Lomake 8915-F

Department of the Treasury

Internal Revenue Service

Instructions for Form 8915-F

(Rev. January 2024)

Qualiﬁed Disaster Retirement Plan Distributions and Repayments

Section references are to the Internal Revenue Code

Reminders

unless otherwise noted.

Qualified 2021 and later disaster distributions (also

known as qualified disaster recovery distributions).

As a result of section 331 of the SECURE 2.0 Act of 2022,

enacted December 29, 2022, you are now eligible for the

benefits of Form 8915-F if you were adversely affected by

a qualified 2021 or later disaster and you received a

distribution described in Qualified Disaster Distribution

Requirements or Qualified Distribution Requirements,

later. Qualified disaster distributions (such as qualified

2021 disaster distributions, qualified 2022 disaster

distributions, qualified 2023 disaster distributions,

qualified 2024 disaster distributions, etc.) are also called

qualified disaster recovery distributions.

Contents

Page

Future Developments . . . . . . . . . . . . . . . . . . . . . . . . 1

What’s New . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Reminders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

General Instructions . . . . . . . . . . . . . . . . . . . . . . . . . 2

Helpful Hints . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

How Do I Distinguish My Form 8915-F and Its

Disasters From Other Forms 8915-F? . . . . . . . . 2

Purpose of Form . . . . . . . . . . . . . . . . . . . . . . . . 2

Purpose of These Instructions . . . . . . . . . . . . . . . 2

When Should I Not Use a Form 8915-F? . . . . . . . . 2

Who Must File . . . . . . . . . . . . . . . . . . . . . . . . . . 2

When and Where To File . . . . . . . . . . . . . . . . . . . 3

What Is a Qualified Disaster Distribution? . . . . . . . 3

Qualified Disaster Distribution . . . . . . . . . . . . . . . 3

Dollar limit. For qualified 2021 and later disasters, the

dollar limit on Form 8915-F for retirement plan

distributions is $22,000 per disaster. It was $100,000 but

that was for qualified 2020 disasters.

Qualified Distribution for the Purchase or

Construction of a Main Home in Qualified

Disaster Areas . . . . . . . . . . . . . . . . . . . . . . . . 6

Determining the qualified disaster distribution peri-

od, in Part I, for a disaster. The qualified disaster

distribution period for each disaster still begins on the day

the disaster began. The last day of the qualified disaster

distribution period for most qualified 2021 disasters and

many qualified 2022 disasters is June 26, 2023. But the

last day of the qualified disaster distribution period for

qualified 2023 and later disasters, some qualified 2022

disasters, and perhaps even a few qualified 2021

disasters will have to be separately calculated. See

Qualified disaster distribution period, later.

Determining the qualified distribution repayment pe-

riod, in Part IV, for a disaster. The qualified distribution

repayment period for each disaster still begins on the day

the disaster began. The last day of the qualified

distribution repayment period for most qualified 2021

disasters and many qualified 2022 disasters is June 27,

2023. But the last day of the qualified distribution

repayment period for qualified 2023 and later disasters,

some qualified 2022 disasters, and perhaps even a few

qualified 2021 disasters will have to be separately

calculated. See Qualified Distribution Repayment Period,

later.

Amending Form 8915-F . . . . . . . . . . . . . . . . . . . 8

Specific Instructions . . . . . . . . . . . . . . . . . . . . . . . . . 9

Required General Information . . . . . . . . . . . . . . 10

Part I—Total Distributions From All Retirement

Plans (Including IRAs) . . . . . . . . . . . . . . . . . . 10

Part II—Qualified Disaster Distributions From

Retirement Plans (Other Than IRAs) . . . . . . . 17

Part III—Qualified Disaster Distributions From

IRAs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Part IV—Qualified Distributions for the

Purchase or Construction of a Main Home

in Qualified Disaster Areas . . . . . . . . . . . . . . 21

Future Developments

For the latest information about developments related to

Form 8915-F and its instructions, such as legislation

enacted after they were published, go to IRS.gov/

Form8915F.

What’s New

Determining the disaster's FEMA number and other

information. See Qualified disaster area, later, for

information on where to find a disaster’s FEMA number,

beginning date, and declaration date.

Worksheet 1B. Worksheet 1B is a tool you may have to

use in figuring amounts for lines 1a through 5 of Form

8915-F. See Worksheet 1B, later, to determine whether

you must use Worksheet 1B. You can choose to use

Worksheet 1B even if you are not required to do so.

SEP IRAs and SIMPLE IRAs. Section 601 of the

SECURE 2.0 Act of 2022 allows for the creation of Roth

accounts for SEP IRAs and SIMPLE IRAs beginning

January 1, 2023. As a result, accounts we had previously

referred to as "SEP IRAs" and "SIMPLE IRAs" in these

instructions will now be called traditional SEP and

traditional SIMPLE IRAs, respectively. We will refer to the

newly enacted Roth accounts as "Roth SEP IRAs" and

"Roth SIMPLE IRAs," respectively. See, for example, the

2023 Instructions for Form 8606.

Jan 30, 2024

Cat. No. 37509G

Income in 2021 and later years from qualified 2020 and

•

General Instructions

later disaster distributions; and

A qualified distribution described in Qualified 2021 and

•

Helpful Hints

later disaster areas under Qualified Distribution for the

Purchase or Construction of a Main Home in Qualified

Disaster Areas, later, that you received this year.

Form 8915-F can be e-filed. Form 8915-F can be

completed electronically and e-filed with your tax return.

Form 8915-F is a forever form. Form 8915-F is a

redesigned Form 8915. Additional alphabetical Forms

8915 (that is, Form 8915-G, Form 8915-H, etc.) will not be

issued. The same Form 8915-F will be used for

If you were adversely affected by a qualified 2020

disaster, use Form 8915-F to report:

A qualified disaster distribution described in Qualified

•

disaster distribution requirements, later, that was made to

you in 2021 (coronavirus-related distributions can't be

made after December 30, 2020);

distributions for qualified 2020 disasters (and qualified

2021 and later disasters) and for each year of reporting of

income and repayments of those distributions. The boxes

you check in items A and B will help us determine the

exact year of the form you are filing, and the year of the

qualified disasters, qualified disaster distributions, and

qualified distributions you are reporting. Earlier Forms

8915 had a different alphabetical Form 8915 for each year

of disasters and a different form for each year the

A repayment of, or income from, a qualified disaster

•

distribution (including a coronavirus-related distribution) in

this year; or

A qualified distribution described in Qualified 2021 and

•

later disaster areas under Qualified Distribution for the

Purchase or Construction of a Main Home in Qualified

Disaster Areas, later, that you received on January 1,

2021, for the Washington (8593-DR-WA) disaster.

alphabetical form existed. See How Do I Distinguish My

Form 8915-F and Its Disasters From Other Forms 8915-F

and When Should I Not Use a Form 8915-F, later.

See Amending Form 8915-F, later.

Purpose of These Instructions

The Instructions for Form 8915-F (Rev. January

These instructions provide detailed information for use

with your Form 8915-F. For your convenience, Parts I and

II of Appendix A, Which Lines Should I Use, later, provide,

as well, the lines you should complete on your Form

8915-F for all tax years applicable to 2020 and later

disasters.

2023) and the Instructions for Form 8915-F (Rev.

February 2022) contain information, including

TIP

examples, relevant to earlier tax years.

This year. "This year" (as used on Form 8915-F and in

these instructions) is the year of the form you check in

item A of your Form 8915-F. For example, if you check

2023, "this year" is 2023.

When Should I Not Use a Form 8915-F?

Reporting coronavirus-related and other distribu-

tions for qualified 2020 disasters made or received in

2020. This form replaces Form 8915-E for tax years

beginning after 2020. Do not use a Form 8915-F to

report, in Part I, qualified 2020 disaster distributions made

in 2020 or, in Part IV, qualified distributions received in

2019 or 2020 for qualified 2020 disasters.

How Do I Distinguish My Form 8915-F and Its

Disasters From Other Forms 8915-F?

Name of form. These instructions will use different

names to refer to your Form 8915-F depending on the

boxes you check in items A and B at the top of page 1 of

your Form 8915-F. For example, if you checked the 2023

box in item A and the 2022 box in item B, your form will be

referred to in these instructions and elsewhere as “2023

Form 8915-F (2022 disasters).” See Names of disasters

and distributions next.

You will still use 2020 Form 8915-E to report

coronavirus-related and other qualified disaster

!

CAUTION

distributions made in 2020 and to report qualified

distributions received in 2020 for qualified 2020 disasters.

Names of disasters and distributions. Except when

referring to them generally, these instructions will refer to

the different qualified disasters and qualified disaster

distributions by their specific names using the year(s) you

checked in item A and item B at the top of page 1 of your

Form 8915-F. For example, if you checked 2023 in item B,

your qualified disasters are referred to as “qualified 2023

disasters” and your qualified disaster distributions are

referred to as “qualified 2023 disaster distributions.”

Qualified 2019 and earlier disasters. Do not use Form

8915-F to report repayments or income from qualified

disaster distributions for 2019 and earlier disasters.

Who Must File

File Form 8915-F for the year you checked in item A at the

top of page 1 of the form if any of the following apply to

you for that year for the disasters listed in items C and D.

A qualified disaster distribution was made to you from

•

an eligible retirement plan.

Purpose of Form

If you were adversely affected by a qualified 2021 or later

disaster, use Form 8915-F to report:

You received a qualified distribution.

•

A qualified disaster distribution was made to you in a

prior year that you are including in income in equal

amounts over 3 years and "this year" is a year within the

3-year period.

A qualified disaster distribution described in Qualified

•

disaster distribution requirements, later, that was made to

you this year;

You made a repayment of a qualified disaster

•

A repayment of, or income from, a qualified disaster

•

distribution and the time for filing the Form 8915-F for that

repayment has not expired.

distribution reported on Part I of a Form 8915-F from this

or an earlier year; or

2

Instructions for Form 8915-F (Rev. 1-2024)

The qualified 2023 disaster distributions for qualified

•

Which Lines Should I Complete?

2023 disasters reported on 2023 Form 8915-F (2023

disasters).

If you e-file your return, the software you use may

determine which lines you need.

TIP

Qualified disaster distributions for 2024 and later years

are the distributions reported, like those for other years, in

Part I of a Form 8915-F for the year because they meet the

criteria in the next section. In all cases, the year checked

in item B of your Form 8915-F is the year in which the

disaster began. There are always qualified disaster

distributions that can be made for a disaster in the year

the disaster began and, for certain disasters, in the year or

2 after the disaster began.

Fill in your name and social security number at the top

of page 1 of your Form 8915-F. As indicated earlier,

complete items A and B, selecting the item A tax year and

the item B disaster year. Also, complete items C and D, as

applicable.

You might not need to enter amounts on each line of

your Form 8915-F. Parts I and II of Appendix A, Which

Lines Should I Use, later, provide the lines you need to

complete on Form 8915-F for each year relating to your

disasters. The lines you use will depend on:

Qualified Disaster Distribution

How Is a Qualified Disaster Distribution Taxed?

Generally, a qualified disaster distribution is included in

your income in equal amounts over 3 years, beginning

with the year in which the distribution was made. However,

if you elect, you can include the entire distribution in your

income in the year the distribution was made.

Whether qualified disaster distributions were made to

•

you,

Whether you have received qualified distributions,

•

Whether you are recognizing income from distributions,

and

Whether you are repaying distributions.

•

When and Where To File

Any repayments made before you file your return, by

the due date (including extensions), and no later than 3

years and 1 day after the distribution was received, reduce

the amount of the distribution included in your income.

File your Form 8915-F with your Form 1040, 1040-SR, or

1040-NR for the year checked in item A at the top of

page 1 of your Form 8915-F. For example, you will file your

2023 Form 8915-F (2022 disasters) with your 2023 Form

1040, 1040-SR, or 1040-NR.

Also, qualified disaster distributions aren't subject to the

additional 10% tax (or the 25% additional tax for certain

distributions from traditional SIMPLE and Roth SIMPLE

IRAs) on early distributions.

The timing of your distributions and repayments will

determine whether you need to file an amended return to

claim them. To determine whether you need to amend

your Form 8915-F, see Amending Form 8915-F, later.

If a taxpayer who spread the income from a

qualified disaster distribution over 3 years dies

!

What Is a Qualified Disaster

Distribution?

CAUTION

before the last tax year of that 3-year period, the

distribution may no longer be spread over 3 years. The

remainder of the distribution must be reported on the

return of the deceased taxpayer. Include the remainder in

the line 13 and/or line 24 totals, as applicable, of the Form

8915-F for the year of their last tax return.

The distributions that are a qualified disaster distributions

for tax years 2021 or later follow.

For 2021, qualified disaster distributions are:

The qualified 2019 disaster distributions for the Puerto

•

Rico Earthquakes (DR-4473-PR) reported on 2021 Form

8915-D,

Qualified Disaster Distribution Requirements

A coronavirus-related distribution can't be made

The qualified 2020 disaster distributions for qualified

•

after 2020. See Qualified disaster distribution

2020 disasters reported on 2021 Form 8915-F (2020

disasters), and

!

CAUTION

period, later, to figure when your qualified disaster

distribution can be made. Also, a distribution is not a

qualified disaster distribution if it is listed in Distributions

that are not qualified disaster distributions, later. See

Limit, later, for the dollar limit on qualified disaster

distributions.

The qualified 2021 disaster distributions for qualified

•

2021 disasters reported on 2021 Form 8915-F (2021

disasters).

For 2022, qualified disaster distributions are:

The qualified 2021 disaster distributions for qualified

•

2021 disasters reported on 2022 Form 8915-F (2021

disasters), or

Qualified disaster distribution requirements.

Qualified disaster distributions must meet the following

criteria. (Coronavirus-related distributions can't be made

in 2021 or later years.) You must meet these requirements

separately for each of your disasters that you are reporting

in item C on Form 8915-F.

The qualified 2022 disaster distributions for qualified

•

2022 disasters reported on 2022 Form 8915-F (2022

disasters).

For 2023, qualified disaster distributions are:

1. The distribution was made:

The qualified 2021 disaster distributions for qualified

•

For 2020 disasters (other than the coronavirus), no later

•

2020 disasters reported on 2023 Form 8915-F (2021

disasters),

than June 24, 2021; or

For 2021 and later disasters, within the disaster's

•

The qualified 2022 disaster distributions for qualified

•

qualified disaster distribution period. See Qualified

disaster distribution period, later.

2022 disasters reported on 2023 Form 8915-F (2022

disasters), and

Instructions for Form 8915-F (Rev. 1-2024)

3

2. Your main home was located in a qualified disaster

area at any time during the disaster period shown for that

area. See Main home, later. The qualified disaster area is

the state, territory, or tribal government in which the

disaster occurs.

3. You sustained an economic loss because of the

disaster(s) in (2) above. Examples of an economic loss

include, but aren't limited to: (a) loss, damage to, or

destruction of real or personal property from fire, flooding,

looting, vandalism, theft, wind, or other cause; (b) loss

related to displacement from your home; or (c) loss of

livelihood due to temporary or permanent layoffs.

All other disasters, including some 2022 disasters.

For all other disasters (including 2022 disasters not

described in Most, but not all, 2021 and 2022 disasters),

the qualified disaster distribution period will end 179 days

after the disaster beginning date or the disaster

declaration date, whichever is later. If this section applies

to your disaster, see Appendix C, Last Day T o M ake

Qualified Disaster Distributions for Y o ur Disaster, later, for

the last date on which a qualified disaster distribution can

be made for your disaster.

Example 1. Mosley was eligible for qualified 2022

disaster distributions for the Washington Severe Winter

Storm, Straight-line Winds, Flooding, Landslides, and

Mudslides disaster (DR-4682-WA) (beginning date

November 3, 2022) (declaration date January 12, 2023).

Qualified disaster distributions can be made for this

disaster through July 10, 2023, even though this is a 2022

disaster. July 10, 2023, is exactly 179 days after January

12, 2023. See also Appendix C, later.

Example 2. Alex was eligible for qualified 2022

disaster distributions for the Havasupai Tribe Flooding

Event disaster (DR-4681) (beginning date October 1,

2022) (declaration date December 30, 2022). Qualified

disaster distributions can be made for this disaster

through June 27, 2023, even though this is a 2022

disaster. June 27, 2023, is exactly 179 days after

December 30, 2022. See also Appendix C, later.

If (1) through (3) apply, you can generally designate any

distribution (including periodic payments and required

minimum distributions) from an eligible retirement plan as

a qualified disaster distribution, regardless of whether the

distribution was made on account of a qualified disaster.

Qualified disaster distributions are permitted without

regard to your need or the actual amount of your

economic loss. See Eligible retirement plan, later, for the

list of plans from which qualified disaster distributions can

be made.

A reduction or offset of your account balance in an

eligible retirement plan (other than an IRA) in order to

repay a loan can also be designated as a qualified

disaster distribution. See Distribution of plan loan offsets,

later.

Example 3. Sam was eligible for qualified 2023

disaster distributions for the Georgia Severe Weather

disaster (DR-4685-GA) (beginning date January 12, 2023)

(declaration date January 16, 2023). Qualified disaster

distributions can be made for this disaster through July 14,

2023. July 14, 2023, is exactly 179 days after January 16,

2023. See also Appendix C, later.

Distributions that are not qualified disaster distribu-

tions. The following distributions are not qualified

disaster distributions.

Qualified disaster distribution period. As a result of

the SECURE 2.0 Act of 2022, enacted December 29,

2022, the period for making qualified disaster distributions

for qualified disasters that begin after 2020 does not have

a set ending date based on the year of the disaster, but

must be separately calculated for each of your qualified

disasters. The qualified disaster distribution period for a

qualified disaster will begin on the date the disaster

begins and will end 179 days after whichever of the

following occurs the latest.

Disaster beginning date.

Corrective distributions of elective deferrals and

•

Disaster declaration date.

employee contributions that are returned to the employee

(together with the income allocable thereto) in order to

comply with the section 415 limitations.

December 29, 2022.

All 2020 disasters. For 2020 disasters, these

Excess elective deferrals under section 402(g), excess

•

instructions replace Form 8915-E for 2021 and later tax

years. The distribution period for all qualified 2020

disasters (other than coronavirus-related distributions)

ended on June 24, 2021. The distribution period for

coronavirus-related distributions ended December 30,

2020.

contributions under section 401(k), and excess aggregate

contributions under section 401(m).

Loans that are treated as deemed distributions

•

pursuant to section 72(p).

Dividends paid on applicable employer securities under

•

section 404(k).

Most, but not all, 2021 and 2022 disasters. If your

disaster began in 2021 (or 2022 on or before December

29, 2022) and your disaster was declared as a major

disaster on or before December 29, 2022, then the period

for making qualified disaster distributions for that disaster

will end on June 26, 2023. June 26, 2023, is exactly 179

days after December 29, 2022.

Example. Mosley was eligible for qualified 2022

disaster distributions for the following 2022 disaster.

Disaster: Virginia Severe Winter Storm and Snowstorm

disaster (DR-4644-VA) (beginning date January 2, 2022)

(declaration date March 11, 2022). Qualified disaster

distributions can be made through June 26, 2023, for that

disaster.

The cost of current life insurance protection.

•

Prohibited allocations that are treated as deemed

distributions pursuant to section 409(p).

Distributions that are permissible withdrawals from an

•

eligible automatic contribution arrangement within the

meaning of section 414(w).

Distributions of premiums for accident or health

•

insurance under Treasury Regulations section

1.402(a)-1(e)(1)(i).

Limit. For each qualified 2020 disaster, the total of your

qualified disaster distributions from all plans is limited to

$100,000. For each qualified 2021 or later disaster, the

total of your qualified disaster distributions from all plans is

4

Instructions for Form 8915-F (Rev. 1-2024)

limited to $22,000. You may allocate the amount among

the plans by any reasonable method when determining

the amounts on lines 2, 3, and 4 of column (b) if all three

of the following apply.

a qualified disaster and you can't include that disaster on

a Form 8915-F.

Declared Disasters

1. You are not using Worksheet 1B.

2. You have distributions from more than one type of

plan, such as a 401(k) plan and an IRA.

Declaration Date

Year (Start)

–Any–

Year (End)

–Any–

3. The total on line 5, column (a), of your Form 8915-F

exceeds your total available qualified disaster distribution

amount from line 1e of your Form 8915-F.

TIP: Modify the start and end year(s) to broaden search.

Distribution of plan loan offsets. A distribution of a

plan loan offset is a distribution that occurs when, under

the terms of a plan, the participant’s accrued benefit is

reduced (offset) in order to repay a loan. A distribution of a

plan loan offset amount can occur for a variety of reasons,

such as when a participant terminates employment or

doesn’t comply with the terms of repayment. Plan loan

offsets are treated as actual distributions and are reported

in box 1 of Form 1099-R.

Declaration Type

–Any–

Incident Type

–Any–

▲

▼

▲

▼

State/Tribe

–Choose some options–

▲

▼

Main home. Generally, your main home is the home

where you live most of the time. A temporary absence due

to special circumstances, such as illness, education,

business, military service, evacuation, or vacation, won’t

change your main home.

Qualified disaster area. For qualified 2020 disasters,

the list of qualified disaster areas is in Appendix B in the

Instructions for Form 8915-F (Rev. February 2022). For

qualified 2021 and later disasters, the qualified disaster

area is the state, territory, or tribal government in which a

qualified disaster, described next, occurred.

Qualified disaster. A qualified disaster is a disaster

that the President has declared as a major disaster. It is

also known as a federally declared major disaster. The

FEMA numbers for these major disasters include the

letters "DR" in capital letters. To determine whether the

President has declared a disaster as a major disaster, go

to FEMA.gov/disaster/declarations. On that page, make

the four selections below and then click the Search and

Filter Disasters box. The Declared Disasters table in these

instructions displays how that FEMA page appears.

Search and Filter Disasters

The Additional Tax and Qualified Disaster

Distributions

Qualified disaster distributions aren’t subject to the

additional 10% tax (or the 25% additional tax for certain

distributions from traditional SIMPLE and Roth SIMPLE

IRAs) on early distributions and aren’t required to be

reported on Form 5329. However, the amount on line 7 of

your Form 8915-F may be subject to the additional tax.

See the Instructions for Form 5329 on how to figure the

additional tax on your distributions.

Note. If you choose to treat a distribution as a qualified

disaster distribution, it is not eligible for the 20% capital

gain election or the 10-year tax option. For information on

those options, see the instructions for Form 4972.

Repayment of a Qualified Disaster Distribution

1. In the Declaration Date box:

If you choose, you can generally repay any portion of a

qualified disaster distribution that is eligible for tax-free

rollover treatment to an eligible retirement plan. Also, you

can repay a qualified disaster distribution made on

account of hardship from a retirement plan. However, see

Exceptions, later, for qualified disaster distributions you

can’t repay.

Under Year (Start), enter the year before your disaster

•

began;

Under Year (End), enter a year that is 2 years after the

•

year in which your disaster began, if available. Otherwise,

enter the year after the disaster began.

2. In the Declaration Type box, select Major Disaster

Declaration.

Your repayment can't be made any earlier than the day

after the date you received the qualified disaster

distribution. You have 3 years from the day after the date

you received the distribution to make a repayment. The

amount of your repayment cannot be more than the

amount of the original distribution. Amounts that are

repaid are treated as a trustee-to-trustee transfer and are

not included in income. Also, for purposes of the

one-rollover-per-year limitation for IRAs, a repayment to

an IRA is not considered a rollover.

3. In the Incident Type box, select Any, or the type of

disaster if you want to be more specific.

4. In the State/Tribe box, select or enter the state,

territory, or tribal government in which your disaster

occurred.

If your disaster is among the results for that search, place

the FEMA number for your qualified disaster in item C on

page 1 of your Form 8915-F, and in the table at the top of

Part I and the table at the top of Part IV, as applicable. If

your disaster is not among the results, your disaster is not

Include on this year's Form 8915-F any repayments you

made before filing this year's return. Any repayments you

made will reduce the amount of qualified disaster

Instructions for Form 8915-F (Rev. 1-2024)

5

distributions reported on this year's return. Do not include

on this year's Form 8915-F any repayments you made

later than the due date (including extensions) for filing this

year's return. However, you may report those repayments

on next year's return or carry the repayments back to an

earlier year, as applicable. See Carrybacks under

Amending Form 8915-F, later. As noted above, amounts

paid later than 3 years and 1 day after you received the

distribution can't be repayments.

Example 1. In 2022, Rudy made a qualified 2022

disaster distribution from their traditional IRA. Rudy did not

check the box on line 22, choosing instead to spread the

income from the distribution over 3 years (2022, 2023, and

2024). Rudy didn't repay any portion of the distribution

until 2024 when Rudy made a repayment of that

distribution before timely filing their 2023 return. Rudy

includes those repayments on their 2023 Form 8915-F

(2022 disasters). Those repayments reduced the amount

of qualified 2022 disaster distributions reported on Rudy's

return for 2023 and any excess may be carried back to

2022 on an amended 2022 Form 8915-F or forward to

2024.

Qualified Distribution for the

Purchase or Construction of a Main

Home in Qualified Disaster Areas

How Is a Qualified Distribution Taxed?

A qualified distribution is included in your income in the

year of the distribution. Any repayments made before you

timely file your return for that year (including extensions)

reduce the amount of the distribution included in your

income on that return. Repayments made during the

qualified distribution repayment period for the disaster, but

after the year of the distribution, can be carried back to

reduce the income from the distribution. Unlike with

qualified disaster distributions, the income can't be spread

over 3 years and the repayment period is much shorter

than 3 years. See Qualified Distribution Repayment

Period, later.

Also, qualified distributions aren't subject to the

additional 10% tax (or the 25% additional tax for certain

distributions from traditional SIMPLE and Roth SIMPLE

IRAs) on early distributions.

Example 2. The facts are the same as in Example 1,

except Rudy made the repayments in 2024, after the due

date (including extensions) of Rudy's 2023 return. Rudy

cannot include those repayments on their 2023 Form

8915-F (2022 disasters). The repayments will reduce the

amount of Rudy’s qualified 2022 disaster distributions

made for 2024 and included in income on their 2024

return and any excess may be carried back on an

amended 2022 or 2023 Form 8915-F to reduce income on

their 2022 or 2023 return.

Qualified Distribution Requirements

Qualified 2020 disaster areas. The earliest tax year in

item A on Form 8915-F is 2021. Qualified distributions for

only one 2020 disaster can be made in 2021, the Alaska

Severe Storm, Flooding, Landslides, and Mudslides

(4585-DR-AK). To be a qualified distribution on 2021 Form

8915-F (2020 disasters) for the purchase or construction

of a main home in a qualified 2020 disaster area, the

distribution must meet all of the following requirements.

1. The disaster was the Alaska Severe Storm,

Flooding, Landslides, and Mudslides (4585-DR-AK).

Leave 2021 Form 8915-F (2020 disasters), Part IV, blank if

your only qualified 2020 disaster was any other 2020

disaster (including the coronavirus).

Eligible retirement plan. An eligible retirement plan

can be any of the following.

A qualified pension, profit-sharing, or stock bonus plan

•

(including a 401(k) plan).

A qualified annuity plan.

•

A tax-sheltered annuity contract.

A governmental section 457 deferred compensation

2. The distribution is a hardship distribution from a

401(k) plan, a hardship distribution from a tax-sheltered

annuity contract, or a qualified first-time homebuyer

distribution from an IRA.

plan.

An IRA.

•

Exceptions. You cannot repay the following types of

distributions.

3. The distribution was received on January 1, 2021.

1. Qualified disaster distributions received as a

4. The distribution was to be used to purchase or

construct a main home in Alaska and the main home was

not purchased or constructed because of the disaster.

See Main home, earlier. The disaster area is the state,

territory, or tribal government in which the disaster occurs.

beneficiary (other than a surviving spouse).

2. Required minimum distributions.

3. Any distribution (other than from an IRA) that is one

of a series of substantially equal periodic payments made

(at least annually) for:

Qualified 2021 and later disaster areas. A qualified

distribution for the purchase or construction of a main

home in a qualified 2021 or later disaster area must meet

all of the following requirements. See Main home and

Qualified disaster area, earlier.

a. A period of 10 years or more,

b. Your life or life expectancy, or

c. The joint lives or joint life expectancies of you and

your beneficiary.

1. For qualified 2021 disasters, the first day of the

disaster can be no earlier than January 26, 2021. For

disasters with beginning dates after 2021, there is no

restriction on when the disaster must begin.

2. The distribution was a hardship distribution from a

401(k) plan, a hardship distribution from a tax-sheltered

annuity contract, or a qualified first-time homebuyer

distribution from an IRA.

6

Instructions for Form 8915-F (Rev. 1-2024)

3. The distribution was received no more than 180

days before the first day of the disaster and no later than

30 days after the last day of the disaster.

4. The distribution was to be used to purchase or

construct a main home in the disaster's qualified disaster

area and the main home must not have been purchased

or constructed because of the disaster. See Main home

and Qualified disaster area, earlier.

December 29, 2022.

•

Most, but not all, 2021 and 2022 disasters. If your

disaster began in 2021 or 2022 (on or before December

29, 2022) and your disaster was declared as a major

disaster on or before December 29, 2022, then the period

for repaying qualified distributions for that disaster will end

on June 27, 2023. June 27, 2023, is exactly 180 days after

December 29, 2022.

Example. Taylor was eligible for qualified distributions

for the Virginia Severe Winter Storm and Snowstorm

(DR-4644-VA) disaster (beginning date January 2, 2022).

Taylor made a qualified distribution on December 5, 2021.

Taylor has until June 27, 2023, to repay the qualified

distribution.

All other 2021 and later disasters. For all other

disasters, the qualified distribution repayment period will

end 180 days after the disaster beginning date or the

disaster declaration date, whichever is later. If this section

applies to your disaster, see Appendix D, Last Day T o

Repay Y o ur Part IV Qualified Distribution, later, for the last

date on which you can repay a qualified distribution for

your disaster.

The Additional Tax and Qualified Distributions

Qualified distributions aren't subject to the additional 10%

tax (or the 25% additional tax for certain distributions from

traditional SIMPLE and Roth SIMPLE IRAs) on early

distributions and aren't required to be reported on Form

5329. However, the amount on line 32 of your Form

8915-F may be subject to the additional tax. See the

Instructions for Form 5329 on how to figure the additional

tax on your distributions.

If the qualified distribution was received in 2020

for a 2021 disaster, see Amending Form 8915-F,

!

CAUTION

later.

Example 1. Mosley was eligible for qualified

distributions for the Washington Severe Winter Storm,

Straight-line Winds, Flooding, Landslides, and Mudslides

(DR-4682-WA) disaster (beginning date November 3,

2022) (declaration date January 12, 2023). Qualified

distributions can be repaid for this disaster through July

11, 2023, even though this is a 2022 disaster. July 11,

2023, is exactly 180 days after January 12, 2023. See

Appendix D, later.

Example 2. Alex was eligible for qualified distributions

for the Havasupai Tribe Flooding Event (DR-4681)

disaster (beginning date October 1, 2022) (declaration

date December 30, 2022). Qualified distributions can be

repaid for this disaster through June 28, 2023, even

though this is a 2022 disaster. June 28, 2023, is exactly

180 days after December 30, 2022. See Appendix D,

later.

Example 3. Sam was eligible for qualified distributions

for the Georgia Severe Weather (DR-4685-GA) disaster

(beginning date January 12, 2023) (declaration date

January 16, 2023). Qualified distributions can be repaid

for this disaster through July 15, 2023. July 15, 2023, is

exactly 180 days after January 16, 2023. See Appendix D,

later.

Repayment of a Qualified Distribution for the

Purchase or Construction of a Main Home

You can choose to repay your qualified distribution to an

eligible retirement plan at any time during the qualified

disaster repayment period for the disaster. See Eligible

retirement plan, earlier and Qualified Distribution

Repayment Period below. Amounts that are repaid, during

the qualified distribution repayment period for the disaster,

are treated as a trustee-to-trustee transfer and are not

included in income. For purposes of the

one-rollover-per-year limitation for IRAs, a repayment to

an IRA is not considered a rollover.

If the qualified distribution (or any portion thereof) is not

repaid on or before the last day of the qualified distribution

repayment period for the disaster, it may be taxable and

may be subject to the additional 10% tax (or the additional

25% tax for certain traditional SIMPLE and Roth SIMPLE

IRAs) on early distributions. See the Instructions for Form

5329 to figure any tax.

Qualified Distribution Repayment Period

The last day of the repayment period for 2020 and later

disasters is below.

2020 disasters. The repayment period for a qualified

distribution for the Alaska Severe Storm, Flooding,

Landslides, and Mudslides (4585-DR-AK) disaster, to

purchase or construct a main home in Alaska ended on

June 25, 2021.

Designating qualified distribution as qualified

disaster distribution

You may be able to designate a qualified distribution for a

disaster as a qualified disaster distribution if all of the

following apply.

2021 and later disasters. As a result of the SECURE

2.0 Act of 2022, enacted December 29, 2022, the period

for repaying a qualified distribution for a disaster that

begins after 2020 does not have a set ending date, but

must be calculated. The qualified distribution repayment

period for each of those qualified disasters will begin on

the date the disaster begins and will end 180 days after

whichever of the following occurs the latest.

1. The distribution (or any portion thereof) is not repaid

on or before the last day of the qualified distribution

repayment period for the disaster.

2. The distribution can otherwise be treated as a

qualified disaster distribution. See Qualified disaster

distribution requirements, earlier.

Disaster beginning date.

Disaster declaration date.

•

Instructions for Form 8915-F (Rev. 1-2024)

7

2021 or later, include the carried back amount on

•

Amending Form 8915-F

line 14 of the Form 8915-F back to which you are carrying

the excess payment.

File Form 1040-X, Amended U.S. Individual Income Tax

Return, to amend a return you have already filed.

Generally, Form 1040-X must be filed for a credit or refund

within 3 years after the date the original return was filed, or

within 2 years after the date the tax was paid, whichever is

later.

If the original distribution was an IRA distribution and

you are carrying an excess repayment back to:

2020, include the carried back amount on 2020 Form

•

8915-E, line 18;

2021 or later, include the carried back amount on

•

Qualified disaster distributions. Depending on when a

repayment is made, you may need to file an amended tax

return to refigure your taxable income.

Include on this year's Form 8915-F any timely

repayments you made before filing this year's tax return.

Do not include on that Form 8915-F any repayments you

made later than the due date (including extensions) for

filing that return.

line 25 of the Form 8915-F back to which you are carrying

the excess payment.

Step 2. Add this sentence. Enter "$_______

carryback from [enter here the year the excess carryback

occurred] Form 8915-[E or F, as applicable]" on the dotted

line to the left of the line on which you are including the

carried back amount.

Example 1. On your 2020 Form 8915-E, you reported

a coronavirus-related distribution of $9,000 made to you

from your traditional IRA on April 14, 2020. You spread the

income over 3 years ($3,000 in each of 2020, 2021, and

2022). You made no repayments of the distribution in 2020

or 2021. On March 14, 2023, you made a repayment of

$4,500. The entire $4,500 is an excess repayment that

can be carried back to 2020, 2021, or 2022. You carry

back $3,000 to 2022, reporting $3,000 of the repayment

on your 2022 Form 8915-F (2020 disasters), line 25. The

excess repayment of $1,500 can be carried back to 2021

and reported on your 2021 Form 8915-F (2020 disasters),

line 25, or carried back to 2020 and reported on your 2020

Form 8915-E, line 18. On the dotted line to the left of your

2022 Form 8915-F (2020 disasters), line 25, you enter

"$3,000 excess repayment from 2023 Form 8915-F (2020

disasters)." On the dotted line to the left of your 2021

Form 8915-F (2020 disasters), line 25, or your 2020 Form

8915-E, line 18, whichever is applicable, you enter

"$1,500 excess repayment from 2023 Form 8915-F (2020

disasters)."

Example 2. You suffered economic losses in 2022 as

the result of DR-4649-PR. Your main home was in Puerto

Rico when that disaster occurred. You received a qualified

2022 disaster distribution from your traditional IRA in the

amount of $18,000 on April 29, 2022, spreading the

income over 3 years (2022, 2023, and 2024). You filed

your 2023 tax return on April 10, 2024. You made a

repayment of $15,000 on April 29, 2024. You report

$6,000 of the repayment on your 2024 Form 8915-F (2022

disasters). You report the excess repayment of $9,000 as

follows. You carry back $6,000 to 2023 Form 8915-F

(2022 disasters), line 25, and $3,000 back to 2022 Form

8915-F (2022 disasters), line 25. On the dotted line to the

left of line 25 of your:

If you make a timely repayment after timely filing this

year's tax return but by the due date of that return

(including extensions), include the repayment on an

original or amended, as applicable, Form 8915-F for this

year.

If you make a timely repayment after the due date of

this year's return (including extensions) but before the due

date of next year's return (including extensions), include

the repayment on next year's Form 8915-F. However, you

may file a Form 1040-X amending this year's or an earlier

year's Form 8915-F or a 2020 Form 8915-E, as applicable.

Example 1. You received a coronavirus-related

distribution in the amount of $9,000 on November 19,

2020. You choose to spread the $9,000 over 3 years

($3,000 in income for 2020, 2021, and 2022). On

November 6, 2023, you make a repayment of $4,500. For

2023, all of the $4,500 is an excess repayment. You carry

back $3,000 to 2022. The remaining excess repayment of

$1,500 ($4,500 − $3,000) can be carried back to 2021.

Also, instead of carrying that portion of the excess

repayment back to 2021, you can choose to carry it back

to 2020.

Example 2. You received a qualified 2020 disaster

distribution in the amount of $90,000 in 2021. You elected

to have the full income from the distribution recognized in

2021. On November 6, 2023, you make a repayment of

$45,000. The entire $45,000 is carried back to 2021.

Example 3. You received a qualified 2021 disaster

distribution in the amount of $21,000 in December 2022.

You choose to spread the $21,000 over 3 years ($7,000 in

income for 2022, 2023, and 2024). On November 6, 2024,

you make a repayment of $10,000. For 2024, none of the

qualified 2021 disaster distribution is included in income.

The excess repayment of $3,000 ($10,000 − $7,000) can

be carried back to 2023 or 2022.

2023 Form 8915-F (2022 disasters), you enter "$6,000

•

excess repayment from 2024 Form 8915-F (2022

disasters)"; and

Carrybacks. Follow Step 1 and Step 2 below when

carrying back amounts. These steps are followed by

examples.

2022 Form 8915-F (2022 disasters), you enter "$3,000

•

excess repayment from 2024 Form 8915-F (2022

disasters)."

Step 1. Determine the line(s) to use. If the original

distribution was not an IRA distribution and you are

carrying an excess repayment back to:

Example 3. You suffered economic losses in 2022 as

the result of DR-4649-PR. Your main home was in Puerto

Rico when that disaster occurred. You received a qualified

2022 disaster distribution from your 401(k) plan in the

amount of $15,000 on April 29, 2023. On your 2023 Form

8915-F, you elected to recognize the income from the full

2020, include the carried back amount on 2020 Form

•

8915-E, line 10;

8

Instructions for Form 8915-F (Rev. 1-2024)

$15,000 in 2023, checking the check box on line 11 of that

form. You filed your 2023 tax return on April 10, 2024. You

made a repayment of $11,000 on April 29, 2024. You

report the full $11,000 of the repayment on your 2024

Form 8915-F (2022 disasters). It is all excess repayment,

as you have no income from the distribution for that year.

You carry back the full $11,000 to 2023 Form 8915-F

(2022 disasters), line 14. On the dotted line to the left of

2023 Form 8915-F (2022 disasters), line 14, you enter

"$11,000 excess repayment from 2024 Form 8915-F

(2022 disasters)."

1040-X, you enter "2020" on the line for the calendar year

at the top of page 1 because you are a calendar year filer

and, in parentheses in column B of line 1, you enter the

amount of the repayment. In the Explanation of Changes

section of your amended return, enter "The amount I

reported on 2020 Form 1040, line 4b, is being reduced by

a contribution made 04/14/2023 to an eligible retirement

plan in repayment of a qualified distribution made

12/14/2020 under section 331(b) of the SECURE 2.0 Act

of 2022. The disaster was the Mississippi Severe Winter

Storms (DR-4598-MS) disaster."

Other qualified distributions received for qualified

2021 disasters and qualified distributions received

for qualified 2022 and later disasters. Because a

qualified distribution can be received up to 180 days

before the disaster began, you may have a qualified

distribution received in the year before the disaster began.

If that happens, you will use a Form 8915-F on which the

year in which the tax year of the qualified distribution was

made is checked in item A, and the year in which the

disaster began is checked in item B. If you need to report

repayments of the distribution, you will not need to follow

the special steps in Qualified distributions received in

2020 for qualified 2021 disasters, earlier, to file an

amended return. However, you will need to make the

repayments during the qualified distribution repayment

period for the disaster. See Repayment of a Qualified

Distribution for the Purchase or Construction of a Main

Home, earlier.

Qualified distributions for qualified 2021 and later

disasters. You may reduce the amount of a qualified

distribution included in income for a qualified disaster by

the amount of a repayment made during the qualified

distribution repayment period. (See Part IV—Qualified

Distributions for the Purchase or Construction of a Main

Home in Qualified Disaster Areas, later, for details on

qualified distributions for qualified 2021 and later

disasters.)

Qualified distributions received in 2020 for

qualified 2021 disasters. If, in 2020, you received a

qualified distribution for a qualified 2021 disaster, you may

reduce the amount of a qualified distribution included in

income in 2020 by the amount of a repayment made

before June 28, 2023. (See Part IV—Qualified

Distributions for the Purchase or Construction of a Main

Home in Qualified Disaster Areas, later, for details on

2020 qualified distributions for qualified 2021 disasters.)

Because a qualified distribution can be received up to 180

days before the disaster began and repayments for that

distribution can be made from the beginning date of the

disaster and through June 27, 2023, you may have a

qualified distribution received in 2020 for which you are

making repayments in 2021, 2022, or 2023. If you have

already filed your 2020 return on which you reported the

distribution, you should file an amended 2020 return to

report the repayment. On your amended return (Form

1040-X), you will enter 2020 as the calendar year (or the

2020 fiscal year) at the top of page 1 and enter, in

parentheses in column B of line 1, the amount of the

repayment. In the Explanation of Changes section enter:

"The amount I reported on [2020 Form 1040 or 1040-NR,

line 4b, as applicable] is being reduced by a contribution

made [mm/dd/2021, 2022, or 2023] to an eligible

retirement plan in repayment of a qualified distribution

made [mm/dd/2020] under section 331(b) of the SECURE

2.0 Act of 2022. The disaster was the [name of the

qualified 2021 disaster from FEMA.gov/disaster/

declarations.] " Use the full name of the disaster. Include

the state, territory, or tribal government and the FEMA DR

number from FEMA.gov/disaster/declarations.

Form 1040-NR. If you are amending a Form 1040-NR,

see the Instructions for Form 1040-X for which portions of

Form 1040-X you will need to complete.

Specific Instructions

Married filers. If both you and your spouse are required

to file Form 8915-F, file a separate Form 8915-F for each

of you. If you and your spouse are both filing Forms

8915-F, the $22,000 limit on qualified 2021 and later

disaster distributions and the elections on lines 11 and 22

to include all qualified disaster distributions in income

(and not spread them over 3 years) are determined

separately for each spouse. Similarly, if you and your

spouse are both filing Forms 8915-F, the $100,000 limit on

qualified 2020 disaster distributions made in 2021 and the

elections on lines 11 and 22 to include all those qualified

disaster distributions in income in the year of the

distribution (and not spread them over 3 years) are

determined separately for each spouse.

Name and social security number (SSN). If you file a

joint return, enter only the name and SSN of the spouse

whose information is being reported on the Form 8915-F.

Example. You received a distribution from a traditional

IRA on December 14, 2020, to construct a home in the

Mississippi Severe Winter Storms (DR-4598-MS) disaster

area which you did not construct because of that disaster.

The disaster began February 11, 2021, and the

Attach your completed worksheets. There are a total

of 6, applicable worksheets in these instructions. Blank

worksheets are in Appendix B, Worksheets, at the end of

these instructions.

Worksheet 1A-1 in Part I.

Worksheet 1B in Part I.

Worksheet 2 in Part II.

Worksheet 3 in Part II.

Worksheet 4 in Part III.

Worksheet 5 in Part III.

•

distribution now qualifies as a qualified distribution. On

April 14, 2023, you made a contribution that qualifies as a

repayment of the distribution. You have already filed your

2020 return, a Form 1040. You will need to file a Form

1040-X for 2020 to claim the repayment. On your Form

Instructions for Form 8915-F (Rev. 1-2024)

9

Complete each worksheet on the last pages of these

instructions that you use in determining amounts on your

Form 8915-F. In the spaces provided at the top of each

worksheet you complete, be sure to enter your name and

social security number as they appear on your Form

8915-F. Attach your completed worksheet(s) to the back of

your Form 8915-F.

Lines 1a through 1d. You may not need to complete

lines 1a through 1d. See Form 8915-F, line 1; also see

When to leave lines 1a through 1d blank next.

When to leave lines 1a through 1d blank. Leave

lines 1a through 1d blank on:

Your 2021 Form 8915-F (2020 disasters) if either you

•

didn’t file 2020 Form 8915-E or the only disaster you

reported on 2020 Form 8915-E was the coronavirus;

Required General Information

This year's Form 8915-F if you listed only one 2021 or

•

Item A. Check the box that describes the tax year of the

return to which you will be attaching your Form 8915-F.

You can only check one box in item A. If the tax year of the

return to which you are attaching your Form 8915-F is

2023, check the "2023" box in item A on your Form

8915-F.

later disaster in the table at the top of Part I and a prior

year's Form 8915-F doesn't list that disaster in item C;

This year's Form 8915-F if you have listed 2021 or later

•

disasters in the table at the top of Part I and no prior year's

Form 8915-F lists any of those disasters in item C. For

example, when you have checked the same year in item A

and item B; or

Item B. Check the box that describes the calendar year in

which the disaster(s) for which you are reporting

This year's Form 8915-F if you are using Worksheet 1B.

Otherwise, enter amounts on lines 1a through 1d as

•

distributions on your Form 8915-F began. You can only

check one box in item B. The disasters for which you are

reporting distributions, repayments, and/or income on

your Form 8915-F must have all started in the same

calendar year. If the disasters all started in 2023, check

the box for "2023" in item B of your Form 8915-F.

indicated later.

Example. You have checked 2023 in item A and item

B of your Form 8915-F. You have listed only these two

disasters both starting in 2023, Florida Severe Storms,

Tornadoes, and Flooding (DR-4709-FL) and Florida

Hurricane Idalia (DR-4734-FL), as your disasters in item

C. You will leave lines 1a through 1d blank.

Item C. Enter the FEMA DR number from Major Disasters

Declarations at FEMA.gov/disaster/declarations. See

Qualified disaster, earlier, for details. For example, for the

2023 Kansas Severe Storms, Straight-line Winds,

Tornadoes, and Flooding disaster, you would enter

DR-4747-KS.

Line 1a. If you are required to complete line 1a,

complete line 1a as follows.

For 2020 disasters, multiply $100,000 by the disasters

•

reported on your 2020 Form 8915-E that you are reporting

in the table at the top of Part I on your 2021 Form 8915-F

(2020 disasters). Enter that product on line 1a.

Do not enter the coronavirus in item C.

!

For 2021 and later disasters:

•

CAUTION

If you only list one disaster in the table at the top of

Part I on this year's Form 8915-F and that disaster was

also reported in item C of a prior year's Form 8915-F,

enter, on line 1a, $22,000.

Item D. Check the box in item D if the coronavirus is a

disaster you are reporting on your Form 8915-F.

Part I—Total Distributions From All

Retirement Plans (Including IRAs)

Coronavirus-related distributions. You can only report

qualified disaster distributions for disasters listed in item

C. Coronavirus-related distributions can’t be made after

December 30, 2020.

Part I disasters. List in the table at the top of Part I all the

qualified disasters in item C for which qualified disaster

distributions have been made to you this year. Only those

disasters and those distributions can be considered in

Part I.

List of disasters. If you are reporting no more than two

disasters, list the FEMA number, the disaster declaration

date, and the disaster beginning date for each disaster in

the spaces provided under the Part I header. If you have

more than two disasters, attach to the back of your Form

8915-F a statement with your name and SSN, and, for

each disaster, the FEMA number, the disaster declaration

date, and the disaster beginning date.

If you list more that one disaster in the table at the top

of Part I and all of your distributions for this year

occurred within the qualified disaster distribution

period (see Qualified disaster distribution period,

earlier) for each of the disasters listed in the table at

the top of Part I, enter, on line 1a, $22,000 times the

number of disasters you entered both in the table at

the top of Part I and in item C on a prior year's Form

8915-F.

Line 1b. If you are required to complete line 1b, complete

line 1b as follows.

For 2020 disasters, enter, on line 1b, the amount on

•

2020 Form 8915-E, line 4, column (c), if you completed

that line (otherwise from the amount on 2020 Form

8915-E, line 4, column (b)) that reflects the distributions

for the disasters you reported on 2020 Form 8915-E that

you are now reporting in the table at the top of Part I of

your 2021 Form 8915-F (2020 disasters). If you used

Worksheet 2 in your 2020 Instructions for Form 8915-E,

the amount for line 1b is figured by adding together the

amounts in column (X), line 4, of that worksheet for the

disasters you reported on 2020 Form 8915-E that you are

reporting in item C of your 2021 Form 8915-F (2020

disasters).

If you are using Worksheet 1B, leave lines 1a

through 1e blank and complete lines 2 through 5

!

CAUTION

as that worksheet directs. See Worksheet 1B.

10

Instructions for Form 8915-F (Rev. 1-2024)

For 2021 and later disasters, enter on line 1b, the

Example 3. You had an economic loss as the result of

Remnants of Tropical Storm Fred (DR-4625-NY)

•

amount of the total qualified disaster distributions made to

you in prior year(s) for all disasters in the table at the top of

Part I.

(beginning August 18, 2021). Qualified disaster

distributions can be made through June 26, 2023, for that

disaster. In May of 2023, qualified disaster distributions

were made to you totalling $9,000 that you report on a

2023 Form 8915-F (2021 disasters) listing the Remnants

of Tropical Storm Fred as your only disaster in the table at

the top of Part I. Earlier, in September of 2021, qualified

disaster distributions were made to you totalling $10,000

that you report on a 2021 Form 8915-F (2021 disasters)

again listing the Remnants of Tropical Storm Fred as your

only disaster in the table at the top of Part I. On line 1a of

your 2023 Form 8915-F (2021 disasters), you enter

$22,000. On line 1b, you enter $10,000. On line 1c, you

enter $12,000 ($22,000 minus $10,000). On line 1d, you

enter -0- and, on line 1e, you enter $12,000.

Example 4. You've only had an economic loss as the

result of one qualified disaster: Remnants of Tropical

Storm Fred (DR-4625-NY) (beginning August 18, 2021).

Qualified disaster distributions can be made through June

26, 2023, for that disaster. In May of 2023, qualified

disaster distributions were made to you totalling $9,000

that you report on a 2023 Form 8915-F (2021 disasters).

You also made qualified disaster distributions in 2021 and

2022 for this disaster. The qualified disaster distributions

made to you for 2021 and 2022 for $5,000 and $2,000 are

on line 6 of your 2021 Form 8915-F (2021 disasters) and

2022 Form 8915-F (2021 disasters), respectively. On

line 1a of your 2023 Form 8915-F (2021 disasters), you

enter $22,000. On line 1b, you enter $7,000 ($5,000 +

$2,000). On line 1c, you enter $15,000 ($22,000 minus

$7,000). On line 1d, you enter -0- and, on line 1e, you

enter $15,000.

Line 1d. If you are required to complete line 1d, complete

line 1d as follows.

Count the disasters reported in the table at the top of

•

Part I on your 2021 Form 8915-F (2020 disasters) that

were not reported on your 2020 Form 8915-E. Enter, on

line 1d, the product of that number and $100,000.

For 2021 and later disasters, count the disasters

•

reported in the table at the top of Part I of this year's Form

8915-F that were not reported on an earlier Form 8915-F.

Enter, on line 1d, the product of that number and $22,000.

Line 1e. Complete line 1e as follows.

If you have been instructed above to leave lines 1a

•

through 1d blank, enter on line 1e the product of $22,000

($100,000 if you checked 2020 in item B on Form 8915-F)

times the number of disasters you reported in the table at

the top of Part I of this year’s Form 8915-F.

Otherwise, enter the sum of lines 1c and 1d on line 1e.

•

Examples for lines 1a through 1e.

Example 1. You had an economic loss as the result of

Remnants of Tropical Storm Fred (DR-4625-NY)

(beginning August 18, 2021). Qualified disaster

distributions can be made through June 26, 2023, for that

disaster. In May of 2023, qualified disaster distributions

were made to you totalling $9,000 that you report on a

2023 Form 8915-F (2021 disasters). Earlier, in January of

2022, qualified disaster distributions were made to you

totalling $10,000 that you report on a 2022 Form 8915-F

(2021 disasters). On line 1a of your 2023 Form 8915-F

(2021 disasters), you enter $22,000. On line 1b, you enter

$10,000. On line 1c, you enter $12,000 ($22,000 minus

$10,000). On line 1d, you enter -0- and on line 1e you

enter $12,000.

Column (a). Your available distributions for this year are

the distributions you received for a retirement plan

(including an IRA).

Example 2. You had an economic loss as the result of

Beginning with Form 8915-F (Rev. January 2024),

Remnants of Tropical Storm Fred (DR-4625-NY)

line 3 mentions traditional SEP and traditional

SIMPLE IRAs and line 4 lists Roth SEP and Roth

TIP

(beginning August 18, 2021) and Severe Winter Storm

and Snowstorm (DR-4694-NY) (beginning December 23,

2022). Qualified disaster distributions can be made from

August 18, 2021, through June 26, 2023, for the first

disaster and December 23, 2022, through September 10,

2023, for the second disaster. You had an economic loss

as the result of each of these disasters. In April of 2023

and May of 2023, an $8,000 and a $21,000 qualified

disaster distribution were made to you, respectively. The

distributions both occurred within the qualified disaster

distribution period of each disaster and, therefore, could

be qualified disaster distributions of either disaster. Earlier,

in January of 2022, qualified disaster distributions were

made to you totalling $10,000 that you report on a 2022

Form 8915-F (2021 disasters). You had listed one

disaster, the Remnants of Tropical Storm Fred, as the

disaster in the table at the top of Part I of your 2022 form.

On line 1a of your 2023 Form 8915-F (2021 disasters),

you enter $22,000 for DR-4625-NY. On line 1b, you enter

$10,000. On line 1c, you enter $12,000 ($22,000 minus

$10,000). On line 1d, you enter $22,000 for DR-4694-NY.

On line 1e, you enter $34,000.

SIMPLE IRAs. Section 601 of the SECURE 2.0 Act of

2022 allows for the creation of Roth accounts for SEP

IRAs and SIMPLE IRAs beginning January 1, 2023. As a

result, accounts we had previously referred to as "SEP

IRAs" and "SIMPLE IRAs" in these instructions and on

Form 8915-F, line 3, will now be called traditional SEP and

traditional SIMPLE IRAs, respectively. In the instructions

and on Form 8915-F, line 4, we refer to the newly enacted

Roth accounts as "Roth SEP IRAs" and "Roth SIMPLE

IRAs," respectively.

Lines 2 through 4 in column (a). If you received a

distribution from a retirement plan (including an IRA), you

should receive a Form 1099-R. The amount of the

distribution should be shown in box 1 of Form 1099-R.

Enter the amounts from box 1 of all your Forms 1099-R on

the lines 2 through 4 in column (a), as applicable.

Column (b). The disasters in item C that are relevant to

column (b) and to all of Part I are only the disasters you

listed in the table at the top of Part I .

Instructions for Form 8915-F (Rev. 1-2024)

11

Beginning with Form 8915-F (Rev. January 2024),

line 3 mentions traditional SEP and traditional

SIMPLE IRAs and line 4 lists Roth SEP and Roth

of 2021 Form 8915-D. See Line 7, later, for the amount to

place on line 7 of your 2021 Form 8915-F.

TIP

See the Filled-in Worksheet 1A-1 example below for

guidance. A blank Worksheet 1A-1 is at the end of the

instructions under Appendix B, Worksheets.

SIMPLE IRAs. Section 601 of the SECURE 2.0 Act of

2022 allows for the creation of Roth accounts for SEP

IRAs and SIMPLE IRAs beginning January 1, 2023. As a

result, accounts we had previously referred to as "SEP

IRAs" and "SIMPLE IRAs" in these instructions and on

Form 8915-F, line 3, will now be called traditional SEP and

traditional SIMPLE IRAs, respectively. In the instructions

and on Form 8915-F, line 4, we refer to the newly enacted

Roth accounts as "Roth SEP IRAs" and "Roth SIMPLE

IRAs," respectively.

Example 1A-1. You suffered an economic loss as the

result of Maine Severe Storm and Flooding (DR-4696-ME)

(beginning date December 23, 2022; declaration date

March 22, 2023) and Maine Severe Storm and Flooding

(DR-4719-ME) (beginning date April 30, 2023; declaration

date July 6, 2023). Your main home was in Maine during

the disaster period for each disaster. Qualified disaster

distributions can be made from December 23, 2022,

through September 17, 2023, for the first disaster and

April 30, 2023, through January 1, 2024, for the second

disaster. No distributions were made until May 9, 2023,

when a $40,000 qualified disaster distribution from your

traditional IRA was made to you. The distribution occurred

within the qualified disaster distribution period of each

disaster and, therefore, could be a qualified disaster

distribution of either disaster. You are completing 2023

Form 8915-F (2022 disasters) and 2023 Form 8915-F

(2023 disasters). You complete your Form 8915-F

reporting the older disaster first: 2023 Form 8915-F (2022

disasters). You report $22,000 from the distribution as a

qualified 2022 disaster distribution on 2023 Form 8915-F

(2022 disasters). You report the remaining $18,000 from

the distribution as qualified 2023 disaster distributions in

the 2023 Form 8915-F (2023 disasters) portion of your

Filled-in Worksheet 1A-1 for Example 1A-1. On lines 2

through 4 of column (a) in Part I of your 2023 Form 8915-F

(2022 disasters), you enter the amounts shown in column

(a), lines 2 through 4, of 2023 Form 8915-F (2022

disasters) from your Filled-in Worksheet 1A-1 for

Lines 2 through 5 in column (b). If you are using

Worksheet 1B, follow the instructions for the worksheet

when completing these lines.

The amounts entered on lines 2 through 5 in column (b)

depend on whether the amount on line 5 in column (a) is

more than the amount on line 1e. The amount on line 5,

column (a), is the sum of lines 2 through 4 in column (a)

reduced by the total distributions from lines 2 through 4 in

column (a) that aren’t qualified disaster distributions.

If the amount on line 5 in column (a) is equal to or less

•

than the amount on line 1e, enter the amounts on lines 2

through 5 in column (a) on lines 2 through 5 in column (b).

If the amount on line 5 in column (a) is more than the

•

amount on line 1e, enter on lines 2 through 4 in column (b)

the amounts on line 5 in column (a) adjusted by any

reasonable means so that their sum on line 5 in column

(b) equals the amount on line 1e.

Are You Claiming Qualified Disaster

Distributions on Part I of more than one Form

8915 for this year?

Example 1A-1. Because the $18,000 is being used on

2023 Form 8915-F (2023 disasters), it should not be

counted on line 7 of your 2023 Form 8915-F (2022

disasters) in determining the taxable amount of

This section does not apply to you unless you are

completing Part I of Forms 8915-F having the

!

CAUTION

same date checked in item A but different dates

checked in item B, or you are completing Part I of both a

2021 Form 8915-D and a 2021 Form 8915-F.

distributions on that form.

The numbers on the left border of the Filled-in

Have you completed Part I of more than one Form

8915-F for this year? For example, you are completing a

2023 Form 8915-F (2023 disasters) and a 2023 Form

8915-F (2022 disasters). The forms should be completed

starting with the Form 8915-F for the oldest disasters and

ending with the Form 8915-F for the most recent

Worksheet are line numbers that correspond to

the lines on the indicated forms.

TIP

Worksheet 1B

If you use Worksheet 1B, you will leave lines 1a

disasters. Your available distributions for Part I of your 2nd

Form 8915-F for this year are the distributions left after

completing Part I of the first Form 8915-F. If you are filing

three Forms 8915-F for this year, which could possibly

happen in 2023, your available distributions for your 3rd

Form 8915-F for this year are the distributions left after

completing Part I of the first two Forms 8915-F. See Line 7,

later, for the amount to place on line 7 of your 1st Form

8915-F (or your 1st and 2nd Form 8915-F if you are filing

three Forms 8915-F for this year).

through 1e of this year's Form 8915-F blank, but

you will fill in the amounts for lines 2 through 4 in

TIP

column (a) and for line 5 in column (b) on that form.

Beginning with Form 8915-F (Rev. January 2024), line 3

mentions traditional SEP and traditional SIMPLE IRAs and

line 4 lists Roth SEP and Roth SIMPLE IRAs. Section 601

of the SECURE 2.0 Act of 2022 allows for the creation of

Roth accounts for SEP IRAs and SIMPLE IRAs beginning

January 1, 2023. As a result, accounts we had previously

referred to as "SEP IRAs" and "SIMPLE IRAs" in these

instructions and on Form 8915-F, line 3, will now be called

traditional SEP and traditional SIMPLE IRAs, respectively.

In the instructions and on Form 8915-F, line 4, we refer to

the newly enacted Roth accounts as "Roth SEP IRAs" and

"Roth SIMPLE IRAs," respectively.

Are you completing Part I of both a 2021 Form 8915-D

and a 2021 Form 8915-F? If so, complete your forms in

this order. First, complete 2021 Form 8915-D. Your

available distributions for your 2021 Form 8915-F (2020

disasters) are the distributions left after completing Part I

12

Instructions for Form 8915-F (Rev. 1-2024)

Filled-in Worksheet 1A-1. Example 1A-1 for column (a).

(a)

(b)

(c)

First Form 8915-F

Total distributions in this year Qualified disaster distributions

Allocation of column (b)

2

3

4

Distributions from retirement plans (other than

IRAs) made this year.

-0-

$40,000

-0-

$22,000

-0-

Distributions from traditional, traditional SEP,

and traditional SIMPLE IRAs made this year.

Distributions from Roth, Roth SEP, and Roth

SIMPLE IRAs made this year.

(a)

Second Form 8915-F

Available distributions for this year

2

3

4

Enter, in column (a), distributions from retirement plans (other

than IRAs) made this year.

-0-

Enter, in column (a), distributions from traditional, traditional

SEP, and traditional SIMPLE IRAs made this year.

$18,000

-0-

Enter, in column (a), distributions from Roth, Roth SEP, and

Roth SIMPLE IRAs made this year.

You can choose to use Worksheet 1B if your qualified

Qualified disaster distributions can be made from April 30,

2023, through January 1, 2024, for Disaster 1 and June

26, 2023, to March 3, 2024, for Disaster 2. In 2023, you

received a traditional IRA distribution of $30,000. The

distribution was made on September 8. You had no other

distribution for 2023. You complete Worksheet 1B. You

apply the distributions up to the $22,000 limit against each

available disaster. You apply $22,000 of the September 8

distribution to Disaster 1 and $8,000 of the September

distribution to Disaster 2. In column (b), lines 2 through 5,

of your 2023 Form 8915-F (2023 disasters), you enter the

amounts from lines 2 through 5 of your filled-in Worksheet

1B, column (b). See the Filled-in Worksheet 1B for

Example 1.

disasters began in 2021 or later years. However, you must

use Worksheet 1B to determine the amounts to place on

lines 1 through 5 of this year's Form 8915-F if your

qualified disasters began in 2021 or later years unless:

You listed only one disaster in the table at the top of Part

•

I; or

All of the distributions for this year occurred within the

•

qualified disaster distribution period (see Qualified

disaster distribution period, earlier) for each of the

disasters listed in the table at the top of Part I.

Line 1a of Form 8915-F provides the instructions for those

situations.

In Worksheet 1B, column (a), enter your available

distributions for this year for lines 2 through 4 from this

year's Form 8915-F. In Worksheet 1B, column (X), start by

entering the amounts you are planning to claim as

qualified disaster distributions for each disaster listed in

the table at the top of Part I on this year's Form 8915-F. A

distribution will not be a qualified disaster distribution for

this year unless the distribution is made within the

qualified disaster distribution period for a disaster listed in

the table at the top of Part I. Enter this year's distributions

for each qualified disaster, from the table at the top of Part

I, in a separate column. Your total qualified disaster

distributions for each disaster can't exceed $22,000. For

simplicity, apply your distributions in $22,000 amounts as

available to each available disaster, beginning with the

disaster with the earliest ending date for qualified disaster

distributions. Examples 1 through 3, later, provide

guidance. A blank Worksheet 1B is in Appendix B,

Worksheets, at the end of the instructions.

Example 2. You have the same disasters as in

Example 1. You are filing 2023 Form 8915-F (2023

disasters). In 2023, two traditional IRA distributions were

made to you: one on May 1 for $30,000 and one on

September 17 for $14,000. You had no other distributions

in 2023. You complete Worksheet 1B. You apply the

distribution up to the $22,000 limit against each available

disaster. You apply $22,000 of the May distribution to

Disaster 1 and the entire $14,000 of the September

distribution to Disaster 2. You can't apply any of the May

distribution to Disaster 2 as it was not made during the

qualified disaster distribution period for that disaster. In

column (b), lines 2 through 5, of your 2023 Form 8915-F

(2023 disasters), you enter the amounts from lines 2

through 5 of your filled-in Worksheet 1B, column (b). See

the Filled-in Worksheet 1B for Example 2.

Example 3. You were eligible for qualified 2023

disaster distributions for the following disasters. Disaster

1: Puerto Rico Severe Storm, Flooding and Landslides

(DR-4649-PR) (beginning date February 4, 2022;

declaration date March 29, 2022). Disaster 2: Puerto Rico

Hurricane Fiona (DR-4671-PR) beginning date

Example 1. You were eligible for qualified 2023

disaster distributions for the following disasters. Disaster

1: Maine Severe Storm and Flooding (DR-4719-ME)

(beginning date April 30, 2023; declaration date July 6,

2023). Disaster 2: Maine Severe Storm and Flooding

(DR-4737-ME) (beginning date June 26, 2023;

September 17, 2022; declaration date September 21,

2022). Your main home was in Puerto Rico during the

disaster period for each disaster. Qualified disaster

distributions can be made from February 4, 2022, through

declaration date September 6, 2023). Your main home

was in Maine during the disaster period for each disaster.

Instructions for Form 8915-F (Rev. 1-2024)

13

June 26, 2023, for Disaster 1 and September 17, 2022,

through June 26, 2023, for Disaster 2. You had a $20,000

qualified 2022 disaster distribution from your 2022 Form

8915-F (2022 disasters) for Disaster 1. No other

You apply the distributions up to the $22,000 limit against

each available disaster. You apply $2,000 of the May 9,

2023, distribution to Disaster 1, as $20,000 of the $22,000

limit was used in 2022. You apply $22,000 of the May 9,

2023, distribution to Disaster 2. In column (b), lines 2

through 5, of your 2023 Form 8915-F (2023 disasters),

you enter the amounts from lines 2 through 5 of your

filled-in Worksheet 1B, column (b). See the Filled-in

Worksheet 1B for Example 3.

distributions were made until May 9, 2023, when a

$40,000 qualified disaster distribution from your traditional

IRA was made to you. The 2023 distribution occurred

within the qualified disaster distribution period of each

disaster and, therefore, could be a qualified disaster

distribution of either disaster. You complete Worksheet 1B.

Example 1 for Worksheet 1B: Use if you are directed on line 1a of your Form 8915-F to use Worksheet 1B or if

you choose to use Worksheet 1B.

Worksheet 1B for Form 8915-F

(a)

(X)

(b)

Total

Qualified 2023²disaster distributions made in 2023¹

Qualified

available

distributi

ons in

2023²

disaster

distribution

s made in

2023¹

_____ ¹

(Total for all

Disaster

1

Disaster 2

Disaster 3 Disaster 4

disasters)

DR-4719-ME DR-4737-ME³________³________³

3

04/30/2023⁴06/26/2023⁴

01/01/2024⁵03/03/2024⁵

________⁴________⁴

________⁵________⁵

1 You do not need to use Worksheet 1B if you checked

2020 in item B of this year's Form 8915-F.

If you checked the same year in both item A and

•

item B on this year's Form 8915-F, enter -0- for each

listed Disaster in column X.

If you did not enter in item C of a prior year's Form

•

8915-F any of the disasters listed in the table at the

top of Part I of this year's Form 8915-F, enter -0- for

each listed Disaster in column X.

If you only entered one disaster in the table at the

•

top of Part I of this year's Form 8915-F and that was

the only disaster you listed in item C of the prior year's

Form 8915-F, enter the amount from line 6 of the prior

year's Form 8915-F.

For each Disaster listed in the table at the top of

•

Part I of this year's Form 8915-F that was not listed in

item C on a Form 8915-F for a prior year, enter -0- in

column (X).

If you listed two or more disasters in the table at the

•

top of Part I of this year's Form 8915-F and you filed a

Form 8915-F for a prior year on which you listed in

item C some or all of those disasters, enter in column

(X) the amounts from line 5 in column (X) of the prior

year's Worksheet 1B. If you did not use Worksheet 1B

in that prior year, allocate the amount from line 6 of

that prior year's Form 8915-F among the Disasters on

line 1 of this worksheet using any reasonable method,

except if all of the disasters listed on the prior year's

Form 8915-F are not listed on this year’s table at the

top of Part I. In the latter case, allocate the amount on

line 6 of that prior year's Form 8915-F first to the

disasters not listed in the table at the top of Part I of

this year's Form 8915-F, and allocate any remaining

amount among the Disasters on line 1 of this

Worksheet 1B using any reasonable method.

Note. If the amount on line 1 of this worksheet is

$22,000 or more for a disaster, you cannot have

qualified disaster distributions in this year for that

disaster. Remove that disaster from the list at the

top of Part I on page 1 of this year's Form 8915-F

and exclude it from your calculations for Part I of

this year's Form 8915-F.

-0-

2

3

Distributions from retirement plans (other than IRAs)

$30,000

09/08/23

Distributions from traditional, traditional SEP, and

traditional SIMPLE IRAs

$22,000

$8,000

$30,000

Distributions from Roth, Roth SEP, and Roth SIMPLE

IRAs

4

5

-0-

$22,000

-0-

$8,000

-0-

$30,000

Totals. Add lines 2 through 4.

$30,000

¹Enter year checked in item A.

²Enter year checked in item B.

³Enter the disaster's FEMA number.

⁴Enter the date the distribution period for the disaster begins.

⁵Enter the date the distribution period for the disaster ends.

14

Instructions for Form 8915-F (Rev. 1-2024)

Example 2 for Worksheet 1B: Use if you are directed on line 1a of your Form 8915-F to use Worksheet 1B or if

you choose to use Worksheet 1B.

Worksheet 1B for Form 8915-F

(a)

(X)

(b)

Total

Qualified 2023²disaster distributions made in 2023¹

Qualified

available

2023²

disaster

distribution

s made in

2023¹

distributi

ons in

_____ ¹

(Total for

Disaster

1

Disaster 2

Disaster 3 Disaster 4

all

DR-4719-ME³DR-4737-ME³________³________³

disasters)

04/30/2023⁴

01/01/2024⁵

06/26/2023⁴

03/03/2024⁵

________⁴________⁴

________⁵________⁵

1 You do not need to use Worksheet 1B if you checked

2020 in item B of this year's Form 8915-F.

If you checked the same year in both item A and

•

item B on this year's Form 8915-F, enter -0- for each

listed Disaster in column X.

If you did not enter in item C of a prior year's Form

•

8915-F any of the disasters listed in the table at the

top of Part I of this year's Form 8915-F, enter -0- for

each listed Disaster in column X.

If you only entered one disaster in the table at the

•

top of Part I of this year's Form 8915-F and that was

the only disaster you listed in item C of the prior year's

Form 8915-F, enter the amount from line 6 of the prior

year's Form 8915-F.

For each Disaster listed in the table at the top of

•

Part I of this year's Form 8915-F that was not listed in

item C on a Form 8915-F for a prior year, enter -0- in

column (X).

If you listed two or more disasters in the table at

•

the top of Part I of this year's Form 8915-F and you

filed a Form 8915-F for a prior year on which you

listed in item C some or all of those disasters, enter in

column (X) the amounts from line 5 in column (X) of

the prior year's Worksheet 1B. If you did not use

Worksheet 1B in that prior year, allocate the amount

from line 6 of that prior year's Form 8915-F among the

Disasters on line 1 of this worksheet using any

reasonable method, except if all of the disasters listed

on the prior year's Form 8915-F are not listed on this

year’s table at the top of Part I. In the latter case,

allocate the amount on line 6 of that prior year's Form

8915-F first to the disasters not listed in the table at

the top of Part I of this year's Form 8915-F, and

allocate any remaining amount among the Disasters

on line 1 of this Worksheet 1B using any reasonable

method.

Note. If the amount on line 1 of this worksheet is

$22,000 or more for a disaster, you cannot have

qualified disaster distributions in this year for that

disaster. Remove that disaster from the list at the

top of Part I on page 1 of this year's Form 8915-F

and exclude it from your calculations for Part I of

this year's Form 8915-F.

-0-

2

3

Distributions from retirement plans (other than IRAs)

$30,000

05/01/23

$14,000

09/17/23

Distributions from traditional, traditional SEP, and

traditional SIMPLE IRAs

$22,000

$14,000

$36,000

Distributions from Roth, Roth SEP, and Roth SIMPLE

4

5

IRAs

-0-

$36,000

Totals. Add lines 2 through 4.

¹Enter year checked in item A.

²Enter year checked in item B.

³Enter the disaster's FEMA number.

⁴Enter the date the distribution period for the disaster begins.

⁵Enter the date the distribution period for the disaster ends.

Instructions for Form 8915-F (Rev. 1-2024)

15

Example 3 for Worksheet 1B: Use if you are directed on line 1a of your Form 8915-F to use Worksheet 1B or if

you choose to use Worksheet 1B.

Worksheet 1B for Form 8915-F

(a)

(X)

(b)

Total

Qualified 2022²disaster distributions made in 2023¹

Qualified

available

distributi

ons in

2022²

disaster

distribution

s made in

2023¹

_____ ¹

(Total for

Disaster

1

Disaster 2

Disaster 3

Disaster 4

all

DR-4649-PR³DR-4671-PR³________³________³

disasters)

02/04/2022⁴09/17/2022⁴

06/26/2023⁵06/26/2023⁵

________⁴________⁴

________⁵________⁵

1 You do not need to use Worksheet 1B if you checked

2020 in item B of this year's Form 8915-F.

If you checked the same year in both item A and

•

item B on this year's Form 8915-F, enter -0- for each

listed Disaster in column X.

If you did not enter in item C of a prior year's Form

•

8915-F any of the disasters listed in the table at the

top of Part I of this year's Form 8915-F, enter -0- for

each listed Disaster in column X.

If you only entered one disaster in the table at the

•

top of Part I of this year's Form 8915-F and that was

the only disaster you listed in item C of the prior year's

Form 8915-F, enter the amount from line 6 of the prior

year's Form 8915-F.

For each Disaster listed in the table at the top of

•

Part I of this year's Form 8915-F that was not listed in

item C on a Form 8915-F for a prior year, enter -0- in

column (X).

If you listed two or more disasters in the table at

•

the top of Part I of this year's Form 8915-F and you

filed a Form 8915-F for a prior year on which you

listed in item C some or all of those disasters, enter in

column (X) the amounts from line 5 in column (X) of

the prior year's Worksheet 1B. If you did not use

Worksheet 1B in that prior year, allocate the amount

from line 6 of that prior year's Form 8915-F among the

Disasters on line 1 of this worksheet using any

reasonable method, except if all of the disasters listed

on the prior year's Form 8915-F are not listed on this

year’s table at the top of Part I. In the latter case,

allocate the amount on line 6 of that prior year's Form

8915-F first to the disasters not listed in the table at

the top of Part I of this year's Form 8915-F, and

allocate any remaining amount among the Disasters

on line 1 of this Worksheet 1B using any reasonable

method.

Note. If the amount on line 1 of this worksheet is

$22,000 or more for a disaster, you cannot have

qualified disaster distributions in this year for that

disaster. Remove that disaster from the list at the

top of Part I on page 1 of this year's Form 8915-F

and exclude it from your calculations for Part I of

this year's Form 8915-F.

$20,000

-0-

$20,000

-0-

2

3

Distributions from retirement plans (other than IRAs)

Distributions from traditional, traditional SEP, and

$40,000

05/09/23

traditional SIMPLE IRAs

$2,000

$22,000

$24,000

Distributions from Roth, Roth SEP, and Roth SIMPLE

IRAs

4

5

-0-

$24,000

Totals. Add lines 2 through 4.

$44,000

¹Enter year checked in item A.

²Enter year checked in item B.

³Enter the disaster's FEMA number.

⁴Enter the date the distribution period for the disaster begins.

⁵Enter the date the distribution period for the disaster ends.

the instructions for your tax return for reporting the

distributions included on line 7. See also the Instructions

for Form 5329 for this year.

Line 7. On line 7, enter the excess of the sum of lines 2

through 4 in column (a) over the amount on line 6, except

if you are also completing Part IV, or are claiming qualified

disaster distributions on Part I of more than one Form

8915 for this year. See If completing both Part I and Part IV

or filing more than one Form 8915, later. The amount on

line 7 should generally be apportioned into IRA and

pension and annuity amounts, as applicable, and reported

on your tax return as taxable distributions in accordance

with Form 5329 and the instructions for that return. See

Example. You reported a total of $40,000 in

distributions in 2023 on lines 3 and 5 in column (a). The

entire $40,000 in distributions were traditional IRA

distributions. You reported $22,000 of those distributions

on lines 3 and 5 in column (b) of your 2023 Form 8915-F.

On line 7, you reported $18,000 ($40,000 minus $22,000).

You are not completing Part IV. You will refer to your tax

16

Instructions for Form 8915-F (Rev. 1-2024)

return, Form 5329, and their instructions for directions on

how to treat this $18,000 in IRA distributions.

If completing both Part I and Part IV or filing more

than one Form 8915.

If there is no amount in box 2a of Form 1099-R and the

first box in box 2b is checked, the issuer of Form 1099-R

may not have had all the facts needed to figure the taxable

amount. You may want to get Pub. 575, Pension and

Annuity Income, to help figure your taxable amount.

Also see Pub. 575 if you use the Simplified Method

Worksheet to figure the taxable amount of your periodic

payments and you designated some of these payments as

qualified disaster distributions on the Form 8915-F you are

completing.

Step 1. If you are completing both Part I and Part IV on this

year's Form 8915-F:

On line 7, enter the excess of the sum of lines 2 through

•

4 in column (a) over the amount on line 6 reduced by the

amount from line 7 that is included on line 28 in Part IV.

On the dotted line to the left of line 7, enter "$________

•

qualified distribution for Part IV, line 28."

If you have a Form 1099-R with both qualified

Step 2. If you are claiming qualified disaster

distributions on Part I of more than one Form 8915 for this

year and you aren't completing Part IV on this year's Form

8915:

disaster distributions and nonqualified

!

CAUTION

distributions, you must separately figure the cost

attributable to each distribution.

On line 7, enter -0- and use that dollar amount as your

•

Line 11. If you don’t check the box on line 11, you must

spread the amount on line 10 over 3 years. By checking

the box, you elect to include the entire amount in income

in the year of distribution. You cannot make or change this

election after the due date (including extensions) for your

tax return. If you checked the box on line 22, you must

check the box on line 11.

If the taxpayer died after receiving a qualified disaster

distribution, the taxable amount of the distribution may not

be spread beyond the year in which they died. The

remainder of the distribution must be reported on the tax

return of the deceased taxpayer.

available distributions on the other Form 8915 you are

filing for this year.

On the dotted line to the left of line 7, enter "$________

•

used as available distribution on Part I of **** Form 8915-F

(**** disasters)."

Step 3. If you are claiming qualified disaster

distributions on Part I of more than one Form 8915-F for

this year and you are completing Part IV on this year's

Form 8915-F for the earliest disasters.

If, on the Form 8915-F for this year with the earliest

•

disasters, the amount on line 30 reduced by the amount

on line 31 is -0-, you don't have any available distributions

for the other Forms 8915-F you are filing this year.

Line 12. Use Worksheet 2 to figure the amount to enter

on line 12 of your Form 8915-F.

However, if the amount on line 30 reduced by the amount

on line 31 is a positive dollar amount, enter -0- on line 32

and use that dollar amount as your available distributions

on the other Form 8915-F you are filing for this year.

Worksheet 2 for Line 12. Total Income From

Other-Than-IRA Distributions Made in Prior

Years

On the dotted line to the left of line 32, enter

•

"$________ used as available distribution on Part I of ****

Form 8915-F (**** disasters)."

Keep for Your Records

Before you begin.

From this year's form:

Example. You reported a total of $40,000 in

distributions in 2023 on lines 3 and 5 in column (a). The

entire $40,000 in distributions were traditional IRA

distributions. You reported $22,000 of those distributions

on lines 3 and 5 in column (b) of your 2023 Form 8915-F.

On line 7, you would report $18,000 ($40,000 minus

$22,000), except you are also completing Part IV. In Part

IV, you are claiming, as qualified distributions, $10,000 of

the traditional IRA distributions that you reported in Part I.

On line 7, you will only report $8,000 ($18,000 minus

$10,000). On the dotted line to the left of line 7, you will

enter "$10,000 qualified distribution for Part IV, line 28."

You will refer to your tax return, Form 5329, and their

instructions for directions on how to treat this $8,000 in

IRA distributions.

Enter the disaster year you checked in item B _________

Enter the tax return year you checked in item A _________

•

1. Enter the amount from column (c) of

Worksheet 2: Supplemental

Information . . . . . . . . . . . . . . . . . . . . . . . 1.

2. Enter the amount from column (d) of

Worksheet 2: Supplemental

Information . . . . . . . . . . . . . . . . . . . . . . . . 2.

3. Enter the total of lines 1 and 2 here and on

line 12 of this year’s Form 8915-F . . . . . . . . 3.

Part II—Qualified Disaster

Distributions From Retirement Plans

(Other Than IRAs)

Line 9. Enter on line 9 your cost, if any. Your cost is

generally your net investment in the plan. It does not

include pre-tax contributions. If there is an amount in

box 2a of Form 1099-R, the difference between box 1 and

box 2a of Form 1099-R is usually your cost. Enter the

difference on line 9.

Instructions for Form 8915-F (Rev. 1-2024)

17

Disaster Year (item B) Tax Return year (item Worksheet 2, line 1: Enter amount, if any, from your:

Worksheet 2, line 2: Enter amount, if any, from your:

A)

2021

2022

2023

2024

2020 Form 8915-E, line 9 (if you checked the box on that

line, enter -0-)

0

2021 Form 8915-F (2020 disasters), line 11 (if you

2020 Form 8915-E, line 9 (if you checked the box on that

line, enter -0-)

checked the box on that line, enter -0-)

2020

0

2021 Form 8915-F (2020 disasters), line 11 (if you

checked the box on that line, enter -0-)

0

Insert on the applicable line of your Worksheet 2 the amount from Form 8915-F (2021 disasters), line 11,

for the tax year shown. If you checked the box on that line, enter -0-.

Tax Return year (item

Disaster Year (item B) A)

Worksheet 2, line 1

Worksheet 2, line 2

2021

2022

2023

2024

2025

2026

0

2021

2022

2023

0

2021

2022

2023

0

2021

0

Insert on the applicable line of your Worksheet 2 the amount from Form 8915-F (2022 disasters), line 11,

for the tax year shown. If you checked the box on that line, enter -0-.

Disaster Year (item B) Tax Return year

(item A)

Worksheet 2, line 1

Worksheet 2, line 2

2022

2023

2024

0

2022

2023

2024

0

2022

2023

2024

0

2022

2025

2026

2027

0

Insert on the applicable line of your Worksheet 2 the amount from Form 8915-F (2023 disasters), line 11, for

the tax year shown. If you checked the box on that line, enter -0-.

Disaster Year (item B) Tax Return year

(item A)

Worksheet 4, line 1

Worksheet 4, line 2

2023

2024

2025

0

2023

2024

2025

0

2023

2024

2025

0

2023

2026

2027

2028

0

Insert on the applicable line of your Worksheet 2 the amount from Form 8915-F (2024 disasters), line 11, for

the tax year shown. If you checked the box on that line, enter -0-.

Disaster Year (item B) Tax Return year

(item A)

Worksheet 4, line 1

Worksheet 4, line 2

2024

2025

2026

2027

2028

2029

0

2024

2025

2026

0

2024

2025

2026

0

2024

0

For Disasters that begin after 2024

Insert on the applicable line of your Worksheet 2 the amount from Form 8915-F (______ * disasters),

line 11, for the tax year shown. If you checked the box on that line, enter -0-.

Tax Return year (item

A)

Disaster Year (item B)

______*

Worksheet 2, line 1

Worksheet 2, line 2

______*

______**

______***

______****

______*****

______******

0

______*

______**

______***

0

_____*

______**

______***

0

* The year you checked in item B.

** Add 1 year to the year you checked in item B.

*** Add 2 years to the year you checked in item B.

**** Add 3 years to the year you checked in item B.

***** Add 4 years to the year you checked in item B.

****** Add 5 years to the year you checked in item B.

18

Instructions for Form 8915-F (Rev. 1-2024)

Line 14. Enter on line 14 of your Form 8915-F your total

repayments—the sum of your excess repayments carried

to this year and your repayments made for this year. See

Worksheet 3, later. A repayment is made in this year if it is

made before you filed your return for this year, and not

later than the due date (including extensions).

Part III—Qualified Disaster

Distributions From IRAs

Line 22. If you don’t check the box on line 22, you must

spread the amount on line 21 over 3 years. By checking

the box, you elect to include the entire amount in income

in the year of distribution. You cannot make or change this

election after the due date (including extensions) for your

tax return. If you checked the box on line 11, you must

check the box on line 22.

If the taxpayer died after receiving a qualified disaster

distribution, the taxable amount of the distribution may not

be spread beyond the year in which they died. The

remainder of the distribution must be reported on the tax

return of the deceased taxpayer.

At any time during the 3-year period that begins the day

after the date you received a qualified disaster distribution,

you can repay any portion of the distribution to an eligible

retirement plan that accepts rollover contributions. You

cannot, however, repay more than the amount of the

original distribution. See Repayment of a Qualified

Disaster Distribution, earlier, for details.

Worksheet 3. Use Worksheet 3 to figure the total

repayment to enter on line 14 of your Form 8915-F.

Don’t use Worksheet 3 to report repayments of

Line 23. Use Worksheet 4 to figure the amount to enter

qualified 2018 or 2019 disaster distributions.

on line 23 of your Form 8915-F.

!

CAUTION

Worksheet 4 for Line 23. Total Income From

IRA Distributions Made in Prior Years

Worksheet 3.

Keep for Your Records

1. Enter the amount, if any, from last year's Form

8915-F, line 14, except as follows.

Keep for Your Records

Before you begin.

From this year's form:

Enter the disaster year you checked in item B _________

Enter the tax return year you checked in item A _________

•

If you are completing 2021 Form 8915-F (2020

disasters), enter the amount, if any, from your

2020 Form 8915-E, line 10.

1. Enter the amount from column (c) of

Worksheet 4: Supplemental

Information . . . . . . . . . . . . . . . . . . . . . . . 1.

If you are completing 2023 Form 8915-F (2021

disasters), enter the amount, if any, from your

2022 Form 8915-F (2021 disasters), line 14, if

you completed that form. If you didn't complete

that form, enter the amount, if any, from your

2021 Form 8915-F (2021 disasters),

2. Enter the amount from column (d) of

Worksheet 4: Supplemental

Information . . . . . . . . . . . . . . . . . . . . . . . . 2.

3. Enter the total of lines 1 and 2 here and on

line 23 of this year’s Form 8915-F . . . . . . . . 3.

line 14. . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.

2. Enter the amount, if any, from last year's Form

8915-F, line 13, except as follows.

If you are completing 2021 Form 8915-F (2020

disasters), , from your 2020 Form 8915-E,

line 9.

If you are completing 2023 Form 8915-F (2021

disasters), enter the amount, if any, from your

2022 Form 8915-F (2021 disasters), line 13, if

you completed that form. If you didn't complete

that form enter the amount, if any, from your

2021 Form 8915-F (2021 disasters),

line 13. . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.

3a. Subtract line 2 from line 1. If zero or less,

enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . 3a.

ꢀb. Enter the amount from line 3a that you have

already carried back to a prior year . . . . . . . b.

ꢀc. Subtract line 3b from line 3a . . . . . . . . . . . .

c.

4. Enter the total amount of any repayments you

made, with respect to this year's Form 8915-F,

before filing this year's tax return . . . . . . . . . 4.

5. Enter the total of lines 3c and 4 here and on

line 14 of this year's Form 8915-F . . . . . . . . 5.

Worksheet 3, line 4: Don't include these amounts.

On line 4 of Worksheet 3, don't include any repayments

made later than the due date (including extensions) for

this year’s return or any repayments of nontaxable

amounts.

Instructions for Form 8915-F (Rev. 1-2024)

19

Disaster Year (item B) Tax Return year (item Worksheet 4, line 1: Enter amount, if any, from your:

Worksheet 4, line 2: Enter amount, if any, from your:

A)

2021

2022

2023

2024

2020 Form 8915-E, line 17 (if you checked the box on that

line, enter -0-)

0

2021 Form 8915-F (2020 disasters), line 22 (if you

2020 Form 8915-E, line 17 (if you checked the box on

that line, enter -0-)

checked the box on that line, enter -0-)

2020

0

2021 Form 8915-F (2020 disasters), line 22 (if you

checked the box on that line, enter -0-)

0

Insert on the applicable line of your Worksheet 4 the amount from Form 8915-F (2021 disasters), line 22,

for the tax year shown. If you checked the box on that line, enter -0-.

Tax Return year (item

Disaster Year (item B) A)

Worksheet 4, line 1

Worksheet 4, line 2

2021

2022

2023

2024

2025

2026

0

2021

2022

2023

0

2021

2022

2023

0

2021

0

Insert on the applicable line of your Worksheet 4 the amount from Form 8915-F (2022 disasters), line 22,

for the tax year shown. If you checked the box on that line, enter -0-.

Disaster Year (item B) Tax Return year

(item A)

Worksheet 4, line 1

Worksheet 4, line 2

2022

2023

2024

0

2022

2023

2024

0

2022

2023

2024

0

2022

2025

2026

2027

0

Insert on the applicable line of your Worksheet 4 the amount from Form 8915-F (2023 disasters), line 22, for

the tax year shown. If you checked the box on that line, enter -0-.

Disaster Year (item B) Tax Return year

(item A)

Worksheet 4, line 1

Worksheet 4, line 2

2023

2024

2025

0

2023

2024

2025

0

2023

2024

2025

0

2023

2026

2027

2028

0

Insert on the applicable line of your Worksheet 4 the amount from Form 8915-F (2024 disasters), line 22, for

the tax year shown. If you checked the box on that line, enter -0-.

Disaster Year (item B) Tax Return year

(item A)

Worksheet 4, line 1

Worksheet 4, line 2

2024

2025

2026

2027

2028

2029

0

2024

2025

2026

0

2024

2025

2026

0

2024

0

For Disasters that begin after 2024

Insert on the applicable line of your Worksheet 4 the amount from Form 8915-F (______* disasters), line 22,

for the tax year shown. If you checked the box on that line, enter -0-.

Tax Return year (item

A)

Disaster Year (item B)

______*

Worksheet 4, line 1

Worksheet 4, line 2

______*

______**

______***

______****

______*****

______******

0

______*

______**

______***

0

______*

______**

______***

0

* The year you checked in item B.

** Add 1 year to the year you checked in item B.

*** Add 2 years to the year you checked in item B.

**** Add 3 years to the year you checked in item B.

***** Add 4 years to the year you checked in item B.

****** Add 5 years to the year you checked in item B.

20

Instructions for Form 8915-F (Rev. 1-2024)

Line 25. Enter on line 25 of this year’s Form 8915-F your

total repayments—the sum of your excess repayments

carried to this year and your repayments made for this

year. See Worksheet 5, later. A repayment is made in this

year if it is made before you filed your return for this year,

and not later than the due date (including extensions).

Part IV—Qualified Distributions for

the Purchase or Construction of a

Main Home in Qualified Disaster

Areas

2021 Form 8915-F (2020 disasters). On 2021 Form

8915-F (2020 disasters), qualified distributions can only

be reported for the Alaska (4585-DR-AK) disaster.

At any time during the 3-year period that begins the day

after the date you received a qualified disaster distribution,

you can repay any portion of the distribution to an eligible

retirement plan that accepts rollover contributions. You

cannot, however, repay more than the amount of the

original distribution. See Repayment of a Qualified

Disaster Distribution, earlier, for details.

Complete Part IV of 2021 Form 8915-F (2020

disasters) if, on January 1, 2021, you received a qualified

distribution described in Qualified 2020 disaster areas

under Qualified Distribution for the Purchase or

Worksheet 5. Use Worksheet 5 to figure the total

repayment to enter on line 25 of your Form 8915-F.

Construction of a Main Home in Qualified Disaster Areas,

earlier, for the Alaska (4585-DR-AK) disaster. You must

complete the required lines of Part IV if you received a

qualified distribution for the Alaska (4585-DR-AK) disaster

on January 1, 2021, even if you made no repayments in

2021. Any portion of the qualified distribution not repaid

before June 26, 2021, for the Alaska (4585-DR-AK)

disaster will not be allowed the special tax benefits

available to qualified distributions.

Don’t use Worksheet 5 to report repayments of

qualified 2018 or 2019 disaster distributions.

!

CAUTION

Worksheet 5

1. Enter the amount, if any, from last year's Form

8915-F, line 25, except as follows.

If you are required to file 2021 Form 8606, complete

If you are completing 2021 Form 8915-F (2020

disasters), enter the amount, if any, from your

2020 Form 8915-E, line 18.

that form before you complete Part IV.

Note. A distribution for the purchase or construction of a

main home may be treated as a qualified 2020 disaster

distribution in certain circumstances. See Qualified 2020

disaster areas under Qualified Distribution for the

Purchase or Construction of a Main Home in Qualified

Disaster Areas, earlier.

If you are completing 2023 Form 8915-F (2021

disasters), enter the amount, if any, from your

2022 Form 8915-F (2021 disasters), line 25, if

you completed that form. If you didn't complete

that form, enter the amount, if any, from your

2021 Form 8915-F (2021 disasters),

Qualified distributions for 2021 and later disasters.

Qualified distributions can be reported for qualified 2021

and later disasters. Complete Part IV of this year's Form

8915-F for your disasters in item C if, this year, you

received a qualified distribution described in Qualified

Distribution for the Purchase or Construction of a Main

Home in Qualified Disaster Areas, earlier, for the disasters

you listed in the table at the top of Part IV on page 4 of this

year's Form 8915-F. You must complete the required lines

of Part IV if you received a qualified distribution, even if

you made no repayments this year. Any portion of the

qualified distribution not repaid by the end of the disaster's

qualified distribution repayment period will not be allowed

the special tax benefits available to qualified distributions.

If the repayment period for a qualified distribution for a

disaster ends next year, repayments for that qualified

distribution can be made in the next year and will be

reported on an amended return for this year.

Example 1. A distribution Mosley received in February

2022 is a qualified distribution for the following 2022

disaster: the Virginia Severe Winter Storm and Snowstorm

disaster (DR-4644-VA) (beginning date January 2, 2022)

(declaration date March 11, 2022). Mosley can make

repayments for this disaster through June 27, 2023.

Mosley reports the distribution on Form 8915-F, Part IV, as

a qualified distribution. Mosley doesn't make a repayment

until May 2023. The repayment must be reported on an

original or amended 2022 Form 8915-F, as applicable.

line 25. . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.

2. Enter the amount, if any, from last year's Form

8915-F, line 24, except as follows.

If you are completing 2021 Form 8915-F (2020

disasters), enter the amount, if any, from your

2020 Form 8915-E, line 17.

If you are completing 2023 Form 8915-F (2021

disasters), enter the amount, if any, from your

2022 Form 8915-F (2021 disasters), line 24, if

you completed that form. If you didn't complete

that form, enter the amount, if any, from your

2021 Form 8915-F (2021 disasters),

line 24. . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.

3a. Subtract line 2 from line 1. If zero or less,

enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . 3a.

ꢀb. Enter the amount from line 3a that you have

already carried back to a prior year . . . . . . . b.

ꢀc. Subtract line 3b from line 3a . . . . . . . . . . . .

c.

4. Enter the total amount of any repayments you

made, with respect to this year's Form 8915-F,

before filing this year's tax return . . . . . . . . . 4.

5. Enter the total of lines 3c and 4 here and on

line 25 of this year's Form 8915-F . . . . . . . . 5.

Worksheet 5, line 4: Don't include these amounts.

On line 4 of Worksheet 5, don't include any repayments

made later than the due date (including extensions) for

this year’s return or any repayments of nontaxable

amounts.

Example 2. A distribution Mosley received on

December 15, 2022, is a qualified distribution for the

Instructions for Form 8915-F (Rev. 1-2024)

21

following 2023 disaster: the Montana Flooding disaster

(DR-4745-MT) (beginning date June 1, 2023) (declaration

date October 11, 2023). Mosley can make repayments for

this disaster through April 8, 2024. Mosley reports the

distribution on Form 8915-F, Part IV, as a qualified

distribution. Mosley doesn't make a repayment until March

2024. The repayment must be reported on an original or

amended 2023 Form 8915-F, as applicable.

You can't, however, repay more than the amount of the

original distribution.

Enter on line 31 the amount of any repayments you

make within the time frame specified. Don't include any

repayments treated as rollovers on this year’s Form 8606

or any repayments of nontaxable amounts.

Line 32. Most distributions from qualified retirement

plans (including IRAs) made to you before you reach age

59¹/2 are subject to an additional tax on early distributions

and are reported on Form 5329. Qualified distributions for

the purchase or construction of a main home in a qualified

disaster area that were not repaid to an eligible retirement

plan within the time frame specified in Qualified

If you are required to file this year's Form 8606,

complete that form before you complete Part IV.

Note. A distribution for the purchase or construction of a

main home may be treated as a qualified disaster

distribution made in this year in certain circumstances.

See Qualified 2020 disaster areas and Qualified 2021 and

later disaster areas under Qualified Distribution for the

Purchase or Construction of a Main Home in Qualified

Disaster Areas, earlier.

Distribution Repayment Period under Repayment of a

Qualified Distribution for the Purchase or Construction of a

Main Home, earlier, may be subject to this additional tax

unless you qualify for an exception. See the Instructions

for Form 5329 for information on exceptions to this tax. If

you have not repaid the distribution before the specified

end date, you may be able to designate the qualified

distribution as a qualified disaster distribution. See

Qualified 2020 disaster areas and Qualified 2021 and

later disaster areas under Qualified Distribution for the

Purchase or Construction of a Main Home in Qualified

Disaster Areas, earlier.

Lines 27 Through 32

You must complete lines 27 and 28 and all other

applicable lines of Part IV for your qualified distribution(s).

Line 27. If you check the “Yes” box, but are not required

to complete lines 28 through 32, you must still file the

required Form 8915-F to show that you received a

qualified distribution.

Line 28. Enter on line 28 your qualified distributions. See

Qualified Distribution for the Purchase or Construction of a

Main Home in Qualified Disaster Areas, earlier.

Don't include any distributions you designated as

qualified disaster distributions reported on line 8 or line 20

of your Form 8915-F. Also, don't include any amounts

reported on this year’s Form 8606.

Privacy Act and Paperwork Reduction

Act Notice

We ask for the information on this form to carry out the

Internal Revenue laws of the United States. We need this

information to ensure that you are complying with these

laws and to allow us to figure and collect the right amount

of tax. You are required to give us this information if you

made certain contributions or received certain

If you are completing both Part I and Part IV on

distributions from qualified plans, including IRAs, and

other tax-favored accounts. Our legal right to ask for the

information requested on this form is sections 6001, 6011,

6012(a), and 6109 and their regulations. If you don’t

provide this information, or you provide incomplete or false

information, you may be subject to penalties. You are not

required to provide the information requested on a form

that is subject to the Paperwork Reduction Act unless the

form displays a valid OMB control number. Books or

records relating to a form or its instructions must be

retained as long as their contents may become material in

the administration of any Internal Revenue law. Generally,

tax returns and return information are confidential, as

required by section 6103. However, we may give this

information to the Department of Justice for civil and

criminal litigation, and to cities, states, the District of

Columbia, and U.S. commonwealths and possessions to

carry out their tax laws. We may also disclose this

information to other countries under a tax treaty, to federal

and state agencies to enforce federal nontax criminal

laws, or to federal law enforcement and intelligence

agencies to combat terrorism.

this year's Form 8915-F, see Line 7, earlier.

!

CAUTION

Line 29. Enter on line 29 your cost, if any. Your cost is

generally your net investment in the plan. It does not

include pre-tax contributions. If there is an amount in

box 2a of Form 1099-R, the difference between box 1 and

box 2a of Form 1099-R is usually your cost. See Pub. 575

for more information about figuring your cost in the plan.

In many cases, a hardship distribution from a 401(k)

plan or a tax-sheltered annuity contract will not have any

cost.

If you received a first-time homebuyer distribution from

an IRA, don't enter any amount on line 29. Any cost or

basis in an IRA is figured on this year’s Form 8606 if you

made nondeductible contributions.

If you have a Form 1099-R with both qualified

distributions and nonqualified distributions, you

!

CAUTION

must separately figure the cost attributable to

each distribution.

Line 31. You can repay any portion of a qualified

The average time and expenses required to complete

and file this form will vary depending on individual

circumstances. For the estimated averages, see the

instructions for your income tax return.

distribution to an eligible retirement plan that accepts

rollovers but the repayments must be made within the time

frame specified in Repayment of a Qualified Distribution

for the Purchase or Construction of a Main Home, earlier.

22

Instructions for Form 8915-F (Rev. 1-2024)

If you have suggestions for making this form simpler,

we would be happy to hear from you. See the instructions

for your income tax return.

Instructions for Form 8915-F (Rev. 1-2024)

23

Appendix A, Which Lines Should I Use?

See Qualified disaster

Part I. Form 8915-F (2020

Disasters): Lines To Use

Look for the year of the form you are

filing.

distribution requirements,

earlier, under Qualified

TIP

Disaster Distribution Requirements

for the cutoff dates for making these

distributions and for other criteria for

these distributions.

2021 Form 8915-F (2020 Disasters)

IF . . .

AND . . .

THEN . . .

Complete Parts I, II, and III, as applicable. If you received qualified distributions for

the Alaska (4585-DR-AK) disaster on January 1, 2021, complete Part IV.

If you must complete Part III, complete 2021 Form 8606 if either of the following

applies.

Qualified 2020 disaster distributions were made to

you in 2021

—

• You received a qualified 2020 disaster distribution in 2021 from a traditional,

SEP, or SIMPLE IRA, and you have a basis in the IRA.

• You received a qualified 2020 disaster distribution from a Roth IRA.

For more information, see 2021 Form 8606 and its instructions.

You did NOT check the box

on line 9 or 17 on the 2020

Form 8915-E

Complete lines 12 through 15 and lines 23 through 26, as applicable, of your 2021

Form 8915-F (2020 disasters). If you received qualified distributions for the Alaska

(4585-DR-AK) disaster on January 1, 2021, complete Part IV.

If you are repaying those distributions, complete lines 14 and 25, as applicable, of

your 2021 Form 8915-F (2020 disasters). If you received qualified distributions for the

Alaska (4585-DR-AK) disaster on January 1, 2021, complete Part IV.

If you aren’t repaying those distributions, but you received qualified distributions for

the Alaska (DR-4585-AK) disaster on January 1, 2021, complete Part IV.

If you aren’t repaying those distributions and you did NOT receive any

qualified distributions, STOP. You can’t use 2021 Form 8915-F (2020

disasters).

You claimed coronavirus-related or other qualified

2020 disaster distributions on a 2020 Form 8915-E

(2020 disasters), but qualified 2020 disaster

distributions were NOT made to you in 2021

You checked the box on

line 9 or 17 on the 2020

Form 8915-E

You received qualified

distributions for the Alaska

(4585-DR-AK) disaster on

January 1, 2021

You did NOT receive

qualified distributions on

January 1, 2021, for

4585-DR-AK

Complete Part IV.

Qualified 2020 disaster distributions were not

made to you in 2021 AND you did not file a 2020

Form 8915-E

STOP. You can’t use 2021 Form 8915-F.

24

2022 Form 8915-F (2020 Disasters)

IF . . .

AND . . .

THEN . . .

You didn’t check the box on Complete lines 12 through 15 and lines 23 through 26, as applicable, of your 2022

line 11 or 22 on the 2021

Form 8915-F (2020

disasters) AND/OR on

line 9 or 17 on the 2020

Form 8915-E

You checked the box on

line 11 or 22 on the 2021

Form 8915-F (2020

disasters) AND on line 9 or

17 on the 2020 Form

8915-E

Form 8915-F (2020 disasters).

You claimed qualified 2020 disaster distributions

on a 2021 Form 8915-F (2020 disasters) AND you

claimed coronavirus-related distributions or other

qualified 2020 disaster distributions on a 2020

Form 8915-E

If you are repaying those distributions, complete lines 14 and 25, as applicable, of your

2022 Form 8915-F.

If you aren’t repaying those distributions, you can’t use 2022 Form 8915-F (2020

disasters).

You claimed qualified 2020 disaster distributions

on a 2021 Form 8915-F (2020 disasters) but you

did not claim coronavirus-related distributions or

other qualified 2020 disaster distributions on a

2020 Form 8915-E

Complete lines 12 through 15 and lines 23 through 26, as applicable, of your 2022

Form 8915-F (2020 disasters).

You didn’t check the box on

line 11 or 22 on the 2021

Form 8915-F (2020

disasters)

You didn’t checked the box Complete lines 12 through 15 and lines 23 through 26, as applicable, of your 2022

on line 9 or 17 on the 2020 Form 8915-F (2020 disasters).

You claimed coronavirus-related distributions or

other qualified 2020 disaster distributions on a

2020 Form 8915-E but not on a 2021 Form 8915-F

(2020 disasters)

Form 8915-E

If you are repaying those distributions, complete lines 14 and 25, as applicable, of your

You checked the box on

2023 Form 8915-F (2020 disasters).

line 9 or 17 on the 2020

If you aren’t repaying those distributions, STOP. You can’t use 2023 Form

Form 8915-E

8915-F.

You did NOT claim qualified 2020 disaster

distributions on a 2021 Form 8915-F (2020

disasters) AND you did not claim

coronavirus-related distributions or other qualified

2020 disaster distributions on a 2020 Form 8915-E

STOP. You can’t use 2023 Form 8915-F (2020 disasters).

—

2023 Form 8915-F (2020 Disasters)

IF . . .

AND . . .

THEN . . .

You did not check the box on line 11

or 22 on that form

Complete lines 12 through 15 and lines 23 through 26, as

applicable, of your 2023 Form 8915-F (2020 disasters).

If you are repaying qualified 2020 disaster distributions

made in 2020 or in 2021, complete lines 14 and 25, as

applicable, of your 2023 Form 8915-F (2020 disasters). .

If you aren’t repaying qualified 2020 disaster distributions

made in 2020 or in 2021, you can’t use 2023 Form 8915-F

(2020 disasters).

You claimed qualified 2020 disaster distributions on a 2021 Form

8915-F (2020 disasters)

You checked the box on line 11 or 22

on that form

If you are repaying coronavirus-related distributions or

other qualified 2020 disaster distributions, complete lines

14 and 25, as applicable, of your 2023 Form 8915-F (2020

disasters).

If you aren’t repaying coronavirus-related

distributions or other qualified 2020 disaster

distributions, STOP. You can’t use 2023 Form 8915-F

(2020 disasters).

You claimed coronavirus-related distributions or other qualified 2020

disaster distributions on a 2020 Form 8915-E and you did NOT claim

qualified 2020 disaster distributions on a 2021 Form 8915-F (2020

disasters)

—

You did NOT claim qualified 2020 disaster distributions on a 2021

Form 8915-F (2020 disasters) AND you did not claim

coronavirus-related distributions or other qualified 2020 disaster

distributions on a 2020 Form 8915-E

STOP. You can’t use 2023 Form 8915-F (2020

disasters).

Note. This is the last year in which a coronavirus-related distribution can be repaid. You cannot repay a coronavirus-related distribution later than 3 years and one day after the

coronavirus-related distribution was received.

25

2024 Form 8915-F (2020 Disasters)

IF . . .

AND . . .

THEN . . .

You claimed qualified 2020 disaster distributions other than

coronavirus-related distributions on a 2020 Form 8915-E and you did

NOT claim qualified 2020 disaster distributions on a 2021 Form

8915-F (2020 disasters)

If you are repaying qualified 2020 disaster distributions

other than coronavirus-related distributions, complete lines

14 and 25, as applicable, of your 2024 Form 8915-F (2020

disasters).

If you aren’t repaying qualified 2020 disaster

distributions other than coronavirus-related

distributions, STOP. You can’t use 2024 Form 8915-F

(2020 disasters).

—

You did NOT claim qualified 2020 disaster distributions on a 2021

Form 8915-F (2020 disasters) AND you did not claim

coronavirus-related distributions or other qualified 2020 disaster

distributions on a 2020 Form 8915-E

STOP. You can’t use 2024 Form 8915-F (2020

disasters).

Note: Coronavirus-related distributions can NOT be repaid after 2023.

26

3. Complete lines 23 through 26

No qualified disaster distributions

It can also occur if no qualified

•

Part II. Form 8915-F (2021 and

Later Disasters): Lines To Use

For qualified 2021 and later

disasters, follow the instructions in

the numerical bullet below that best

describe your situation.

1. Complete Part I and, as

applicable, Parts II, III, and IV if

qualified disaster distributions were

made to you this year for a disaster

listed in item C of this year’s Form

8915-F.

if:

disaster distributions were made to

you this year; on, an earlier Form

8915-F, you did not check the box on

line 11 and/or 22 (thus spreading the

income over 3 years); the 3 years for

reporting income on your

•

were made to you this year.

•

On an earlier Form 8915-F, you did

not check the box on line 22 (thus

spreading the income over 3 years)

and, on line 23 of this year’s Form

8915-F, you must report income from

those distributions.

distributions has passed; the

repayment period for the qualified

disaster distributions has not ended;

and you received no qualified

distributions this year.

You received no qualified

•

distributions this year.

4. Complete line 14 and/or 25, as

applicable, if you are only making

repayments this year.

5. Complete Part IV also in any of

the scenarios above if you received

qualified distributions this year.

6. Complete Part IV if you

received qualified distributions this

year and if you are not completing

Part I, and are not required to

complete any lines in Part II or III, on

this year’s Form 8915-F.

2. Complete lines 12 through 15

if:

No qualified disaster distributions

•

This can occur if no qualified

•

were made to you this year.

disaster distributions were made to

you this year; on, an earlier Form

8915-F, you checked the box on

line 11 and/or 22 (thus not spreading

the income over 3 years); the

On an earlier Form 8915-F, you did

•

not check the box on line 11 (thus

spreading the income over 3 years)

and, on line 12 of this year’s Form

8915-F, you must report income from

those distributions.

repayment period for the disaster has

not ended; and you received no

qualified distributions this year.

You received no qualified

•

distributions this year.

27

Appendix B, Worksheets

Blank Worksheets 1A-1,1B, 2, 3, 4,

and 5 are in this appendix. If you

complete any of these worksheets in

determining amounts to enter on

lines 1a through 5, 12, 14, 23, and

25, of this year’s Form 8915-F, attach

the page(s) with the completed

worksheet(s) to this year’s Form

8915-F.

28

Keep for Your Records

Worksheet 1A-1.

Name

Social Security No.

(b)

(a)

(c)

First Form 8915-F

Total distributions in this year Qualified disaster distributions

Allocation of column (b)

2

3

4

Distributions from retirement plans (other than

IRAs) made this year

Distributions from traditional, SEP, and SIMPLE

IRAs made this year

Distributions from Roth IRAs made this year

(a)

Available distributions for this year

Second Form 8915-F

2

3

4

Enter, in column (a), distributions from retirement plans (other

than IRAs) made this year.

Enter, in column (a), distributions from traditional, SEP, and

SIMPLE IRAs made this year.

Enter, in column (a), distributions from Roth IRAs made this

year.

29

Worksheet 1B: Use if you are directed on line 1a of your Form 8915-F to

use Worksheet 1B.

Keep for Your Records

Name

Social Security No.

(X)

Qualified _____²disaster distributions made in _____¹

Worksheet 1B for Form 8915-F

(a)

(b)

Qualified

Total

available

_____²disaster

distributions

made in _____¹

distributi

ons in

_____ ¹

(Total for all

Disaster 1 Disaster 2

Disaster 3

Disaster 4

disasters)

________³________³

________⁴________⁴

________⁵________⁵

________³

________⁴

________⁵

________³

________⁴

________⁵

1 You do not need to use Worksheet 1B if you checked

2020 in item B of this year's Form 8915-F.

If you checked the same year in both item A and

•

item B on this year's Form 8915-F, enter -0- for each

listed Disaster in column X.

If you did not enter in item C of a prior year's Form

•

8915-F any of the disasters listed in the table at the top

of Part I of this year's Form 8915-F, enter -0- for each

listed Disaster in column X.

If you only entered one disaster in the table at the

•

top of Part I of this year's Form 8915-F and that was

the only disaster you listed in item C of the prior year's

Form 8915-F, enter the amount from line 6 of the prior

year's Form 8915-F.

For each Disaster listed in the table at the top of

•

Part I of this year's Form 8915-F that was not listed in

item C on a Form 8915-F for a prior year, enter -0- in

column (X).

If you listed two or more disasters in the table at the

•

top of Part I of this year's Form 8915-F and you filed a

Form 8915-F for a prior year on which you listed in item

C some or all of those disasters, enter in column (X)

the amounts from line 5 in column (X) of the prior

year's Worksheet 1B. If you did not use Worksheet 1B

in that prior year, allocate the amount from line 6 of that

prior year's Form 8915-F among the Disasters on

line 1 of this worksheet using any reasonable method,

except if all of the disasters listed on the prior year's

Form 8915-F are not listed on this year’s table at the

top of Part I. In the latter case, allocate the amount on

line 6 of that prior year's Form 8915-F first to the

disasters not listed in the table at the top of Part I of

this year's Form 8915-F, and allocate any remaining

amount among the Disasters on line 1 of this

Worksheet 1B using any reasonable method.

Note. If the amount on line 1 of this worksheet is

$22,000 or more for a disaster, you cannot have

qualified disaster distributions in this year for that

disaster. Remove that disaster from the list at the

top of Part I on page 1 of this year's Form 8915-F

and exclude it from your calculations for Part I of

this year's Form 8915-F.

2

3

4

5

Distributions from retirement plans (other than IRAs)

Distributions from traditional, SEP, and SIMPLE IRAs

Distributions from Roth IRAs

Totals. Add lines 2 through 4.

¹Enter year checked in item A.

²Enter year checked in item B.

³Enter the disaster's FEMA number.

⁴Enter the date the distribution period for the disaster begins.

⁵Enter the date the distribution period for the disaster ends.

30

Worksheet 2 for Line 12. Total Income From Other- Than-IRA Distribu-

tions Made in Prior Years

Keep for Your Records

Name

SSN

Before you begin.

From this year's form:

Enter the disaster year you checked in item B _________

Enter the tax return year you checked in item A _________

•

1.

2.

3.

Enter the amount from column (c) of Worksheet 2: Supplemental Information . . . . . . . . . . . . . . .

Enter the amount from column (d) of Worksheet 2: Supplemental Information . . . . . . . . . . . . . . .

Enter the total of lines 1 and 2 here and on line 12 of this year’s Form 8915-F . . . . . . . . . . . . . . .

1.

2.

3.

31

Worksheet 2: Supplemental Information

This section provides the information you will need to complete lines 1 and 2 of Worksheet 2.

(a)

(b)

(c)

(d)

Disaster Year (item B)

Tax Return year (item A) Worksheet 2, line 1: Enter amount, if any, from your:

Worksheet 2, line 2: Enter amount, if any, from your:

2021

2022

2023

2024

2020 Form 8915-E, line 9 (if you checked the box on that line,

enter -0-)

0

2021 Form 8915-F (2020 disasters), line 11 (if you checked the box 2020 Form 8915-E, line 9 (if you checked the box on that line,

on that line, enter -0-)

enter -0-)

2020

0

2021 Form 8915-F (2020 disasters), line 11 (if you checked the box

on that line, enter -0-)

0

Insert on the applicable line of your Worksheet 2 the amount from Form 8915-F (2021 disasters), line 11, for the tax year

shown. If you checked the box on that line, enter -0-.

Disaster Year (item B)

Tax Return year (item A)

Worksheet 2, line 1

Worksheet 2, line 2

2021

2022

2023

2024

2025

2026

0

2021

2022

2023

0

2021

2022

2023

0

2021

0

Insert on the applicable line of your Worksheet 2 the amount from Form 8915-F (2022 disasters), line 11, for the tax year

shown. If you checked the box on that line, enter -0-.

Disaster Year (item B)

Tax Return year

(item A)

Worksheet 2, line 1

Worksheet 2, line 2

2022

2023

2024

2025

2026

2027

0

2022

2023

2024

0

2022

2023

2024

0

2022

0

Insert on the applicable line of your Worksheet 2 the amount from Form 8915-F (2023 disasters), line 11, for the tax year

shown. If you checked the box on that line, enter -0-.

Disaster Year (item B)

Tax Return year

(item A)

Worksheet 2, line 1

Worksheet 2, line 2

2023

2024

2025

2026

2027

2028

0

2023

2024

2025

0

2023

2024

2025

0

2023

0

Insert on the applicable line of your Worksheet 2 the amount from Form 8915-F (2024 disasters), line 11, for the tax year

shown. If you checked the box on that line, enter -0-.

Disaster Year (item B)

Tax Return year

(item A)

Worksheet 2, line 1

Worksheet 2, line 2

2024

2025

2026

2027

2028

2029

0

2024

2025

2026

0

2024

2025

2026

0

2024

0

For Disasters that begin after 2024

Insert on the applicable line of your Worksheet 2 the amount from Form 8915-F (______ * disasters), line 11, for the tax year

shown. If you checked the box on that line, enter -0-.

Disaster Year (item B)

Tax Return year (item A)

Worksheet 2, line 1

Worksheet 2, line 2

______*

______**

0

______*

______**

______***

0

______***

______****

______*****

______******

_____*

______**

______***

0

______*

0

* The year you checked in item B.

** Add 1 year to the year you checked in item B.

*** Add 2 years to the year you checked in item B.

**** Add 3 years to the year you checked in item B.

***** Add 4 years to the year you checked in item B.

****** Add 5 years to the year you checked in item B.

32

Keep for Your Records

Worksheet 3

Name

SSN

1.

Enter the amount, if any, from last year's Form 8915-F, line 14, except as follows.

If you are completing 2021 Form 8915-F (2020 disasters), enter the amount, if any, from your

2020 Form 8915-E, line 10.

If you are completing 2023 Form 8915-F (2021 disasters), enter the amount, if any, from your

2022 Form 8915-F (2021 disasters), line 14, if you completed that form. If you didn't complete

that form, enter the amount, if any, from your 2021 Form 8915-F (2021 disasters),

line 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1.

2.

Enter the amount, if any, from last year's Form 8915-F, line 13, except as follows.

If you are completing 2021 Form 8915-F (2020 disasters), enter the amount, if any, from your

2020 Form 8915-E, line 9.

If you are completing 2023 Form 8915-F (2021 disasters), enter the amount, if any, from your

2022 Form 8915-F (2021 disasters), line 13, if you completed that form. If you didn't complete

that form, enter the amount, if any, from your 2021 Form 8915-F (2021 disasters),

line 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2.

3a.

b.

3a.

ꢀb.

ꢀc.

4.

Subtract line 2 from line 1. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Enter the amount from line 3a that you have already carried back to a prior year . . . . . . . . . . .

Subtract line 3b from line 3a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c.

Enter the total amount of any repayments you made, with respect to this year’s Form 8915-F,

before filing this year's tax return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Enter the total of lines 3c and 4 here and on line 14 of this year's Form 8915-F . . . . . . . . . . . .

4.

5.

33

Worksheet 4 for Line 23. Total Income From IRA Distributions Made in

Prior Years

Keep for Your Records

Name

SSN

Before you begin.

From this year's form:

Enter the disaster year you checked in item B _________

Enter the tax return year you checked in item A _________

•

1.

2.

3.

Enter the amount from column (c) of Worksheet 4: Supplemental Information . . . . . . . . . . . .

Enter the amount from column (d) of Worksheet 4: Supplemental Information . . . . . . . . . . . .

Enter the total of lines 1 and 2 here and on line 23 of this year’s Form 8915-F . . . . . . . . . . . .

1.

2.

3.

34

Keep for Your Records

Worksheet 4: Supplemental Information

This section provides the information you will need to complete lines 1 and 2 of Worksheet 4.

(a)

(b)

(c)

(d)

Disaster Year (item B)

Tax Return year (item A) Worksheet 4, line 1: Enter amount, if any, from your:

Worksheet 4, line 2: Enter amount, if any, from your:

2021

2022

2023

2024

2020 Form 8915-E, line 17 (if you checked the box on that line,

enter -0-)

0

2021 Form 8915-F (2020 disasters), line 22 (if you checked the box 2020 Form 8915-E, line 17 (if you checked the box on that line,

on that line, enter -0-)

enter -0-)

2020

0

2021 Form 8915-F (2020 disasters), line 22 (if you checked the box

on that line, enter -0-)

0

Insert on the applicable line of your Worksheet 4 the amount from Form 8915-F (2021 disasters), line 22, for the tax year

shown. If you checked the box on that line, enter -0-.

Disaster Year (item B)

Tax Return year (item A)

Worksheet 4, line 1

Worksheet 4, line 2

2021

2022

2023

2024

2025

2026

0

2021

2022

2023

0

2021

2022

2023

0

2021

0

Insert on the applicable line of your Worksheet 4 the amount from Form 8915-F (2022 disasters), line 22, for the tax year

shown. If you checked the box on that line, enter -0-.

Disaster Year (item B)

Tax Return year

(item A)

Worksheet 4, line 1

Worksheet 4, line 2

2022

2023

2024

2025

2026

2027

0

2022

2023

2024

0

2022

2023

2024

0

2022

0

Insert on the applicable line of your Worksheet 4 the amount from Form 8915-F (2023 disasters), line 22, for the tax year

shown. If you checked the box on that line, enter -0-.

Disaster Year (item B)

Tax Return year

(item A)

Worksheet 4, line 1

Worksheet 4, line 2

2023

2024

2025

2026

2027

2028

0

2023

2024

2025

0

2023

2024

2025

0

2023

0

Insert on the applicable line of your Worksheet 4 the amount from Form 8915-F (2024 disasters), line 22, for the tax year

shown. If you checked the box on that line, enter -0-.

Disaster Year (item B)

Tax Return year

(item A)

Worksheet 4, line 1

Worksheet 4, line 2

2024

2025

2026

2027

2028

2029

0

2024

2025

2026

0

2024

2025

2026

0

2024

0

For Disasters that begin after 2024

Insert on the applicable line of your Worksheet 4 the amount from Form 8915-F (______* disasters), line 22, for the tax year

shown. If you checked the box on that line, enter -0-.

Disaster Year (item B)

Tax Return year (item A)

Worksheet 4, line 1

Worksheet 4, line 2

______*

______**

0

______*

______**

______***

0

______***

______****

______*****

______******

______*

______**

______***

0

______*

0

* The year you checked in item B.

** Add 1 year to the year you checked in item B.

*** Add 2 years to the year you checked in item B.

**** Add 3 years to the year you checked in item B.

***** Add 4 years to the year you checked in item B.

****** Add 5 years to the year you checked in item B.

35

Keep for Your Records

Worksheet 5

Name

SSN

1.

Enter the amount, if any, from last year's Form 8915-F, line 25, except as follows.

If you are completing 2021 Form 8915-F (2020 disasters), enter the amount, if any, from your 2020

Form 8915-E, line 18.

If you are completing 2023 Form 8915-F (2021 disasters), enter the amount, if any, from your 2022

Form 8915-F (2021 disasters), line 25, if you completed that form. If you didn't complete that form,

enter the amount, if any, from your 2021 Form 8915-F (2021 disasters), line 25 . . . . . . . . . . . . . . .

1.

2.

Enter the amount, if any, from last year's Form 8915-F, line 24, except as follows.

If you are completing 2021 Form 8915-F (2020 disasters), enter the amount, if any, from your 2020

Form 8915-E, line 17.

If you are completing 2023 Form 8915-F (2021 disasters), enter the amount, if any, from your 2022

Form 8915-F (2021 disasters), line 24, if you completed that form. If you didn't complete that form,

enter the amount, if any, from your 2021 Form 8915-F (2021 disasters), line 24 . . . . . . . . . . . . . . .

Subtract line 2 from line 1. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Enter the amount from line 3a that you have already carried back to a prior year . . . . . . . . . . . . . . .

Subtract line 3b from line 3a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2.

3a.

b.

3a.

ꢀb.

ꢀc.

4.

c.

Enter the total amount of any repayments you made, with respect to this year's Form 8915-F, before

filing this year's tax return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Enter the total of lines 3c and 4 here and on line 25 of this year's Form 8915-F. . . . . . . . . . . . . . . . .

4.

5.

36

disaster declaration date. Scan down

to that date in the "Later of

disaster distributions for your disaster

was August 27, 2023.

Appendix C, Last Day To

Make Qualified Disaster

Distributions for Your

Disaster

Declaration and Beginning Date"

column. The last day on which you

can make qualified disaster

We add here the two dates not in

the table below. For a disaster for

which the later of the disaster

declaration date and disaster

beginning date was:

distributions for your disaster will be

the corresponding date in the "Last

Day To Make Qualified Disaster

Distribution for Disaster" column. For

example, if the later of your disaster's

declaration or beginning date was

March 1, 2023, the table below

shows the last day to make qualified

This is the appendix referenced in All

other disasters, including some 2022

disasters under Qualified disaster

distribution period, earlier. This

December 30, 2022, the last day to

•

make qualified disaster distributions

for the disaster was June 27, 2023;

or

appendix counts the 179 days for

you. To use this appendix, you must

first determine which is later, your

disaster beginning date or your

December 31, 2022, the last day to

•

make qualified disaster distributions

for the disaster was June 28, 2023.

Last Day To Make Qualified Disaster Distributions for Your Disaster

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for

Disaster

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for

Disaster

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for Disaster

January 2023

February 2023

March 2023

1

June 29, 2023

1

July 30, 2023

1

August 27, 2023

2

30

2

31

2

28

3

July 1, 2023

3

August 1, 2023

3

29

4

2

4

2

4

30

5

3

5

3

5

31

6

4

6

4

6

September 1, 2023

7

5

7

5

7

2

8

6

8

6

8

3

9

7

9

7

9

4

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

8

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

8

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

5

9

6

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

37

Last Day To Make Qualified Disaster Distributions for Your Disaster (continued)

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for

Disaster

Later of

Declaration or

Beginning Date

Last Day To Make

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for Disaster

April 2023

May 2023

1

June 2023

1

September 27, 2023

October 27, 2023

1

November 27, 2023

2

28

2

28

2

28

3

29

3

29

3

29

4

30

4

30

4

30

5

October 1, 2023

5

31

5

December 1, 2023

6

2

6

November 1, 2023

6

2

7

3

7

2

7

3

8

4

8

3

8

4

9

5

9

4

9

5

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

6

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

5

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

6

7

6

7

8

7

8

9

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

38

Last Day To Make Qualified Disaster Distributions for Your Disaster (continued)

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for

Disaster

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for

Disaster

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for Disaster

July 2023

1

August 2023

September 2023

December 27, 2023

1

January 27, 2024

1

February 27, 2024

2

28

2

28

2

28

3

29

3

29

3

29

4

30

4

30

4

March 1, 2024

5

31

5

31

5

2

6

January 1, 2024

6

February 1, 2024

6

3

7

2

7

2

7

4

8

3

8

3

8

5

9

4

9

4

9

6

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

5

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

5

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

7

6

8

7

9

8

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

39

Last Day To Make Qualified Disaster Distributions for Your Disaster (continued)

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for

Disaster

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for

Disaster

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for Disaster

October 2023

November 2023

December 2023

1

March 28, 2024

1

April 28, 2024

1

May 28, 2024

2

29

2

29

2

29

3

30

3

30

3

30

4

31

4

May 1, 2024

4

31

5

April 1, 2024

5

2

5

June 1, 2024

6

2

6

3

6

2

7

3

7

4

7

3

8

4

8

5

8

4

9

5

9

6

9

5

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

6

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

7

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

6

7

8

7

8

9

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

40

Last Day To Make Qualified Disaster Distributions for Your Disaster (continued)

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for

Disaster

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for

Disaster

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for Disaster

January 2024

February 2024

March 2024

1

June 28, 2024

1

July 29, 2024

1

August 27, 2024

2

29

2

30

2

28

3

30

3

31

3

29

4

July 1, 2024

4

August 1, 2024

4

30

5

2

5

2

5

31

6

3

6

3

6

September 1, 2024

7

4

7

4

7

2

8

5

8

5

8

3

9

6

9

6

9

4

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

7

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

7

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

5

8

6

9

7

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

41

Last Day To Make Qualified Disaster Distributions for Your Disaster (continued)

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for

Disaster

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for

Disaster

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for Disaster

April 2024

May 2024

1

June 2024

1

September 27, 2024

October 27, 2024

1

November 27, 2024

2

28

2

28

2

28

3

29

3

29

3

29

4

30

4

30

4

30

5

October 1, 2024

5

31

5

December 1, 2024

6

2

6

November 1, 2024

6

2

7

3

7

2

7

3

8

4

8

3

8

4

9

5

9

4

9

5

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

6

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

5

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

6

7

6

7

8

7

8

9

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

42

Last Day To Make Qualified Disaster Distributions for Your Disaster (continued)

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for

Disaster

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for

Disaster

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for Disaster

July 2024

1

August 2023

September 2024

December 27, 2024

1

January 27, 2025

1

February 27, 2025

2

28

2

28

2

28

3

29

3

29

3

March 1, 2025

4

30

4

30

4

2

5

31

5

31

5

3

6

January 1, 2025

6

February 1, 2025

6

4

7

2

7

2

7

5

8

3

8

3

8

6

9

4

9

4

9

7

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

5

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

5

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

8

6

9

7

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

43

Last Day To Make Qualified Disaster Distributions for Your Disaster (continued)

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for

Disaster

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for

Disaster

Later of

Declaration or

Beginning Date

Last Day To Make

Qualified Disaster

Distribution for Disaster

October 2024

November 2024

December 2024

1

March 29, 2025

1

April 29, 2025

1

May 29, 2025

2

30

2

30

2

30

3

31

3

May 1, 2025

3

31

4

April 1, 2025

4

2

4

June 1, 2025

5

2

5

3

5

2

6

3

6

4

6

3

7

4

7

5

7

4

8

5

8

6

8

5

9

6

9

7

9

6

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

7

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

8

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

7

8

9

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

44

date. Scan down to that date in the

"Later of declaration and beginning

date" column. The last day on which

you can repay your Part IV qualified

distribution will be the corresponding

date in the "Last day to repay your

Part IV qualified distribution" column.

For example, if the later of your

We add here the two dates not in

the table below. For a disaster for

which the later of the disaster

declaration date and disaster

beginning date was:

Appendix D, Last Day To

Repay Your Part IV

Qualified Distribution

This is the appendix referenced in All

other 2021 and later disasters under

Qualified Distribution Repayment

Period, earlier. This appendix counts

the 180 days for you. To use this

appendix, you must first determine

which is later, your disaster beginning

date or your disaster declaration

December 30, 2022, the last day to

•

repay qualified distributions for the

disaster was June 28, 2023; or

disaster's declaration or beginning

date was March 1, 2023, the table

below shows the last day to make

qualified disaster distributions for

your disaster was August 28, 2023.

December 31, 2022, the last day to

•

repay qualified distributions for the

disaster was June 29, 2023.

Last Day To Repay Your Part IV Qualified Distribution

Later of

Declaration or

Beginning Date

Last Day To Repay

Your Part IV Qualified

Distribution

Later of

Declaration or

Beginning Date

Last Day To Repay

Your Part IV Qualified

Distribution

Later of

Declaration or

Beginning Date

Last Day To Repay

Your Part IV Qualified

Distribution

January 2023

February 2023

March 2023

1

June 30, 2023

1

July 31, 2023

1

August 28, 2023

2

July 1, 2023

2

August 1, 2023

2

29

3

2

3

2

3

30

4

3

4

3

4

31

5

4

5

4

5

September 1, 2023

6

5

6

5

6

2

7

6

7

6

7

3

8

7

8

7

8

4

9

8

9

8

9

5

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

6

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

45

Last Day To Repay Your Part IV Qualified Distribution (continued)

Later of

Declaration or

Beginning Date

Last Day To Repay

Your Part IV Qualified

Distribution

Later of

Declaration or

Beginning Date

Last Day To Repay

Your Part IV Qualified

Distribution

Later of

Declaration or

Beginning Date

Last Day To Repay

Your Part IV Qualified

Distribution

April 2023

May 2023

1

June 2023

1

September 28, 2023

October 28, 2023

1

November 28, 2023

2

29

2

29

2

29

3

30

3

30

3

30

4

October 1, 2023

4

31

4

December 1, 2023

5

2

5

November 1, 2023

5

2

6

3

6

2

6

3

7

4

7

3

7

4

8

5

8

4

8

5

9

6

9

5

9

6

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

7

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

6

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

7

8

7

8

9

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

46

Last Day To Repay Your Part IV Qualified Distribution (continued)

Later of

Declaration or

Beginning Date

Last Day To Repay

Your Part IV Qualified

Distribution

Later of

Declaration or

Beginning Date

Last Day To Repay

Your Part IV Qualified

Distribution

Later of

Declaration or

Beginning Date

Last Day To Repay Your

Part IV Qualified

Distribution

July 2023

1

August 2023

September 2023

December 28, 2023

1

January 28, 2024

1

February 28, 2024

2

29

2

29

2

29

3

30

3

30

3

March 1, 2024

4

31

4

31

4

2

5

January 1, 2024

5

February 1, 2024

5

3

6

2

6

2

6

4

7

3

7

3

7

5

8

4

8

4

8

6

9

5

9

5

9

7

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

6

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

6

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

8

7

9

8

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

47

Last Day To Repay Your Part IV Qualified Distribution (continued)

Later of

Declaration or

Beginning Date

Last Day To Repay

Your Part IV Qualified

Distribution

Later of

Declaration or

Beginning Date

Last Day To Repay

Your Part IV Qualified

Distribution

Later of

Declaration or

Beginning Date

Last Day To Repay Your

Part IV Qualified

Distribution

October 2023

November 2023

December 2023

1

March 29, 2024

1

April 29, 2024

1

May 29, 2024

2

30

2

30

2

30

3

31

3

May 1, 2024

3

31

4

April 1, 2024

4

2

4

June 1, 2024

5

2

5

3

5

2

6

3

6

4

6

3

7

4

7

5

7

4

8

5

8

6

8

5

9

6

9

7

9

6

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

7

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

8

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

7

8

9

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

48

Last Day To Repay Your Part IV Qualified Distribution (continued)

Later of

Declaration or

Beginning Date

Last Day To Repay

Your Part IV Qualified

Distribution

Later of

Declaration or

Beginning Date

Last Day To Repay

Your Part IV Qualified

Distribution

Later of

Declaration or

Beginning Date

Last Day To Repay Your

Part IV Qualified

Distribution

January 2024

February 2024

March 2024

1

June 29, 2024

1

July 30, 2024

1

August 28, 2024

2

30

2

31

2

29

3

July 1, 2024

3

August 1, 2024

3

30

4

2

4

2

4

31

5

3

5

3

5

September 1, 2024

6

4

6

4

6

2

7

5

7

5

7

3

8

6

8

6

8

4

9

7

9

7

9

5

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

8

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

8

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

6

9

7

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

49

Last Day To Repay Your Part IV Qualified Distribution (continued)

Later of

Declaration or

Beginning Date

Last Day To Repay

Your Part IV Qualified

Distribution

Later of

Declaration or

Beginning Date

Last Day To Repay

Your Part IV Qualified

Distribution

Later of

Declaration or

Beginning Date

Last Day To Repay

Your Part IV Qualified

Distribution

April 2024

May 2024

1

June 2024

1

September 28, 2024

October 28, 2024

1

November 28, 2024

2

29

2

29

2

29

3

30

3

30

3

30

4

October 1, 2024

4

31

4

December 1, 2024

5

2

5

November 1, 2024

5

2

6

3

6

2

6

3

7

4

7

3

7

4

8

5

8

4

8

5

9

6

9

5

9

6

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

7

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

6

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

7

8

7

8

9

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

50

Last Day To Repay Your Part IV Qualified Distribution (continued)

Later of

Declaration or

Beginning Date

Last Day To Repay

Your Part IV Qualified

Distribution

Later of

Declaration or

Beginning Date

Last Day To Repay

Your Part IV Qualified

Distribution

Later of

Declaration or

Beginning Date

Last Day To Repay

Your Part IV Qualified

Distribution

July 2024

1

August 2024

September 2024

December 27, 2024

1

January 27, 2025

1

February 27, 2025

2

28

2

28

2

28

3

29

3

29

3

March 1, 2025

4

30

4

30

4

2

5

31

5

31

5

3

6

January 1, 2025

6

February 1, 2025

6

4

7

2

7

2

7

5

8

3

8

3

8

6

9

4

9

4

9

7

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

5

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

5

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

8

6

9

7

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

51

Last Day To Repay Your Part IV Qualified Distribution (continued)

Later of

Declaration or

Beginning Date

Last Day To Repay

Your Part IV Qualified

Distribution

Later of

Declaration or

Beginning Date

Last Day To Repay

Your Part IV Qualified

Distribution

Later of

Declaration or

Beginning Date

Last Day To Repay

Your Part IV Qualified

Distribution

October 2024

November 2023

December 2024

1

March 29, 2025

1

April 29, 2025

1

May 29, 2025

2

30

2

30

2

30

3

31

3

May 1, 2025

3

31

4

April 1, 2025

4

2

4

June 1, 2025

5

2

5

3

5

2

6

3

6

4

6

3

7

4

7

5

7

4

8

5

8

6

8

5

9

6

9

7

9

6

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

7

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

8

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

7

8

9

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

52

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