| 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 | 13 | Amount | Box 1: Gross distribution | |
| Box 2 Amount | 13 | Amount | Box 2: Earnings (or loss) | |
| Box 3 Amount | 13 | Amount | Box 3: Basis | |
| Box 4 Checkbox | 1 | Text | Box 4 Chackbox: Trustee to Trustee Transfer Indicator | |
| Box 5 Checkbox 1 | 1 | Text | Box 5 checkbox: Type of Tuition Payment: Private program payment | |
| Box 5 Checkbox 2 | 1 | Text | Box 5 checkbox: Type of Tuition Payment: State program payment | |
| Box 5 Checkbox 3 | 1 | Text | Box 5 checkbox: Type of Tuition Payment: Coverdell ESA contribution | |
| Box 6 Checkbox | 1 | Text | Box 6 checkbox: Designated Beneficiary | |
| Box X Amount | 12 | Character | Fair Market Value amount | |
| Box X Code | 1 | Amount | Distribution Code 1-6 | |