IRS Form 1099-R

Form 1099-R for each person to whom a designated distribution has been made or is treated as having made a distribution of $10 or more from:

  • Profit-sharing or retirement plans.
  • Any individual retirement arrangements (IRAs).
  • Annuities, pensions, insurance contracts, survivor income benefit plans.
  • Permanent and total disability payments under life insurance contracts.
  • Charitable gift annuities, etc.

The form_type parameter A_1099_R for the Upload PDF endpoint is required for this Form Type.

Optional fields captured

Field data attributed directly to Form 1099-R is captured as Form Data objects, each one keyed off the following attribute names.

📘

Configuration-Driven Output

All fields below are optionally captured, depending on your order form. To adjust fields captured, please speak with your Ocrolus Account Manager.

JSON Attribute

Data Type

Description

a_1099_r-Part1-PayerPii:payerName

Text

Payer Name

a_1099_r-Part1-PayerPii:payerAddress:addressLine1

Text

Payer Address Line 1

a_1099_r-Part1-PayerPii:payerAddress:addressLine2

Text

Payer Address Line 2

a_1099_r-Part1-PayerPii:payerAddress:city

Text

Payer Address City

a_1099_r-Part1-PayerPii:payerAddress:state

Text

Formatted as a 2 character state code.
Payer Address State

a_1099_r-Part1-PayerPii:payerAddress:country

Text

Payer Address Country

a_1099_r-Part1-PayerPii:payerAddress:zip

Text

5 digit zip code in which Payer is located. Payer Address Zip

a_1099_r-Part1-PayerPii:payerTelephoneNo.

Text

Payer Telephone Number

a_1099_r-Part1-PayerPii:payerTin

Text

Payer TIN

a_1099_r-Part2-RecipientPii:recipientTin

Text

Recipient TIN

a_1099_r-Part2-RecipientPii:recipientName

Text

Recipient Name

a_1099_r-Part2-RecipientPii:recipientAddress:addressLine1

Text

Recipient Address Line 1

a_1099_r-Part2-RecipientPii:recipientAddress:addressLine2

Text

Recipient Address Line 2

a_1099_r-Part2-RecipientPii:recipientAddress:city

Text

Recipient Address City

a_1099_r-Part2-RecipientPii:recipientAddress:state

Text

Formatted as a 2 character state code.
Recipient Address State

a_1099_r-Part2-RecipientPii:recipientAddress:country

Text

Recipient Address Country

a_1099_r-Part2-RecipientPii:recipientAddress:zip

Text

5 digit zip code in which Recipient is located. Payer Address Zip

a_1099_r-Part2-RecipientPii:accountNumber

Text

Account Number

a_1099_r-Part2-RecipientPii:dateOfPayment

Date

Date Of Payment

a_1099_r-Part2-RecipientPii:fatcaFilingRequirement

CHECKED
NOT CHECKED

FATCA Filing Requirement

a_1099_r-Part3-Boxes(1-8):box1-GrossDistribution

Money

Box 1 - Gross Distribution

a_1099_r-Part3-Boxes(1-8):box2A-TaxableAmount

Money

Box 2A - Taxable Amount

a_1099_r-Part3-Boxes(1-8):box2B-TaxableAmountNotDetermined

CHECKED
NOT CHECKED

Box 2B - Taxable Amount Not Determined

a_1099_r-Part3-Boxes(1-8):box2B-TotalDistribution

CHECKED
NOT CHECKED

Box 2B - Total Distribution

a_1099_r-Part3-Boxes(1-8):box3-CapitalGain(IncludedInBox2A)

Money

Box 3 - Capital Gain (Included In Box 2A)

a_1099_r-Part3-Boxes(1-8):box4-FederalIncomeTaxWithheld

Money

Box 4 - Federal Income Tax Withheld

a_1099_r-Part3-Boxes(1-8):box5-EmployeeContributions/DesignatedRothContributionsOrInsurancePremiums

Money

Box 5 - Employee Contributions/Designated Roth Contributions Or Insurance Premiums

a_1099_r-Part3-Boxes(1-8):box6-NetUnrealizedAppreciationInEmployersSecurities

Money

Box 6 - Net Unrealized Appreciation In Employers Securities

a_1099_r-Part3-Boxes(1-8):box7-DistributionCode(S)

Money

Box 7 - Distribution Code(s)

a_1099_r-Part3-Boxes(1-8):box7-Ira/Sep/Simple

CHECKED
NOT CHECKED

Box 7 - IRA/SEP/SIMPLE

a_1099_r-Part3-Boxes(1-8):box8-Other($)

Money

Box 8 - Other ($)

a_1099_r-Part3-Boxes(1-8):box8-Other(%)

Percentage

Box 8 - Other (%)

a_1099_r-Part4-Boxes(9-17):box9A-YourPercentageOfTotalDistribution

Percentage

Box 9A - Your Percentage Of Total Distribution

a_1099_r-Part4-Boxes(9-17):box9B-TotalEmployeeContributions

Money

Box 9B - Total Employee Contributions

a_1099_r-Part4-Boxes(9-17):box10-AmountAllocableToIrrWithin5Years

Money

Box 10 - Amount Allocable To IRR Within 5 Years

a_1099_r-Part4-Boxes(9-17):box11-1StYearOfDesig.RothContrib.

Text

Box 11 - 1st Year Of Desig. Roth Contrib.

a_1099_r-Part4-Boxes(9-17):box12-StateTaxWithheld

Money

Box 12 - State Tax Withheld

a_1099_r-Part4-Boxes(9-17):box13-State/PayerStateNo.

Text

Box 13 - State/Payer State No.

a_1099_r-Part4-Boxes(9-17):box14-StateDistribution

Money

Box 14 - State Distribution

a_1099_r-Part4-Boxes(9-17):box15-LocalTaxWithheld

Money

Box 15 - Local Tax Withheld

a_1099_r-Part4-Boxes(9-17):box16-NameOfLocality

Text

Box 16 - Name Of Locality

a_1099_r-Part4-Boxes(9-17):box17-LocalDistribution

Money

Box 17 - Local Distribution

Sample Form

The below Ocrolus Sample PDF (input) matches the below Sample JSON Result (output).

Sample JSON Result

{
    "status": 200,
    "response": {
        "pk": 32552669,
        "uuid": "d4e52947-9eed-4a6e-adbc-13bb49de9255",
        "forms": [
            {
                "pk": 31534537,
                "uuid": "adc52175-c19d-43f1-8986-016f02097951",
                "form_type": "A_1099_R",
                "form_config_pk": 21191,
                "tables": [],
                "raw_fields": {
                    "a_1099_r-Part1-PayerPii:payerTin": {
                        "value": "DB727796-001",
                        "is_empty": false,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part1-PayerPii:payerName": {
                        "value": "FIDELITY INVESTMENTS INSTITUTIONAL OPERATIONS CO",
                        "is_empty": false,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part3-Boxes(1-8):box8-Other($)": {
                        "value": "",
                        "is_empty": true,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part3-Boxes(1-8):box8-Other(%)": {
                        "value": "$ 0.00",
                        "is_empty": false,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part1-PayerPii:payerAddress:zip": {
                        "value": "41015-1987",
                        "is_empty": false,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part2-RecipientPii:recipientTin": {
                        "value": "",
                        "is_empty": true,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part1-PayerPii:payerAddress:city": {
                        "value": "COVINGTON",
                        "is_empty": false,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part1-PayerPii:payerTelephoneNo.": {
                        "value": "(800) 894-4194",
                        "is_empty": false,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part2-RecipientPii:accountNumber": {
                        "value": "",
                        "is_empty": true,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part2-RecipientPii:dateOfPayment": {
                        "value": "",
                        "is_empty": true,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part2-RecipientPii:recipientName": {
                        "value": "",
                        "is_empty": true,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part1-PayerPii:payerAddress:state": {
                        "value": "KY",
                        "is_empty": false,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part1-PayerPii:payerAddress:country": {
                        "value": "",
                        "is_empty": true,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part3-Boxes(1-8):box2A-TaxableAmount": {
                        "value": "5004.90",
                        "is_empty": false,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part3-Boxes(1-8):box7-Ira/Sep/Simple": {
                        "value": "",
                        "is_empty": true,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part4-Boxes(9-17):box16-NameOfLocality": {
                        "value": "",
                        "is_empty": true,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part2-RecipientPii:recipientAddress:zip": {
                        "value": "",
                        "is_empty": true,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part3-Boxes(1-8):box1-GrossDistribution": {
                        "value": "5,004.90",
                        "is_empty": false,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part1-PayerPii:payerAddress:addressLine1": {
                        "value": "100 MAGELLAN WAY KWIC",
                        "is_empty": false,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part1-PayerPii:payerAddress:addressLine2": {
                        "value": "",
                        "is_empty": true,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part2-RecipientPii:recipientAddress:city": {
                        "value": "",
                        "is_empty": true,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part3-Boxes(1-8):box2B-TotalDistribution": {
                        "value": "",
                        "is_empty": true,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part4-Boxes(9-17):box12-StateTaxWithheld": {
                        "value": "$ 80.00",
                        "is_empty": false,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part4-Boxes(9-17):box15-LocalTaxWithheld": {
                        "value": "",
                        "is_empty": true,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part2-RecipientPii:fatcaFilingRequirement": {
                        "value": "",
                        "is_empty": true,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part2-RecipientPii:recipientAddress:state": {
                        "value": "",
                        "is_empty": true,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part3-Boxes(1-8):box7-DistributionCode(S)": {
                        "value": "2",
                        "is_empty": false,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part4-Boxes(9-17):box14-StateDistribution": {
                        "value": "",
                        "is_empty": true,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part4-Boxes(9-17):box17-LocalDistribution": {
                        "value": "",
                        "is_empty": true,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part2-RecipientPii:recipientAddress:country": {
                        "value": "",
                        "is_empty": true,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part4-Boxes(9-17):box13-State/PayerStateNo.": {
                        "value": "CA 80438179",
                        "is_empty": false,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part3-Boxes(1-8):box4-FederalIncomeTaxWithheld": {
                        "value": "480.00",
                        "is_empty": false,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part2-RecipientPii:recipientAddress:addressLine1": {
                        "value": "",
                        "is_empty": true,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part2-RecipientPii:recipientAddress:addressLine2": {
                        "value": "",
                        "is_empty": true,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part3-Boxes(1-8):box2B-TaxableAmountNotDetermined": {
                        "value": "",
                        "is_empty": true,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part3-Boxes(1-8):box3-CapitalGain(IncludedInBox2A)": {
                        "value": "0.00",
                        "is_empty": false,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part4-Boxes(9-17):box9B-TotalEmployeeContributions": {
                        "value": "",
                        "is_empty": true,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part4-Boxes(9-17):box11-1StYearOfDesig.RothContrib.": {
                        "value": ".",
                        "is_empty": false,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part4-Boxes(9-17):box10-AmountAllocableToIrrWithin5Years": {
                        "value": "$ 0.00",
                        "is_empty": false,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part4-Boxes(9-17):box9A-YourPercentageOfTotalDistribution": {
                        "value": "%",
                        "is_empty": false,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part3-Boxes(1-8):box6-NetUnrealizedAppreciationInEmployersSecurities": {
                        "value": "0.00",
                        "is_empty": false,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    },
                    "a_1099_r-Part3-Boxes(1-8):box5-EmployeeContributions/DesignatedRothContributionsOrInsurancePremiums": {
                        "value": "$ 0.00",
                        "is_empty": false,
                        "alias_used": null,
                        "source_filename": "1099-R_.pdf"
                    }
                }
            }
        ]
    },
    "message": "OK"
}

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