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Publication 590
Individual Retirement Arrangements (IRAs)

For use in preparing 2002 Returns
APPENDIX A. Summary Record of Traditional IRA(s) for 2002 (Keep for Your Records)
Name ______________________________________
I was [ ] covered [ ] not covered by my employer's retirement plan during the year.
I became 59½ on ______________________________________(month) (day) (year)
I became 70½ on ______________________________________(month) (day) (year)
    
Contributions
Name of traditional IRA Date Amount contributed for 2002 Check if rollover contribution Fair Market Value of IRA as of December 31, 2002, from Form 5498
1.
2.
3.
4.
5.
Total
Total contributions deducted on tax return $
Total contributions treated as nondeductible on Form 8606 $
    
Distributions
Name of traditional IRA Date Amount of Distribution Reason (e.g., retirement, rollover, conversion, withdrawal of excess contributions) Income earned on IRA Taxable amount reported on income tax return Nontaxable amount from Form 8606, line 13
1.
2.
3.
4.
5.
6.
7.
Total
Basis of all traditional IRAs for 2002 and earlier years (from Form 8606, line 14) $
Note: You should keep copies of your income tax return, and Forms W-2, 8606, and 5498.