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IRS.gov Website
Instructions for Form 5329
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Additional Information(p2)

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See Pub. 590; Pub. 560, Retirement Plans for Small Business; Pub. 575, Pension and Annuity Income; Pub. 969, Health Savings Accounts and Other Tax-Favored Health Plans; Pub. 970, Tax Benefits for Education; and Pub. 4492-B, Information for Affected Taxpayers in the Midwestern Disaster Areas.
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Specific Instructions(p2)

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Joint returns.(p2)
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If both you and your spouse are required to file Form 5329, complete a separate form for each of you. Include the combined tax on Form 1040, line 58.
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Amended returns.(p2)
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If you are filing an amended 2010 Form 5329, check the box at the top of page 1 of the form. Do not use the 2010 Form 5329 to amend your return for any other year. Instead, see Prior tax years on page 1.
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Part I—Additional Tax on Early Distributions(p2)

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In general, if you receive an early distribution (including an involuntary cashout) from an IRA, other qualified retirement plan, or modified endowment contract, the part of the distribution included in income generally is subject to an additional 10% tax. But see Exception for Roth IRA Distributions on this page.
The additional tax on early distributions does not apply to any of the following:
See the instructions for line 2 on page 3 for other distributions that are not subject to the tax.
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Line 1(p2)

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Enter the amount of early distributions included in income that you received from:
Certain prohibited transactions, such as borrowing from your IRA or pledging your IRA assets as security for a loan, are considered to be distributions and may also cause you to owe the additional tax on early distributions. See Pub. 590 for details.
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In-plan Roth Rollovers.(p2)
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If you received an early distribution from your designated Roth account, you must include on line 1 the amount allocable to the taxable amount of the in-plan Roth rollover. This amount is the smaller of (a) Form 8606, line 23; or (b) the amount in the box to the far left of box 10 of your 2010 Form 1099-R. Also include on line 1 any amount in box 2a of this 2010 Form 1099-R. For more information on in-plan Roth rollovers, see Pub. 575.
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Exception for Roth IRA Distributions(p2)

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If you received an early distribution from a Roth IRA, first allocate the amount on your 2010 Form 8606, line 26, in the order shown, to the amounts on the lines listed below (to the extent a prior year distribution was not allocable to the amount).  
*Only include those amounts rolled over to a Roth IRA. 
**Only include any contributions (usually Form 1099-R, box 5) that were taxable to you when made and rolled over to a Roth IRA.
Then, include on line 1 of Form 5329 the amount from your 2010 Form 8606, line 36, plus the amount, if any, allocated to the amount on your 2010 Form 8606, line 27, and the amount, if any, allocated to line 18 of your 2006 through 2010 Forms 8606, and line 23 of your 2010 Form 8606. You need to also include on line 1, any amounts allocated to your 2008 and 2009 Forms 1040, line 16b; Forms 1040A, line 12b; and Form 1040NR, line 17b. Also include the amount, if any, from your 2010 Form 8606, line 27, on Form 5329, line 2, and enter exception number 09.
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If you entered amounts on your 2010 Form 8606, lines 20a and 20b, or 25a and 25b (for Roth IRA rollovers), see Additional Tax on Early Distributions in chapter 2 of Pub. 590 for the amount to enter on Form 5329, line 1.
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Note.(p3).
Do not include any amounts attributable to in-plan Roth rollovers reported on your 2010 Form 8606, lines 22, 23, and 36. Also, if you were instructed to enter -0- on your 2010 Form 8606, line 27, for this purpose, figure any allocation for line 27 as if you entered your qualified first-homebuyer distributions on Form 8606, line 27.


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Example.(p3)

You converted $20,000 from a traditional IRA to a Roth IRA in 2006 and converted $10,000 in 2007. Your 2006 Form 8606 had $5,000 on line 17 and $15,000 on line 18 and your 2007 Form 8606 had $3,000 on line 17 and $7,000 on line 18. You made Roth IRA contributions of $2,000 for 2006 and 2007. You did not make any Roth IRA conversions or contributions for 2008 through 2010, or take any Roth IRA distributions before 2010.
On July 9, 2010, at age 53, you took a $33,000 distribution from your Roth IRA. Your 2010 Form 8606 shows $33,000 on line 26; $29,000 on line 30 ($33,000 minus $4,000 for your contributions on line 29) and $0 on line 36 ($29,000 minus your basis in conversions of $30,000).
First, $4,000 of the $33,000 is allocated to your 2010 Form 8606, line 29; then $15,000 to your 2006 Form 8606, line 18; $5,000 to your 2006 Form 8606, line 17; and $7,000 to your 2007 Form 8606, line 18. The remaining $2,000 is allocated to the $3,000 on your 2007 Form 8606, line 17. On line 1, enter $22,000 ($15,000 allocated to your 2006 Form 8606, line 18, plus the $7,000 that was allocated to your 2007 Form 8606, line 18).
If you take a Roth IRA distribution in 2011, the first $1,000 will be allocated to the $1,000 remaining from your 2007 Form 8606, line 17, and will not be subject to the additional tax on early distributions.
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Additional information.(p3)
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For more details, see Are Distributions Taxable? in Pub. 590.
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Line 2(p3)

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The additional tax on early distributions does not apply to the distributions described below. Enter on line 2 the amount that can be excluded. In the space provided, enter the applicable exception number (01-12).
No. Exception
01Qualified retirement plan distributions (does not apply to IRAs) you receive after separation from service in or after the year you reach age 55 (age 50 for qualified public safety employees).
02Distributions made as part of a series of substantially equal periodic payments (made at least annually) for your life (or life expectancy) or the joint lives (or joint life expectancies) of you and your designated beneficiary (if from an employer plan, payments must begin after separation from service).
03Distributions due to total and permanent disability.
04Distributions due to death (does not apply to modified endowment contracts).
05Qualified retirement plan distributions up to (1) the amount you paid for unreimbursed medical expenses during the year minus (2) 7.5% of your adjusted gross income for the year.
06Qualified retirement plan distributions made to an alternate payee under a qualified domestic relations order (does not apply to IRAs).
07IRA distributions made to unemployed individuals for health insurance premiums.
08IRA distributions made for higher education expenses.
09IRA distributions made for purchase of a first home, up to $10,000.
10Distributions due to an IRS levy on the qualified retirement plan.
11Qualified distributions to reservists while serving on active duty for at least 180 days.
12Other (see Other, below). Also, enter this code if more than one exception applies.
  
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Other.(p3)
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The following exceptions also apply.
For additional exceptions that apply to annuities, see Pub. 575.
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Line 4(p3)

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If any amount on line 3 was a distribution from a SIMPLE IRA received within 2 years from the date you first participated in the SIMPLE IRA plan, you must multiply that amount by 25% instead of 10%. These distributions are included in boxes 1 and 2a of Form 1099-R and are designated with code S in box 7.