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8915- F forma Instrukcijos

8915- F formos kvalifikuoto nedarbingumo plano išplatinimo ir grąžinimo nurodymai

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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  
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  
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  
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/  
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  
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  
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  
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  
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  
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 To Make  
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  
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  
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  
all of the following requirements. See Main home and  
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 To  
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  
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  
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  
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  
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  
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  
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  
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  
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-  
-0-  
$22,000  
-0-  
-0-  
-0-  
-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 20232 disaster 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
04/30/20234 06/26/20234  
01/01/20245 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-  
-0-  
-0-  
-0-  
-0-  
-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  
1 Enter year checked in item A.  
2 Enter year checked in item B.  
3 Enter the disaster's FEMA number.  
4 Enter the date the distribution period for the disaster begins.  
5 Enter 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 20232 disaster 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-ME3 DR-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-  
-0-  
-0-  
-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  
$22,000  
$14,000  
$14,000  
$36,000  
Distributions from Roth, Roth SEP, and Roth SIMPLE  
4
5
IRAs  
-0-  
$36,000  
Totals. Add lines 2 through 4.  
1 Enter year checked in item A.  
2 Enter year checked in item B.  
3 Enter the disaster's FEMA number.  
4 Enter the date the distribution period for the disaster begins.  
5 Enter 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 20222 disaster 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-PR3 DR-4671-PR3 ________3 ________3  
disasters)  
02/04/20224 09/17/20224  
06/26/20235 06/26/20235  
________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  
$2,000  
$22,000  
$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  
1 Enter year checked in item A.  
2 Enter year checked in item B.  
3 Enter the disaster's FEMA number.  
4 Enter the date the distribution period for the disaster begins.  
5 Enter 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
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
0
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
0
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
0
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
0
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
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
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
0
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
0
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
0
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
0
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
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  
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.  
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  
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  
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  
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?  
Part I. Form 8915-F (2020  
Disasters): Lines To Use  
Look for the year of the form you are  
filing.  
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.  
1 Enter year checked in item A.  
2 Enter year checked in item B.  
3 Enter the disaster's FEMA number.  
4 Enter the date the distribution period for the disaster begins.  
5 Enter 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
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
0
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
0
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
0
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
0
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
______***  
______****  
______*****  
______******  
_____*  
______**  
______***  
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.  
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
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
0
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
0
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
0
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
0
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
______***  
______****  
______*****  
______******  
______*  
______**  
______***  
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.  
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  
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
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  
Qualified Disaster  
Distribution for 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
6
8
7
7
9
8
8
10  
11  
12  
13  
14  
15  
16  
17  
18  
19  
20  
21  
22  
23  
24  
25  
26  
27  
9
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
8
6
9
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
6
9
7
7
10  
11  
12  
13  
14  
15  
16  
17  
18  
19  
20  
21  
22  
23  
24  
25  
26  
27  
28  
8
8
9
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