Form 1099-Q Payments From Qualified Education Programs (Under Sectio

Attention:
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scannable, but the online version of it, printed from this website, is not. Do not print and file
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Instructions for Certain Information Returns, available at www.irs.gov/form1099, for more
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forms.

3131

VOID

CORRECTED

PAYER’S/TRUSTEE'S name, street address, city or town, state or province, country,
ZIP or foreign postal code, and telephone no.

1 Gross distribution

2017

$
2 Earnings

Form 1099-Q

$
PAYER’S/TRUSTEE'S federal identification no. RECIPIENT’S taxpayer identification no. 3 Basis

4 Trustee-to-trustee
transfer

$
5 Check one:

RECIPIENT’S name

• Qualified tuition program—
Private

Street address (including apt. no.)

• Coverdell ESA

City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
Form 1099-Q

Cat. No. 32223J

OMB No. 1545-1760

www.irs.gov/form1099q

or State

6 Check if the recipient is
not the designated
beneficiary

Payments From
Qualified
Education
Programs
(Under Sections
529 and 530)

Copy A
For
Internal Revenue
Service Center
File with Form 1096.
For Privacy Act
and Paperwork
Reduction Act
Notice, see the
2017 General
Instructions for
Certain Information
Returns.

Department of the Treasury - Internal Revenue Service

Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page

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

1 Gross distribution

2017

$
2 Earnings

Form 1099-Q

$
PAYER’S/TRUSTEE'S federal identification no. RECIPIENT’S taxpayer identification no. 3 Basis

4 Trustee-to-trustee
transfer

$
5 Check one:

RECIPIENT’S name

• Qualified tuition program—
Private

Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code

(keep for your records)

6 If this box is checked, the
recipient is not the
designated beneficiary

or State

• Coverdell ESA

If the fair market value (FMV) is shown below, see Pub. 970,
Tax Benefits for Education, for how to figure earnings.

Account number (see instructions)
Form 1099-Q

OMB No. 1545-1760

www.irs.gov/form1099q

Payments From
Qualified
Education
Programs
(Under Sections
529 and 530)

Copy B
For Recipient
This is important tax
information and is
being furnished to the
Internal Revenue
Service. If you are
required to file a return,
a negligence penalty or
other sanction may be
imposed on you if this
income is taxable and
the IRS determines that
it has not been
reported.

Department of the Treasury - Internal Revenue Service

Instructions for Recipient
Note: Nontaxable distributions from Coverdell education savings accounts
(CESAs) under section 530, and qualified tuition programs (QTPs) under section
529, including rollovers, are not required to be reported on your income tax
return. You must determine the taxability of any distribution. See Pub. 970 for
more information.
Recipient's taxpayer identification no. For your protection, this form may
show only the last four digits of your SSN, ITIN, ATIN, or EIN. However, the
payer or trustee has reported your complete identification number to the IRS.
Account number. May show an account or other unique number the payer has
assigned to distinguish your account.
Box 1. Shows the gross distribution (including in-kind distributions) paid to you
this year from a QTP or a CESA. This amount is the total of the amounts shown
in box 2 and box 3. See Pub. 970 for more information.
Caution: For CESA distributions (other than earnings on excess contributions)
made during 2017, the payer/trustee is not required to report amounts in boxes
2 and 3. Instead, the payer/trustee may report the fair market value of the CESA
as of December 31, 2017, in the blank box below boxes 5 and 6. To figure your
earnings and basis, use the Coverdell ESA—Taxable Distributions and Basis
worksheet in Pub. 970.
Box 2. Shows the earnings part of the gross distribution shown in box 1.
Generally, amounts distributed that are used to pay for qualified education
expenses, transferred between trustees, or rolled over to another qualified
education program within 60 days, are not included in income. Report taxable
amounts as “Other Income” on Form 1040. Also see Form 5329 and its separate
instructions.

Under a QTP, the amount in box 2 is included in income if there has been
(a) more than one transfer or rollover within any 12-month period with respect
to the same beneficiary, or (b) a change in the designated beneficiary and the
new designated beneficiary is not a family member.
Under a CESA, the amount in box 2 is included in income if there has been a
change in the designated beneficiary and the new designated beneficiary is not
a family member or is over age 30 (except for beneficiaries with special needs).
Also, an additional 10% tax may apply to part or all of any amount included in
income from the CESA or QTP. See Form 5329 and your tax return instructions
for more information.
If a final (total) distribution is made from your account and you have not
recovered your contributions, see Pub. 970 to determine if you have a
deductible loss and how to claim it.
Box 3. Shows your basis in the gross distribution reported in box 1.
Box 4. This box is checked if a trustee-to-trustee transfer was made from one
QTP to another QTP, from one CESA to another CESA, or from a CESA to a
QTP. However, in certain transfers from a CESA, the box will be blank.
Box 5. Shows whether the gross distribution was from a QTP (private or state)
or from a CESA.
Box 6. The designated beneficiary is the individual named in the document
creating the trust or custodial account to receive the benefit of the funds in the
account. If you are not the designated beneficiary, see Pub. 970 and the
Instructions for Form 1040.
Distribution codes. For 2017, the payer/trustee may, but is not required to,
report (in the box below boxes 5 and 6) one of the following codes to identify the
distribution you received: 1—Distributions (including transfers); 2—Excess
contributions plus earnings taxable in 2017; 3—Excess contributions plus
earnings taxable in 2016; 4—Disability; 5—Death; 6—Prohibited transaction.

VOID

CORRECTED

PAYER’S/TRUSTEE'S name, street address, city or town, state or province, country,
ZIP or foreign postal code, and telephone no.

1 Gross distribution

2017

$
2 Earnings

Form 1099-Q

$
PAYER’S/TRUSTEE'S federal identification no. RECIPIENT’S taxpayer identification no. 3 Basis

4 Trustee-to-trustee
transfer

$
RECIPIENT’S name

5 Check one:
• Qualified tuition program—
Private

Street address (including apt. no.)

• Coverdell ESA

City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
Form 1099-Q

OMB No. 1545-1760

www.irs.gov/form1099q

or State

6 Check if the recipient is
not the designated
beneficiary

Payments From
Qualified
Education
Programs
(Under Sections
529 and 530)

Copy C
For Payer
For Privacy Act
and Paperwork
Reduction Act
Notice, see the
2017 General
Instructions for
Certain
Information
Returns.

Department of the Treasury - Internal Revenue Service

Instructions for Payer/Trustee
To complete Form 1099-Q, use:
• the 2017 General Instructions for Certain Information
Returns, and
• the 2017 Instructions for Form 1099-Q.
To order these instructions and additional forms, go
to www.irs.gov/form1099q.
Caution: Because paper forms are scanned during
processing, you cannot file with the IRS Forms 1096,
1097, 1098, 1099, 3921, 3922, or 5498 that you
download from the IRS website.
Due dates. Furnish Copy B of this form to the recipient
by January 31, 2018.

File Copy A of this form with the IRS by February 28,
2018. If you file electronically, the due date is April 2,
2018. To file electronically, you must have software that
generates a file according to the specifications in Pub.
1220. The IRS does not provide a fill-in form option.
Need help? If you have questions about reporting on
Form 1099-Q, call the information reporting customer
service site toll free at 1-866-455-7438 or 304-263-8700
(not toll free). Persons with a hearing or speech
disability with access to TTY/TDD equipment can call
304-579-4827 (not toll free).