Form 8606, page 1 — Nondeductible IRAs 2012

Summary: This is an example of Form 8606 (2012) with items included as described in the text. Additionally, these line items are completed:

Name. If married, file a separate form for each spouse required to file Form 8606. See instructions. field contains Rose Green
Your social security number field contains 001-00-0000
UnderPart I: Nondeductible Contributions to Traditional IRAs and Distributions From Traditional, SEP, and SIMPLE IRAs:
- 1. Enter your nondeductible contributions to traditional IRAs for 2012 including those made for 2012 from January 1, 2013 through April 15, 2013 field contains 500
- 2. Enter your total basis in traditional IRAs (see page 5 of the instructions) field contains 300
- 3. Add lines 1 and 2 field contains 800
- 4. Enter those contributions included on line 1 that were made from January 1, 2013, through April 15, 2013 field contains 0
- 5. Subtract line 4 from line 3 field contains 800
- 13. Add lines 11 and 12. This is the nontaxable portion of all your distributions field contains 460 Footnote: From Worksheet in Publication 590.
- 14. Subtract line 13 from line 3. This is your total basis in traditional IRAs for 2012 and earlier years field contains 340
- 15. Subtract line 12 from line 7. If more than zero, also include this amount on Form 1040, line 15b; Form 1040A, line 11b; or Form 1040NR, line 16b field contains 0
- UnderPart II: 2012 Conversions From Traditional, SEP, or SIMPLE IRAs to Roth IRAs: