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.

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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 AttributeData TypeDescription
a_1099_r-Part1-PayerPii:payerNameTextPayer Name
a_1099_r-Part1-PayerPii:payerAddress:addressLine1TextPayer Address Line 1
a_1099_r-Part1-PayerPii:payerAddress:addressLine2TextPayer Address Line 2
a_1099_r-Part1-PayerPii:payerAddress:cityTextPayer Address City
a_1099_r-Part1-PayerPii:payerAddress:stateTextFormatted as a 2 character state code. Payer Address State
a_1099_r-Part1-PayerPii:payerAddress:countryTextPayer Address Country
a_1099_r-Part1-PayerPii:payerAddress:zipText5 digit zip code in which Payer is located. Payer Address Zip
a_1099_r-Part1-PayerPii:payerTelephoneNo.TextPayer Telephone Number
a_1099_r-Part1-PayerPii:payerTinTextPayer TIN
a_1099_r-Part2-RecipientPii:recipientTinTextRecipient TIN
a_1099_r-Part2-RecipientPii:recipientNameTextRecipient Name
a_1099_r-Part2-RecipientPii:recipientAddress:addressLine1TextRecipient Address Line 1
a_1099_r-Part2-RecipientPii:recipientAddress:addressLine2TextRecipient Address Line 2
a_1099_r-Part2-RecipientPii:recipientAddress:cityTextRecipient Address City
a_1099_r-Part2-RecipientPii:recipientAddress:stateTextFormatted as a 2 character state code. Recipient Address State
a_1099_r-Part2-RecipientPii:recipientAddress:countryTextRecipient Address Country
a_1099_r-Part2-RecipientPii:recipientAddress:zipText5 digit zip code in which Recipient is located. Payer Address Zip
a_1099_r-Part2-RecipientPii:accountNumberTextAccount Number
a_1099_r-Part2-RecipientPii:dateOfPaymentDateDate Of Payment
a_1099_r-Part2-RecipientPii:fatcaFilingRequirementCHECKEDNOT CHECKEDFATCA Filing Requirement
a_1099_r-Part3-Boxes(1-8):box1-GrossDistributionMoneyBox 1 - Gross Distribution
a_1099_r-Part3-Boxes(1-8):box2A-TaxableAmountMoneyBox 2A - Taxable Amount
a_1099_r-Part3-Boxes(1-8):box2B-TaxableAmountNotDeterminedCHECKEDNOT CHECKEDBox 2B - Taxable Amount Not Determined
a_1099_r-Part3-Boxes(1-8):box2B-TotalDistributionCHECKEDNOT CHECKEDBox 2B - Total Distribution
a_1099_r-Part3-Boxes(1-8):box3-CapitalGain(IncludedInBox2A)MoneyBox 3 - Capital Gain (Included In Box 2A)
a_1099_r-Part3-Boxes(1-8):box4-FederalIncomeTaxWithheldMoneyBox 4 - Federal Income Tax Withheld
a_1099_r-Part3-Boxes(1-8):box5-EmployeeContributions/DesignatedRothContributionsOrInsurancePremiumsMoneyBox 5 - Employee Contributions/Designated Roth Contributions Or Insurance Premiums
a_1099_r-Part3-Boxes(1-8):box6-NetUnrealizedAppreciationInEmployersSecuritiesMoneyBox 6 - Net Unrealized Appreciation In Employers Securities
a_1099_r-Part3-Boxes(1-8):box7-DistributionCode(S)MoneyBox 7 - Distribution Code(s)
a_1099_r-Part3-Boxes(1-8):box7-Ira/Sep/SimpleCHECKEDNOT CHECKEDBox 7 - IRA/SEP/SIMPLE
a_1099_r-Part3-Boxes(1-8):box8-Other($)MoneyBox 8 - Other ($)
a_1099_r-Part3-Boxes(1-8):box8-Other(%)PercentageBox 8 - Other (%)
a_1099_r-Part4-Boxes(9-17):box9A-YourPercentageOfTotalDistributionPercentageBox 9A - Your Percentage Of Total Distribution
a_1099_r-Part4-Boxes(9-17):box9B-TotalEmployeeContributionsMoneyBox 9B - Total Employee Contributions
a_1099_r-Part4-Boxes(9-17):box10-AmountAllocableToIrrWithin5YearsMoneyBox 10 - Amount Allocable To IRR Within 5 Years
a_1099_r-Part4-Boxes(9-17):box11-1StYearOfDesig.RothContrib.TextBox 11 - 1st Year Of Desig. Roth Contrib.
a_1099_r-Part4-Boxes(9-17):box12-StateTaxWithheldMoneyBox 12 - State Tax Withheld
a_1099_r-Part4-Boxes(9-17):box13-State/PayerStateNo.TextBox 13 - State/Payer State No.
a_1099_r-Part4-Boxes(9-17):box14-StateDistributionMoneyBox 14 - State Distribution
a_1099_r-Part4-Boxes(9-17):box15-LocalTaxWithheldMoneyBox 15 - Local Tax Withheld
a_1099_r-Part4-Boxes(9-17):box16-NameOfLocalityTextBox 16 - Name Of Locality
a_1099_r-Part4-Boxes(9-17):box17-LocalDistributionMoneyBox 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": {
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                        "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"
}