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Get Tax On Lump-sum Distributions 2003 G-1

Use this form only for lump-sum distributions from qualified plans. Social security number or FEIN Complete this part to see if you can use Schedule G-1. 1 Was this a distribution of a plan participant s entire balance from all of an employer s qualified plans of one kind (pension, profit-sharing, or stock bonus)? If No, do not use this form . . . . . . . . . . . . . . . . . . . . . . . . 2 Did you roll over any part of the distribution? If Yes, do not use this form . . . . . .

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