0425 Form 1099-QA (PDF) — verbatim text

Official source: IRS Forms, Instructions & Publications (https://www.irs.gov/pub/irs-pdf/f1099qa.pdf), retrieved 2026-10-03. U.S. Government work (17 U.S.C. § 105).

Copy A

For Internal Revenue

Service Center

For filing information,

Privacy Act, and Paperwork Reduction

Act Notice, see the General Instructions

for Certain Information Returns .

www.irs.gov/Form1099

Distributions

From ABLE

Accounts

1A1A VOID CORREC		CTED
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	1 Gross distribution $	Form1099-QA (Rev. April 2025) OMB No. 1545-2262
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2 Earnings $	2 Earnings $
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2 Earnings $	For calendar year
PAYER’S TIN	RECIPIENT’S TIN	3 Basis $	4 Program-to-program transfer
RECIPIENT’S name	RECIPIENT’S name	5 Check if ABLE account terminated in the calendar year reported	6 Check if the recipient is not the designated beneficiary
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)
Street address (including apt. no.)	Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)	Account number (see instructions)	Account number (see instructions)	Account number (see instructions)

Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page

Cat. No. 67554X

Department of the Treasury - Internal Revenue Service

CORRECTED (if checked)

information and is being furnished to the IRS. If you are required

it has not been

reported.

Distributions

From ABLE

Accounts

Copy B For Recipient

This is important tax

to file a return, a negligence penalty or other sanction may be

imposed on you if this

income is taxable and the IRS determines that

PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.		1 Gross distribution $	OMB No. 1545-2262 1099-QA Form (Rev. April 2025)
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2 Earnings $	2 Earnings $
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2 Earnings $	For calendar year
PAYER’S TIN	RECIPIENT’S TIN	3 Basis $	4 Program-to-program transfer
RECIPIENT’S name Street address (including apt. no.) City or town, state or province, country, and ZIP or foreign postal code	RECIPIENT’S name Street address (including apt. no.) City or town, state or province, country, and ZIP or foreign postal code	5 Check if ABLE account terminated in the calendar year reported	6 If this box is checked, the recipient is not the designated beneficiary
RECIPIENT’S name Street address (including apt. no.) City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)	Account number (see instructions)	Account number (see instructions)	Account number (see instructions)

Department of the Treasury - Internal Revenue Service

Instructions for Recipient

Recipient’s taxpayer identification number (TIN). For your protection, this form may show only the last four digits of your TIN (social security number (SSN), individual taxpayer identification number (ITIN), or adoption taxpayer identification number (ATIN)). However, the payer has reported your complete TIN to the IRS. Account number. May show an account or other unique number the payer has assigned to distinguish your account. Box 1. Shows the gross distribution paid to you this year from an Achieving a Better Life Experience (ABLE) savings account in the calendar year being reported. Gross distribution includes distributions from the ABLE account for both qualified and nonqualified disability expenses. The gross distribution also includes amounts distributed that the designated beneficiary intends to roll over to another ABLE account, but does not include program-to-program transfers. A gross distribution also includes a return of excess contributions plus earnings. Box 2. Shows the earnings part of the gross distribution shown in box 1. Generally, amounts distributed that are used to pay for qualified disability expenses, or rolled over to another ABLE account within 60 days, are not included in income. Report taxable amounts as “Other income” on Form 1040 or 1040-SR. Also see Form 5329 and its separate instructions.

Box 3. Shows your basis in the gross distribution reported in box 1. Box 4. This box is checked if a program-to-program transfer was made from this ABLE account to another ABLE account. Box 5. This box is checked if the ABLE account was terminated in the calendar year being reported. Box 6. The designated beneficiary is the individual named in the document creating the ABLE account to receive the benefit of the funds in the account. If this box is checked, you are not the designated beneficiary of this ABLE account. You and/or the designated beneficiary may be subject to additional taxes and/or penalties on the box 1 gross distribution. See Form 5329 and its separate instructions and the Instructions for Form 1040. Future developments. For the latest information about developments related to Form 1099-QA and its instructions, such as legislation enacted after they were published, go to www.irs.gov/Form1099QA . Free File Program. Go to www.irs.gov/FreeFile to see if you qualify for no-cost online federal tax preparation, e-filing, and direct deposit or payment options.