP, or an ABLE account 5 Text
Enter the distributions included in income from a Coverdell ESA, a QTP, or an ABLE account.
6 Distributions included on line 5 that are not subject to the additional tax (see instructions) 6 Text
Enter the distributions included on line 5 that are not subject to the additional tax. Refer to the instructions for more details.
Amount subject to additional tax. Subtract line 6 from line 5 7 Text
Enter the amount subject to additional tax by subtracting line 6 from line 5.
9 Enter your excess contributions from line 16 of your 2022 Form 5329. See instructions. If zero, go to line 15 9 Text
Enter your excess contributions from line 16 of your 2022 Form 5329. Refer to the instructions if the amount is zero.
allowable contribution, see instructions. Otherwise, enter -0- . 10 Text
Enter the allowable contribution as instructed. If not applicable, enter -0-.
12 2023 distributions of prior year excess contributions (see instructions) 12 Text
Enter the 2023 distributions of prior year excess contributions. Refer to the instructions for more details.
13 Add lines 10, 11, and 12 Text
Add the amounts on lines 10, 11, and 12 and enter the total.
14 Prior year excess contributions. Subtract line 13 from line 9. If zero or less, enter -0--14 17 Text
Enter the prior year excess contributions by subtracting line 13 from line 9. If the result is zero or less, enter -0-.
15 Excess contributions for 2023 (see instructions) Text
Enter the excess contributions for 2023. Refer to the instructions for more details.
31, 2023 (including 2023 contributions made in 2024). Include this amount on Schedule 2 (Form 1040), line 8 17 Text
Enter the total excess contributions for 2023, including contributions made in 2024. Include this amount on Schedule 2 (Form 1040), line 8.
Enter your excess contributions from line 24 of your 2022 Form 5329. See instructions. If zero, go to line 23 18 Text
Enter your excess contributions from line 24 of your 2022 Form 5329. Refer to the instructions if the amount is zero.
20 2023 distributions from your Roth IRAS (see instructions) 20 Text
Enter the 2023 distributions from your Roth IRAs. Refer to the instructions for more details.
20 2023 distributions from your Roth IRAS (see instructions) 20 Text
Enter the 2023 distributions from your Roth IRAs. Refer to the instructions for more details.
21 Add lines 19 and 20 Text
Add the amounts on lines 19 and 20 and enter the total.
Prior year excess contributions. Subtract line 21 from line 18. If zero or less, enter -0 Text
Enter the prior year excess contributions by subtracting line 21 from line 18. If the result is zero or less, enter -0-.
24 Total excess contributions. Add lines 22 and 23 Text
Add the amounts on lines 22 and 23 and enter the total.
2 2023 (including 2023 contributions made in 2024). Include this amount on Schedule 2 (Form 1040), line 8 25 Text
Enter the total excess contributions for 2023, including contributions made in 2024. Include this amount on Schedule 2 (Form 1040), line 8.
26 Enter the excess contributions from line 32 of your 2022 Form 5329. See instructions. If zero, go to line 31 Text
Enter the excess contributions from line 32 of your 2022 Form 5329. Refer to the instructions if the amount is zero.
27 If the contributions to your Coverdell ESAs for 2023 were less than the maximum allowable contribution, see instructions. Otherwise, enter -0--27 Text
Enter the allowable contribution for your Coverdell ESAs for 2023. If the contributions are less than the maximum allowable, refer to the instructions. Otherwise, enter -0-.
31 31 Excess contributions for 2023 (see instructions) Text
Enter the excess contributions for 2023. Refer to the instructions for more details.
Total excess contributions. Add lines 30 and 31 Text
Add the amounts on lines 30 and 31 and enter the total.
31, 2023 (including 2023 contributions made in 2024). Include this amount on Schedule 2 (Form 1040), line 8 Text
Enter the total excess contributions for 2023, including contributions made in 2024. Include this amount on Schedule 2 (Form 1040), line 8.
35 If the contributions to your Archer MSAs for 2023 are less than the maximum allowable contribution, see instructions. Otherwise, enter -0--35 3 Text
Enter the allowable contribution for your Archer MSAs for 2023. If the contributions are less than the maximum allowable, refer to the instructions. Otherwise, enter -0-.
2023 distributions from your Archer MSAs from Form 8853, line 8 36 Text
Enter the 2023 distributions from your Archer MSAs as reported on Form 8853, line 8.
41 Additional tax. Enter 6% (0.06) of the smaller of line 40 or the value of your Archer MSAs on December 31, 2023 (including 2023 contributions made in 2024). Include this amount on Schedule 2 (Form 1040), line 8. 41 Text
Calculate and enter 6% (0.06) of the smaller of line 40 or the value of your Archer MSAs on December 31, 2023, including contributions made in 2024. Include this amount on Schedule 2 (Form 1040), line 8.
Tax Reporting
2023 (including 2023 contributions made in 2024). Include this amount on Schedule 2 (Form 1040), line 8 49 Text
Include this amount on Schedule 2 (Form 1040), line 8 for 2023 (including 2023 contributions made in 2024).
December 31, 2023. Include this amount on Schedule 2 (Form 1040), line 8 51 Text
Include this amount on Schedule 2 (Form 1040), line 8 for December 31, 2023.
Include this amount on Schedule 2 (Form 1040), line 8 or Form 1041, Schedule G, line 8 55 Text
Include this amount on Schedule 2 (Form 1040), line 8 or Form 1041, Schedule G, line 8.