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I'll assume that the return of contribution was made in 2016 or you would already have the Form 1099-R and wouldn't be asking this question.
The Form 1099-R will have $190 in box 1 and $0 box 2a. The code in box 7 will be either code JP if the contribution that was returned was made in 2015 or code J8 if the contribution that was returned was made in 2016. A code JP 2016 Form 1099-R is reported on your 2015 tax return while a code J8 2016 Form 1099-R would be reported on your 2016 tax return.
With no tax withholding, the details of the Form 1099-R will not be included with your tax return, either e-filed or mailed, so it doesn't matter much what you put in for the payer information.
I'll assume that the return of contribution was made in 2016 or you would already have the Form 1099-R and wouldn't be asking this question.
The Form 1099-R will have $190 in box 1 and $0 box 2a. The code in box 7 will be either code JP if the contribution that was returned was made in 2015 or code J8 if the contribution that was returned was made in 2016. A code JP 2016 Form 1099-R is reported on your 2015 tax return while a code J8 2016 Form 1099-R would be reported on your 2016 tax return.
With no tax withholding, the details of the Form 1099-R will not be included with your tax return, either e-filed or mailed, so it doesn't matter much what you put in for the payer information.
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