Import Form Fields:
| Field Name | Size | Type | Description | Notes |
|---|---|---|---|---|
| See Form Filer Common Fields | Filer fields common to all form types. | |||
| See Recipient Common Fields | Recipient fields common to all form types. | |||
Box 1 Amount | 12 | Amount | Total balance at the beginning of year | |
| Box 2 Amount | 12 | Amount | Contributions for the taxable year | |
| Box 3 Amount | 12 | Amount | Rollover contributions | |
| Box 4 Amount | 12 | Amount | Rollover withdrawals | |
| Box 5 Amount | 12 | Amount | Refund of excess contributions | |
| Box 6 Amount | 12 | Amount | Penalty withheld | |
| Box 7 Amount | 12 | Amount | Tax w/h from interest (17% line 11D) | |
| Box 8 Amount | 12 | Amount | Tax w/h inc from PR (17% line 11E) | |
| Box 9 Amount | 12 | Amount | Tax w/h inc gov pension (10% 11G2-11G3) | |
| Box 10 Amount | 12 | Amount | Tax w/h at source to nonresidents | |
| Box 11a Amount | 12 | Amount | Contributions | |
| Box 11b Amount | 12 | Amount | Voluntary contributions | |
| Box 11c Amount | 12 | Amount | Exempt interest | |
| Box 11d Amount | 12 | Amount | Interest from eligible financial ins | |
| Box 11e Amount | 12 | Amount | Income from sources within PR | |
| Box 11f Amount | 12 | Amount | Other income | |
| Box 11g1 Amount | 12 | Amount | Gov pensioners contributions | |
| Box 11g2 Amount | 12 | Amount | Gov pensioners eligible interest | |
| Box 11g3 Amount | 12 | Amount | Gov pensioners other income | |
| Box 11h Amount | 12 | Amount | Prepaid (10%) under section 1081.06 | |
| Box 11i Amount | 12 | Amount | Prepaid (5%) under section 1081.06 | |
| Box 11j Amount | 12 | Amount | Prepaid (8%) under section 1023.23 | |
| Box 11k Amount | 12 | Amount | Total (Add lines 11A through 11J) | |
| See Form Common Fields | Form fields common to all form types. | |||