//1ä1ò RETURN FOR ADDITIONAL TAXES ATTRIBUTABLE TOò 1990 * 29ÝFORM 5329ò QUALIFIED RETIREMENT PLANS (INCLUDING IRAs),Ýò ANNUITIES, AND MODIFIED ENDOWMENT CONTRACTS     OMB No. 1545-0203Ýò-OÝò :|  SSN:ßãC1*ßDãC2*Ýò :|Check box ifßãADDR*Ýò :|amended return >>[ ]ßãCITY*Ýò=OÝPART I - EXCESS CONTRIBUTIONS TAX FOR IRA (SEC 4973)Ýò-OÝ 1.  Excess contributions for 1990ò.1.|ßEîá
ïÝ 2.  Earlier excess contrib not eliminatedò.2.|ò 
|ß6îáïÝ 3.  Contribution creditò.3.|ò 
|ß6îáïÝ 4a. 1990 IRA distrib. incl. in taxable income..4a.|ò 
|ß6îáïÝ  b. 1989 excess contributions withdrawn after     |ò 
|Ý     due date of 1989 return and 1988 and earlier  |ò 
|Ý     excess contributions withdrawn in 1990.....4b.|ò 
|ß6îáïÝ  c. Add lines 3 through 4bò.4c.|ò 
|ß6îáïÝ 5.  Subtract line 4c from line 2, but not less than zeroò.5.|ßEîáïÝ 6.  Total excess contributions (add lines 1 and 5)ò.6.|ßEîáïÝ 7.  Tax (enter 6% of line 6 or 6% of value of IRA, whichever     |Ý     is smaller).  Enter here and on Form 1040, line 52ò.7.|ßEîá	ïÝò=OÝPART II - TAX ON EARLY DISTRIBUTIONS (SEC. 72)Ýò-OÝ 8.  Early distrib. incl. in gross income from:    |ò 
|Ý  a. Qualified retirement plans (incl IRAs).....8a.|ò 
|ß6îá
ïÝ  b. Annuity contractsò.8b.|ò 
|ß6îáïÝ  c. Modified endowment contractsò.8c.|ò 
|ß6îáïÝ  d. Prohibited transactionsò.8d.|ò 
|ß6îá
ïÝ  e. Pledging of accounts as securityò.
8e.|ò 
|ß6îáïÝ  f. Cost of collectiblesò.8f.|ò 
|ß6îáïÝ  g. Total distributions (add lines 8a through 8f)ò.8g.|ßEîáïÝ 9.  Exceptions not subject to additional tax:     |ò 
|Ý  a. Due to deathò.9a.|ò 
|ß6îáïÝ  b. Due to total and permanent disabilityò.9b.|ò 
|ß6îáïÝ  c. Part of substantial eq. periodic payments..9c.|ò 
|ß6îáïÝ  d. Due to separation from service at age 55...9d.|ò 
|ß6îáïÝ  e. Used to pay medical expensesò.9e.|ò 
|ß6îáïÝ  f. Made to a qual. domestic relations order...9f.|ò 
|ß6îáïÝ  g. Other (specify) [ò ].....9g.|ò 
|ßîáïß6îáïÝ  h. Total distributions (add lines 9a through 9g)ò.9h.|ßEîáïÝ10.  Amount subject to tax (subtract ln 9h from ln 8g)ò.10.|ßEîáïÝ11.  Multiply ln 10 by 10%.  Enter here and on 1040, ln 52.....11.|ßEîáïÝò=OÝFor Paperwork Reduction Act Notice, see instructionsò 
Form 5329 (1990)ÝAM Software H838ð//1ä2FORM 5329 (1990)ò 9Page 2Ýò=OÝPART III - TAX ON EXCESS ACCUMULATIONS (SEC. 4974)Ýò-OÝ12.  Minimum required distributionsò.12.|ßEîáïÝ13.  Amount actually distributed to youò.13.|ßEîáïÝ14.  Subtract line 13 from line 12, but not less than zero.....14.|ßEîáïÝ15.  Multiply line 14 by 50%.  Enter here and on 1040, ln 52...15.|ßEîáïÝò=OÝPART IV - TAX ON EXCESS DISTRIBUTIONS (SEC. 4980A)Ýò-OÝÝNOTE: Lines 16-19c are to be completed for regular distributions onlyÝÝ16.  Enter aggregate amt. of reg. retirement distributions.....16.|ßEîá ïÝ17a. Enter threshold amountò.17a.|ò 
|ß6îá!ïÝ  b. Recovery of grandfather amountò.17b.|ò 
|ß6îá"ïÝ  c. Enter greater of line 17a or 17bò.17c.|ßEîá#ïÝ18.  Excess distributions (subtract ln 17c from ln 16)ò.18.|ßEîá$ïÝ19a. Tentative tax (multiply line 18 by 15%)ò.19a.|ßEîá%ïÝ  b. Section 72(t) tax offsetò. 19b.|ßEîá&ïÝ  c. Tax (subtract ln 19b from 19a). Enter on 1040, ln 52.....19c.|ßEîá'ïÝÝNOTE: Lines 20-23c are to be completed for lump-sum distributions onlyÝÝ20.  Enter aggregate amount of lump-sum distributionsò.	20.|ßEîá(ïÝ21a. Enter threshold amountò.21a.|ò 
|ß6îá)ïÝ  b. Recovery of grandfather amountò.21b.|ò 
|ß6îá*ïÝ  c. Enter greater of line 21a or 21bò.21c.|ßEîá+ïÝ22.  Excess distributions (subtract ln 21c from ln 20)ò.22.|ßEîá,ïÝ23a. Tentative tax (multiply line 22 by 15%)ò.23a.|ßEîá-ïÝ  b. Section 72(t) tax offsetò. 23b.|ßEîá.ïÝ  c. Tax (subtract ln 23b from 23a). Enter on 1040, ln 52.....23c.|ßEîá/ïÝò=OÝACCELERATION ELECTIONSÝÝ  1.  Check here >>> [ ] if you elected the discretionary method in 1987 or 1988ßá0Ýò and wish to make an acceleration election under sec. 54.4981A-1Tb-12ÝÝ  2.  Check here >>> [ ] if you made an acceleration election in 1987, 1988,ßá1Ýò or 1989 and wish to revoke that election.Ýò=OÝ PLEASE | Under penalty of perjury, I declare that I have examined this formÝò | and attachments and to the best of my knowledge and belief, it isÝ SIGN   | true, correct, and complete.Ýò |Ý HERE   | ò_.  Date ò_Ýò=OÝð//2ä2ôN9053291*ß" XÝÝßF5329ÝÝÝÝÝÝÝßãC1*ßCãC2*ÝÝßãADDR*ÝÝßãCTY*ßãSTATE*ß#ãZIP*ÝÝÝÝÝßEá
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