Form RRB-1099-R Annuities or Pensions by the Railroad Retirement Board 2004. Summary: This is an example of Form RRB-1099-R (2004) with these line items to be completed by the railroad retirement board
with information
regarding annuity and pension payments:
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“1. Claim number and Payee Code” field
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“2. Recipient's Identification Number” field
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“Recipient's Name, Street Address, City, State, and ZIP Code” field
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“3. Employee Contributions” field
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“4. Contributory Amount Paid” field
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“5. Vested Dual Benefit” field
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“6. Supplemental Annuity” field
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“7. Total Gross Paid” field
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“8. Repayments” field
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“9. Federal Income Tax Withheld” field
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“10. Rate of Tax” field
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“11. Country”>
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“11. Country” field
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“12. Medicare Premium Total” field
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