Create Your 1099-R

1 Payer details

Tax year

The person or business that made the payments.

Payer name *

Tax ID typeTaxpayer ID number *

Street address *

City / town *State *ZIP / postal code *

Apartment, country & phone Optional

Apartment / suiteCountryTelephone number

2 Recipient details

The person or business that received the payments. Use the name and TIN from their Form W-9.

Recipient name *

Tax ID typeTaxpayer ID number *

Street address *

City / town *State *ZIP / postal code *

Apartment, country Optional

Apartment / suiteCountry

3 Annual payment details

Enter actual amounts paid during 2025. This is a payment statement; taxes are not estimated or deducted automatically.

Use the distribution codes and amounts from your plan records. Taxable amounts and withholding are not estimated.

Gross distribution · Box 1Taxable amount · Box 2a

Taxable amount not determined · Box 2b

Distribution code *Second code (only if applicable)

Use up to two compatible codes. Code Y (qualified charitable distribution) must be paired with 4, 7 or K. IRS code guide ↗

IRA / SEP / SIMPLE applies

Withholding, contributions & other amounts Only if applicable

Federal income tax withheld · Box 4Capital gain included in taxable amount · Box 3Employee / designated Roth contributions or insurance premiums · Box 5Net unrealized appreciation in employer securities · Box 6Other amount · Box 8 / 8aTotal employee contributions · Box 9bAmount allocable to in-plan Roth rollover within 5 years · Box 10

Percentages, Roth year & payment date Only if applicable

Other / annuity contract percentage · Box 8 / 8bPercentage of total distribution · Box 9aFirst year of designated Roth contributions · Box 11Date of payment · Box 13

Box 13 is for reportable death benefits. Leave it blank when it does not apply.

Reporting options Optional

Account numberTotal distribution · Box 2bFATCA filing requirement · Box 12Mark as CORRECTED

State distribution & withholding Optional · up to 2 states

Local distribution & withholding Optional · up to 2 localities

Review & download

Copies 1, B, C and 2 will contain your details. All nine original pages are included, with red Copy A left blank. Tax-agency filing is not included.

By clicking “Continue to checkout,” you confirm that you reviewed the preview and amounts against your records.

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A little treat for your next form.

1 Payer details

2 Recipient details

3 Annual payment details

Review & download

Your 1099-R, ready to go.