Form 5329 Additional Taxes on Qualified Plans (Including IRAs) and Other Tax-Favored Accounts 2012

Summary: This is an example of Form 5329 (2012) with items included as described in the text. Additionally, these line items are completed:

Name of individual subject to additional tax. If married filing jointly, see instructions. field contains Paul Jones
Your social security number field contains 003-00-0000
UnderPart III: Additional Tax on Excess Contributions to Traditional IRAs:
- 15. Excess contributions for 2011 (see instructions)field contains 500
- 16. Total excess contributions. Add lines 14 and 15 field contains 500
- 17. Additional tax. Enter 6% (.06) of the smaller of line 16 or the value of your traditional IRAs on December 31, 2012 (including 2012 contributions made in 2013). Include this amount on Form 1040, line 58, or Form 1040NR, line 54 field contains 30