Ds 5026 PDF Template

Ds 5026 PDF Template

The DS 5026 form is the FSPS Annuity Supplement Earnings Report, which is necessary for retirees who wish to assess their eligibility for annuity benefits after reaching their Minimum Retirement Age (MRA). This form helps determine if a retiree's earnings exceed the legal exempt amount, affecting their annuity supplement. It is important to complete and submit this form to avoid termination of benefits.

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Overview

The DS 5026 form, known as the FSPS Annuity Supplement Earnings Report, plays a crucial role for retirees receiving an annuity supplement as part of the Federal Employees Retirement System. It serves to determine the impact of additional earnings on the annuity. After reaching the Minimum Retirement Age (MRA), retirees must report any income to ensure they continue receiving the full benefits of their annuity supplement. The form outlines the specifics of what constitutes reportable income and the rules regarding potential reductions to the annuity based on earnings that exceed an exempt amount, similar to the earnings test applied to Social Security benefits. Importantly, retirees need to submit this form annually, even if they had no income, to avoid automatic termination of their benefits. The document includes detailed instructions on what types of income should be included and excluded, such as wages from employment, self-employment income, or payments for domestic services. Consequently, ensuring accurate completion and timely submission of the DS 5026 is vital for maintaining eligibility for important retirement benefits.

Ds 5026 Preview

FSPS ANNUITY SUPPLEMENT EARNINGS REPORT

1.The annuity supplement part of your FSPS is subject to an earnings test that begins after a retiree reaches the Minimum Retirement Age (MRA-see the chart below). The earnings test is similar to the one applied to Social Security benefits and uses the same annual exempt amount, as required by law in 5 U.S.C.

Section 8421a. The exempt amount changes from year to year and can be found at www.ssa.gov. Your annuity supplement will be reduced $1.00 for every $2.00 by which your calendar year earnings exceed

the exempt amount. The reduction, termination or reinstatement of benefits will become effective January 1st of the year following the year of income reported. Refer to the chart below to find your MRA based on your year of birth.

If you were born…

Your MRA is…

 

Before 1948

 

55 years

 

 

 

 

 

 

 

 

 

1948

 

 

55 years and 2 month

 

1949

 

 

55 years and 4 months

 

 

 

 

 

1950

 

 

55 years and 6 months

 

1951

 

 

55 years and 8 months

 

 

 

 

 

1952

 

 

55 years and 10 months

 

1953-1964

 

 

56 years

 

 

 

 

 

1965

 

 

56 years and 2 months

 

1966

 

 

56 years and 4 months

 

 

 

 

 

1967

 

 

56 years and 6 months

 

1968

 

 

56 years and 8 months

 

 

 

 

 

1969

 

 

56 years and 10 months

 

 

1970 or later

 

57 years

 

 

 

 

 

 

2.Refer to the chart on the next page to see which types of income are reportable for the purpose of the earnings test. Please do not include pre-retirement salary or post-retirement annuity payments. If you have questions, please telephone the HR Service Center at 866-300-7419 Monday through Friday between 8:00 AM and 5:00 PM, Eastern Time.

3.In order for the Department of State to apply the earnings test to your annuity supplement, you must submit this form by January 10, 2014, starting the year after you reach your MRA. Submit the form even if you had no earnings for that previous year. Your annuity supplement will be terminated if the

FSPS Annuity Supplement Report is not received on time to establish your eligibility.

4.Please provide clear and legible information. Sign and send the form by one of the following methods:

Mailing Address

Fax

Scan/Email

Department of State, HR Service

843-202-3807

HRSC@state.gov

Center, Annuitant Services,

 

 

1999 Dyess Avenue, Building E,

 

 

Charleston, SC 29405

 

 

5.Retain copies of evidence supporting your claimed earnings in the event you are required to furnish documentation of earnings.

How To Determine Which Income to Report

Include as earnings:

-All wages from employment covered by Social Security.

-Net Income from self-employment

-All cash pay for agricultural work, domestic

work in a private home, service not in the course of your employer’s trade of business.

-All pay, cash or non-cash, for work as a home worker for a non-profit organization, no matter the amount. (The Social Security $100.00 tax does not apply.)

-All pay for work not covered by Social Security, if the work is done in the United States, including pay for:

Family employment

Work as a student, student nurse, intern, newspaper and magazine vendor,

Work for States or foreign governments or instrumentalities, and

Work covered by the Railroad Retirement Act.

Regardless of what income is called, if it is actually wages for services you performed or net earnings from self-employment you secured, it must be included in applying the earnings test.

Do not include as earnings:

-Pensions or annuities paid as retirement income, including your FSPS benefit or any benefits received as a survivor.

-Salary earned before retirement and/or lump- sum payment for annual leave upon retirement. This includes any separation incentives.

-Distributions from our Thrift Savings Plan or Individual Retirement Accounts.

-Unemployment compensation.

-Gifts, insurance proceeds, inheritances, scholarships, alimony, capital gains, net business losses, prize winnings.

-Payments-in-kind for domestic service in the employer’s private home, for agricultural

labor, for work not in the course of the employer’s trade or business, or the value of meals and lodging.

-Rentals from real estate that cannot be counted in earnings from self-employment because, for instance, you were not a real estate dealer.

-Interest and dividends not resulting from trade or business.

-Pay for military training or for jury duty.

-Payments by an employer which are reimbursement specifically for your travel expenses and which are so identified by the employer at the time of payment and/or reimbursement or allowance for moving expenses, if they are not counted as wages for Social Security purposes.

FSPS Annuity Supplement Report

Print Name Clearly

Year of Income

Employee ID or last four digits of SSN

Date Received by HRSC (completed by HRSC)

1.Is your annuity supplement currently reduced or terminated because you reported excess earnings last year? (Darken only one oval.)

OYes (Please skip directly to question 3.)

ONo (Please continue to question 2.)

2.Did you have any earnings after retirement and in the year entered above? (Darken only one oval.)

OYes (Please continue to question 3.)

ONo (Please sign and return document.)

3. What were your earnings for the year entered above?

DollarsCents

Warning: Your earnings are subject to verification with the Social Security Administration’s earnings file. Any intentional false statement or willful misrepresentation is punishable by fine, imprisonment, or both (18 U.S.C. 1001).

Complete and return this form even if you had no earnings for the year indicated in the box above.

Failure to return this form may result in the termination of your annuity supplement.

Please do not include your salary before your date of retirement or any annuity payments.

Signature

Daytime Phone Number

E-mail address

Date: (mm/dd/yyyy)

 

Privacy Act Statement

AUTHORITY

The information is sought pursuant to the Foreign Service Act (22 U.S.C. § 3901 et seq. and

 

22 U.S.C. § 4071) and E.O. 9397, as amended. 31 U.S.C. § 7701 requires any person doing

 

business with the Federal government furnish a Social Security Number or tax identification

 

number.

PURPOSE

The information solicited on this form will be used to determine your eligibility to continue

 

receiving the annuity supplement and the amount of the supplement.

USES

The information may be shared with national, state or local government, or the Social

 

Security Administration in order to determine benefits and issue benefits under their

 

programs, to obtain information necessary for determination or continuation of benefits

 

under this program or to report income for tax purposes. It may also be shared and verified,

 

as noted above with law enforcement agencies when they are investigating a violation or

 

potential violation of civil or criminal law. More information on the Routine Uses for the

 

system can found in the System of Records Notice, State-31, Human Resources Records.

DISCLOSURE

The collection of this information is voluntary, however, failure to provide may result in

 

benefits being denied.

File Properties

Fact Title Description
Purpose of the Form The DS 5026 form is used to report earnings for the FSPS Annuity Supplement in order to determine eligibility and benefit amounts.
Earnings Test Initiation The earnings test applies after the retiree reaches the Minimum Retirement Age (MRA).
Reduction of Benefits For every $2 earned above the annual exempt amount, benefits will be reduced by $1.
Reporting Deadline The form must be submitted by January 10 of the year following the year in which income is reported.
Contact Information Questions can be directed to the HR Service Center at 866-300-7419, available Monday to Friday, 8:00 AM to 5:00 PM, Eastern Time.
Income Reporting Guidelines Only certain types of income are reportable; pre-retirement salaries and post-retirement annuity payments are not included.
Evidence Retention Retain copies of documentation supporting claimed earnings for future verification if required.
Privacy Act Compliance The information collected is done so under the authority of the Foreign Service Act and will be used to verify eligibility for benefits.
Consequences of Non-Submission Failure to submit the form on time can result in termination of the annuity supplement.
Exempted Income Specific incomes such as pensions, unemployment compensation, and some non-cash payments do not count as earnings for the test.

Instructions on Utilizing Ds 5026

Filling out the DS-5026 form accurately is essential for ensuring that your annuity supplement continues without interruption. The following steps will guide you through the necessary process, making it easier to provide the required information clearly and effectively.

  1. Begin with the Print Name Clearly section and enter your full name.
  2. Fill in the Year of Income for which you are reporting earnings.
  3. Provide your Employee ID or the last four digits of your Social Security Number (SSN).
  4. Leave the Date Received by HRSC section blank; this will be completed by HRSC.
  5. In the first question, determine if your annuity supplement is currently reduced or terminated due to excess earnings last year. Darken either the Yes or No oval.
  6. If you answered No, proceed to the second question. Indicate whether you had any earnings after retirement for the year listed by darkening the appropriate oval.
  7. If you answered Yes to question 2, report your earnings for the year in the specified box. Ensure you enter the correct amount in Dollars and Cents.
  8. Read the warning regarding verification of your earnings. Ensure you understand the seriousness of providing accurate information.
  9. Sign the form, and provide your Daytime Phone Number and E-mail address.
  10. Finally, enter the Date in the format (mm/dd/yyyy).

Once you've completed the form, be sure to keep a copy for your records. Submit your completed DS-5026 form by mailing, faxing, or scanning and emailing it to the HR Service Center. This will ensure that your annuity supplement remains active and correctly adjusted based on your reported earnings.

Important Facts about Ds 5026

1. What is the purpose of the DS 5026 form?

The DS 5026 form, also known as the FSPS Annuity Supplement Earnings Report, is used to report earnings for individuals receiving an annuity supplement from the Foreign Service Pension System (FSPS). Completing this form accurately is necessary to determine your eligibility for the annuity supplement and to assess the amount you may continue to receive, especially after reaching the Minimum Retirement Age (MRA).

2. When must this form be submitted?

This form must be submitted by January 10 of the year following the year for which you are reporting income. This requirement applies starting the year after you reach your MRA. It’s crucial to submit the form on time, even if you had no earnings during that year. Failure to do so could result in the termination of your annuity supplement.

3. How does the earnings test affect my annuity supplement?

The annuity supplement is subject to an earnings test similar to that of Social Security benefits. If your earnings exceed an exempt amount, your annuity supplement will be reduced by $1.00 for every $2.00 you earn above this amount. The exempt amount changes annually, and it is your responsibility to stay informed about these updates through resources like the Social Security Administration's website at www.ssa.gov.

4. What types of income should I report on this form?

You must report all wages from employment covered by Social Security, net income from self-employment, cash pay for specific types of work (like agricultural or domestic work), and any cash or non-cash pay for volunteering with a non-profit organization. Importantly, any earnings from employment in the US, regardless of the label, also need to be included, while pre-retirement salary and annuities should be excluded.

5. Are there types of income that I do not need to report?

Yes, certain types of income should not be included when filling out the DS 5026 form. Do not report pensions, pre-retirement salary, Thrift Savings Plan distributions, unemployment benefits, gifts, or other specified incomes like rental income from non-self-employment or interest and dividends not tied to a business.

6. What should I do if I believe I had no earnings for the year?

Even if you believe you had no earnings for the year in question, it is still mandatory to complete and submit the DS 5026 form. You will be asked to confirm that you had no earnings, but submitting the form is crucial to maintain your benefits and ensure compliance with reporting requirements.

7. How can I submit the DS 5026 form?

You can submit the DS 5026 form via multiple methods for your convenience. You can choose to mail it to the designated HR Service Center address, fax it to the provided number, or scan and email it. Make sure to keep a copy for your own records as a safeguard in case of any questions or disputes regarding your reported earnings.

8. What happens if I don't submit the form on time?

Failure to submit the DS 5026 form within the required timeframe may lead to the termination of your annuity supplement. It is vital to adhere to the deadlines outlined to avoid any interruptions in your benefits, as the processing of the form is essential to validate your eligibility.

Common mistakes

Filling out the DS 5026 form requires careful attention to detail. One common mistake individuals make is incorrectly reporting earnings. People often misinterpret what constitutes reportable income. It is crucial to include all wages from employment covered by Social Security, net income from self-employment, and various forms of pay. However, pensions, pre-retirement salary, or annuity payments aren’t included. Failing to accurately classify these earnings can lead to complications with the annuity supplement.

Another frequent error involves missing deadlines. The form must be submitted by January 10 of the year following the year of income that is being reported. Many retirees miss this deadline, thinking they have more time. Late submissions can have significant consequences, including the possible termination of the annuity supplement. It is vital for retirees to remain aware of these timelines to avoid interruptions in their benefits.

Inadequate documentation is also a common issue. Retirees often neglect to keep copies of evidence supporting their claimed earnings. This oversight can be problematic if the Department of State requires additional documentation to verify income. Having clear records can prevent delays and ensure continued eligibility for the annuity supplement. It is wise to maintain thorough documentation of all income sources.

Another mistake is failing to provide clear and legible information on the form. Illegible handwriting or incomplete responses can lead to confusion and processing delays. It is best practice to write clearly and review the form for accuracy before submission. Attention to detail in this aspect demonstrates professionalism and helps ensure that the form is processed without unnecessary complications.

Lastly, individuals often overlook the importance of signing and including contact information on the form. Without a signature, the form may be deemed incomplete and, therefore, not processed. Also, providing a daytime phone number and email address facilitates communication in case further information is needed. This oversight can lead to unnecessary delays and frustration. Properly finalizing the form is as important as the information it contains.

Documents used along the form

When submitting the DS-5026 form, there are several additional documents that may be required. Below, you will find a brief description of each of these forms. Each one serves a specific purpose and can be important for ensuring the accurate and timely processing of your annuity supplement eligibility.

  • Social Security Administration Earnings Statement: This document provides a detailed report of your earnings that have been subject to Social Security taxes. It is essential for verifying the income reported on the DS-5026 form.
  • Form W-2: This form summarizes an employee's total earnings and the amount of taxes withheld during the year. It can serve as a crucial piece of evidence when reporting your earnings for the earnings test.
  • Self-Employment Income Report: If you are self-employed, you may need to provide a report outlining your net earnings from self-employment. This report helps in determining the appropriate income to report on the DS-5026 form.
  • Tax Returns: Your personal tax return can provide additional evidence of your total income for the year. This can be essential, especially if there are discrepancies in your reported earnings.

Gathering these documents ahead of time can facilitate the process of ensuring your annuity supplement continues without interruption. Be sure to keep copies of all documents submitted for your personal records.

Similar forms

  • Social Security Earnings Report: This document helps individuals report their earnings to the Social Security Administration, similar to how the DS 5026 form enables reporting for the Federal Employee Retirement System. Both forms involve declaring income to determine benefit eligibility.
  • Form 1040 (U.S. Individual Income Tax Return): Like the DS 5026, Form 1040 requires a detailed account of annual income. It’s essential for assessing tax liabilities, just as the DS 5026 is critical for calculating the annuity supplement based on earnings.
  • Federal Employee Health Benefits (FEHB) Enrollment Form: This form collects similar information regarding personal circumstances to maintain benefits eligibility. The DS 5026 also gathers information to verify continued eligibility for retirement benefits.
  • Thrift Savings Plan (TSP) Withdrawal Request: Both forms request financial information from individuals. The TSP form determines the proper withdrawal amount, whereas the DS 5026 assesses income for annuity adjustments.
  • Retirement Application Form: This form is used by federal employees to apply for retirement benefits. Similar to the DS 5026, it requires specifics about service history and earnings to process retirement benefits.
  • Annual Earnings Test Form for Rail Road Workers: This document serves a similar function for railroad workers. Just like the DS 5026, it evaluates earnings to confirm compliance with benefit requirements, ensuring the correct payout of benefits based on income.

Dos and Don'ts

Things to Do When Filling Out the DS 5026 Form:

  • Submit the form by January 10, 2014, to ensure your annuity supplement eligibility.
  • Provide clear and legible information on the form.
  • Include all wages covered by Social Security and net income from self-employment.
  • Retain copies of any evidence supporting your claimed earnings.
  • Follow the instructions about which types of income to report for the earnings test.

Things Not to Do When Filling Out the DS 5026 Form:

  • Do not include pre-retirement salary or post-retirement annuity payments.
  • Avoid leaving any required fields blank.
  • Do not submit the form late, as it may result in termination of your benefits.
  • Refrain from including pensions or annuities as part of your reported earnings.
  • Do not forget to sign and date the form before submission.

Misconceptions

Misunderstandings surrounding the DS 5026 form can lead to issues with your annuity supplement. Below are six common misconceptions, along with clarifications to help you navigate this important document.

  • The DS 5026 form is only for individuals with high earnings. This is incorrect. All annuitants must submit the DS 5026 form, regardless of earnings. Even if you have no earnings for the previous year, submitting the form is required to maintain your eligibility for the annuity supplement.
  • Missing the January 10 deadline has no consequences. Failing to submit the form on time can lead to the termination of your annuity supplement. It’s crucial to be mindful of this deadline to secure your financial benefits.
  • Only wages from traditional employment count as earnings. This is a misunderstanding. Earnings can come from various sources, including self-employment and cash payments for domestic work. All reportable income must be included, regardless of how it is classified.
  • Once I reach retirement age, I no longer need to worry about the earnings test. This is misleading. The earnings test applies after you have reached the Minimum Retirement Age (MRA) and your annuity supplement may still be reduced based on your reported earnings.
  • Reporting my pre-retirement salary is necessary. Pre-retirement salary should not be included on the DS 5026 form. Focus on income earned during the specified reporting year to comply with requirements.
  • It's okay to submit unclear information. Providing clear and legible information is essential. If your form is difficult to read, it may cause delays or errors in processing your annuity supplement.

Understanding these points can greatly enhance your experience with the DS 5026 form. Ensure you stay informed and compliant to avoid unnecessary complications with your benefits.

Key takeaways

Filling out the DS-5026 form requires careful attention to detail. This ensures that the submitted information is accurate and legible, which helps prevent delays. Always double-check for any missing information before sending it.

The earnings test for your annuity supplement is a crucial factor. It begins once you reach your Minimum Retirement Age (MRA). This means income earned beyond a specific amount will reduce your benefits.

Submit the DS-5026 form by January 10th of the year after you reach your MRA. Failure to do so may result in the termination of your annuity supplement. This rule applies regardless of whether you had earnings during that year.

Each year, the exempt amount for earnings may change. Stay informed by visiting www.ssa.gov for the latest information regarding these changes.

This form requires you to report specific types of income. Reportable earnings include wages from employment covered by Social Security and net income from self-employment. Do not include pensions, retirement payments, or any form of compensation received prior to retirement.

Maintain copies of all documentation supporting your reported income. This is essential should the Department of State require verification of your earnings. Keeping these records can facilitate the process and protect your benefits.

If you need assistance or have questions while completing the form, the HR Service Center can provide help on weekdays from 8:00 AM to 5:00 PM Eastern Time.

It is vital to understand what income counts toward this earnings test. Identifying included and excluded payments will enable you to fill out the form accurately and maintain your benefits.

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