Fillable F5498e 2019 Form 5498-ESA

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F5498e 2019 Form 5498-ESA

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Form 5498-ESA
2019
Cat. No. 34011J
Coverdell ESA
Contribution
Information
Copy A
For
Internal Revenue
Service Center
Department of the Treasury - Internal Revenue Service
File with Form 1096.
OMB No. 1545-1815
For Privacy Act and
Paperwork Reduction
Act Notice, see the
2019 General
Instructions for
Certain Information
Returns.
7272
VOID CORRECTED
TRUSTEE’S or ISSUER’S name, street address, city or town, state or
province, country, and ZIP or foreign postal code
TRUSTEE’S/ISSUER’S TIN BENEFICIARY’S TIN
BENEFICIARY’S name
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
1 Coverdell ESA contributions
$
2 Rollover contributions
$
Form 5498-ESA
www.irs.gov/Form5498ESA
Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page
Form 5498-ESA
2019
Coverdell ESA
Contribution
Information
Copy B
For Beneficiary
Department of the Treasury - Internal Revenue Service
This information
is being furnished
to the IRS.
OMB No. 1545-1815
CORRECTED
TRUSTEE’S or ISSUER’S name, street address, city or town, state or
province, country, and ZIP or foreign postal code
TRUSTEE’S/ISSUER’S TIN BENEFICIARY’S TIN
BENEFICIARY’S name
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
1 Coverdell ESA contributions
$
2 Rollover contributions
$
Form 5498-ESA
(keep for your records)
www.irs.gov/Form5498ESA
Instructions for Beneficiary
The information on Form 5498-ESA is furnished to you by
the trustee or issuer of your Coverdell education savings
account (ESA) by April 30, 2020. Form 5498-ESA reports
contributions and rollover contributions made for you for
2019. For more information about Coverdell ESAs, see
Pub. 970.
Beneficiary’s taxpayer identification number (TIN). For
your protection, this form may show only the last four digits
of your TIN (social security number (SSN), individual
taxpayer identification number (ITIN), adoption taxpayer
identification number (ATIN), or employer identification
number (EIN)). However, the issuer has reported your
complete TIN to the IRS.
Account number. May show an account or other unique
number the trustee/issuer assigned to distinguish your
account.
Box 1. Shows Coverdell ESA contributions made in 2019
and through April 15, 2020, for 2019 on your behalf. Do not
deduct these amounts on your income tax return.
If the total contributions made to all your Coverdell ESAs
for 2019 exceeded $2,000, you must withdraw the excess,
plus earnings, by June 1, 2020, or you may owe a penalty.
You must keep track of your Coverdell ESA basis
(contributions and distributions).
Box 2. Shows any rollover (including a direct rollover and
contribution of a military death gratuity) you made in 2019.
Generally, any amount rolled over from one Coverdell ESA
to another Coverdell ESA for the benefit of the named
beneficiary or a member of the beneficiary’s family who is
under age 30 (except for a beneficiary with special needs)
is not taxable.
Future developments. For the latest information about
developments related to Form 5498-ESA and its
instructions, such as legislation enacted after they were
published, go to www.irs.gov/Form5498ESA.
Form 5498-ESA
2019
Coverdell ESA
Contribution
Information
Copy C
For Trustee
Department of the Treasury - Internal Revenue Service
OMB No. 1545-1815
For Privacy Act
and Paperwork
Reduction Act
Notice, see the
2019 General
Instructions for
Certain
Information
Returns.
VOID CORRECTED
TRUSTEE’S or ISSUER’S name, street address, city or town, state or
province, country, and ZIP or foreign postal code
TRUSTEE’S/ISSUER’S TIN BENEFICIARY’S TIN
BENEFICIARY’S name
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
1 Coverdell ESA contributions
$
2 Rollover contributions
$
Form 5498-ESA
www.irs.gov/Form5498ESA
Instructions for Trustee or Issuer
To complete Form 5498-ESA, use:
• The 2019 General Instructions for Certain Information
Returns, and
• The 2019 Instructions for Form 5498-ESA.
To get or to order these instructions, go to
www.irs.gov/Form5498ESA.
Due dates. Furnish Copy B of this form to the
beneficiary (participant) by April 30, 2020.
File Copy A of this form with the IRS by June 1, 2020.
To file electronically, you must have software that
generates a file according to the specifications in Pub.
1220.
Need help? If you have questions about reporting on
Form 5498-ESA, call the information reporting customer
service site toll free at 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).
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F5498e 2019 Form 5498-ESA

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Completed 7 December 2019

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