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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 
Contents                                                              Page
                                                                             known as qualified disaster recovery distributions). 
Future Developments     . . . . . . . . . . . . . . . . . . . . . . . .   1
                                                                             As a result of section 331 of the SECURE 2.0 Act of 2022, 
What’s New . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  1  enacted December 29, 2022, you are now eligible for the 
Reminders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1  benefits of Form 8915-F if you were adversely affected by 
General Instructions  . . . . . . . . . . . . . . . . . . . . . . . . .   2  a qualified 2021 or later disaster and you received a 
Helpful Hints     . . . . . . . . . . . . . . . . . . . . . . . . . . .   2  distribution described in Qualified Disaster Distribution 
How Do I Distinguish My Form 8915-F and Its                                  Requirements or Qualified Distribution Requirements, 
Disasters From Other Forms 8915-F?                      . . . . . . . .   2  later. Qualified disaster distributions (such as qualified 
                                                                             2021 disaster distributions, qualified 2022 disaster 
Purpose of Form         . . . . . . . . . . . . . . . . . . . . . . . .   2
                                                                             distributions, qualified 2023 disaster distributions, 
Purpose of These Instructions . . . . . . . . . . . . . . .               2  qualified 2024 disaster distributions, etc.) are also called 
When Should I Not Use a Form 8915-F?                    . . . . . . . .   2  qualified disaster recovery distributions.
Who Must File       . . . . . . . . . . . . . . . . . . . . . . . . . .   2
                                                                             Dollar limit. For qualified 2021 and later disasters, the 
When and Where To File . . . . . . . . . . . . . . . . . . .              3  dollar limit on Form 8915-F for retirement plan 
What Is a Qualified Disaster Distribution? . . . . . . .                  3  distributions is $22,000 per disaster. It was $100,000 but 
Qualified Disaster Distribution           . . . . . . . . . . . . . . .   3  that was for qualified 2020 disasters.
Qualified Distribution for the Purchase or                                   Determining the qualified disaster distribution peri-
Construction of a Main Home in Qualified                                     od, in Part I, for a disaster. The qualified disaster 
Disaster Areas          . . . . . . . . . . . . . . . . . . . . . . . .   6  distribution period for each disaster still begins on the day 
Amending Form 8915-F              . . . . . . . . . . . . . . . . . . .   8  the disaster began. The last day of the qualified disaster 
Specific Instructions . . . . . . . . . . . . . . . . . . . . . . . . .   9  distribution period for most qualified 2021 disasters and 
Required General Information              . . . . . . . . . . . . . .     10 many qualified 2022 disasters is June 26, 2023. But the 
Part I—Total Distributions From All Retirement                               last day of the qualified disaster distribution period for 
Plans (Including IRAs)            . . . . . . . . . . . . . . . . . .     10 qualified 2023 and later disasters, some qualified 2022 
Part II—Qualified Disaster Distributions From                                disasters, and perhaps even a few qualified 2021 
Retirement Plans (Other Than IRAs)                      . . . . . . .     17 disasters will have to be separately calculated. See 
                                                                             Qualified disaster distribution period, later.
Part III—Qualified Disaster Distributions From 
IRAs       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    19 Determining the qualified distribution repayment pe-
Part IV—Qualified Distributions for the                                      riod, in Part IV, for a disaster.  The qualified distribution 
Purchase or Construction of a Main Home                                      repayment period for each disaster still begins on the day 
in Qualified Disaster Areas               . . . . . . . . . . . . . .     21 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, 
Future Developments
                                                                             2023. But the last day of the qualified distribution 
For the latest information about developments related to                     repayment period for qualified 2023 and later disasters, 
Form 8915-F and its instructions, such as legislation                        some qualified 2022 disasters, and perhaps even a few 
enacted after they were published, go to IRS.gov/                            qualified 2021 disasters will have to be separately 
Form8915F.                                                                   calculated. See Qualified Distribution Repayment Period, 
                                                                             later.
What’s New                                                                   Determining the disaster's FEMA number and other 
                                                                             information.  See Qualified disaster area, later, for 
SEP IRAs and SIMPLE IRAs.               Section 601 of the                   information on where to find a disaster’s FEMA number, 
SECURE 2.0 Act of 2022 allows for the creation of Roth                       beginning date, and declaration date.
accounts for SEP IRAs and SIMPLE IRAs beginning 
January 1, 2023. As a result, accounts we had previously                     Worksheet 1B.   Worksheet 1B is a tool you may have to 
referred to as "SEP IRAs" and "SIMPLE IRAs" in these                         use in figuring amounts for lines 1a through 5 of Form 
instructions will now be called traditional SEP and                          8915-F. See Worksheet 1B, later, to determine whether 
traditional SIMPLE IRAs, respectively. We will refer to the                  you must use Worksheet 1B. You can choose to use 
newly enacted Roth accounts as "Roth SEP IRAs" and                           Worksheet 1B even if you are not required to do so.
"Roth SIMPLE IRAs," respectively. See, for example, the 
2023 Instructions for Form 8606.

Jan 30, 2024                                                        Cat. No. 37509G

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• 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
Form 8915-F can be e-filed. Form 8915-F can be
Disaster Areas, later, that you received this year.
completed electronically and e-filed with your tax return.
Form 8915-F is a forever form. Form 8915-F is a If you were adversely affected by a qualified 2020
redesigned Form 8915. Additional alphabetical Forms disaster, use Form 8915-F to report:
8915 (that is, Form 8915-G, Form 8915-H, etc.) will not be • A qualified disaster distribution described in Qualified
issued. The same Form 8915-F will be used for disaster distribution requirements, later, that was made to
distributions for qualified 2020 disasters (and qualified you in 2021 (coronavirus-related distributions can't be
2021 and later disasters) and for each year of reporting of made after December 30, 2020);
income and repayments of those distributions. The boxes • A repayment of, or income from, a qualified disaster
you check in items A and B will help us determine the distribution (including a coronavirus-related distribution) in
exact year of the form you are filing, and the year of the this year; or
qualified disasters, qualified disaster distributions, and • A qualified distribution described in Qualified 2021 and
qualified distributions you are reporting. Earlier Forms later disaster areas under Qualified Distribution for the
8915 had a different alphabetical Form 8915 for each year Purchase or Construction of a Main Home in Qualified
of disasters and a different form for each year the Disaster Areas, later, that you received on January 1,
alphabetical form existed. See How Do I Distinguish My 2021, for the Washington (8593-DR-WA) disaster.
Form 8915-F and Its Disasters From Other Forms 8915-F See Amending Form 8915-F, later.
and When Should I Not Use a Form 8915-F, later.
Purpose of These Instructions
The Instructions for Form 8915-F (Rev. January
TIP 2023) and the Instructions for Form 8915-F (Rev. These instructions provide detailed information for use
February 2022) contain information, including with your Form 8915-F. For your convenience, Parts I and
examples, relevant to earlier tax years. II of Appendix A, Which Lines Should I Use, later, provide,
as well, the lines you should complete on your Form
This year. "This year" (as used on Form 8915-F and in 8915-F for all tax years applicable to 2020 and later
these instructions) is the year of the form you check in disasters.
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-
How Do I Distinguish My Form 8915-F and Its tions for qualified 2020 disasters made or received in
Disasters From Other Forms 8915-F? 2020. This form replaces Form 8915-E for tax years
Name of form. These instructions will use different beginning after 2020. Do not use a Form 8915-F to
names to refer to your Form 8915-F depending on the report, in Part I, qualified 2020 disaster distributions made
boxes you check in items A and B at the top of page 1 of in 2020 or, in Part IV, qualified distributions received in
your Form 8915-F. For example, if you checked the 2023 2019 or 2020 for qualified 2020 disasters.
box in item A and the 2022 box in item B, your form will be You will still use 2020 Form 8915-E to report
referred to in these instructions and elsewhere as “2023 ! coronavirus-related and other qualified disaster
Form 8915-F (2022 disasters).” See Names of disasters CAUTION distributions made in 2020 and to report qualified
and distributions next. distributions received in 2020 for qualified 2020 disasters.
Names of disasters and distributions. Except when
referring to them generally, these instructions will refer to Qualified 2019 and earlier disasters. Do not use Form
the different qualified disasters and qualified disaster 8915-F to report repayments or income from qualified
distributions by their specific names using the year(s) you disaster distributions for 2019 and earlier disasters.

checked in item A and item B at the top of page 1 of your Who Must File
Form 8915-F. For example, if you checked 2023 in item B,
your qualified disasters are referred to as “qualified 2023 File Form 8915-F for the year you checked in item A at the
disasters” and your qualified disaster distributions are top of page 1 of the form if any of the following apply to
referred to as “qualified 2023 disaster distributions.” you for that year for the disasters listed in items C and D.
• A qualified disaster distribution was made to you from
Purpose of Form an eligible retirement plan.
If you were adversely affected by a qualified 2021 or later • You received a qualified distribution.
disaster, use Form 8915-F to report: • A qualified disaster distribution was made to you in a
prior year that you are including in income in equal
• A qualified disaster distribution described in Qualified
amounts over 3 years and "this year" is a year within the
disaster distribution requirements, later, that was made to
3-year period.
you this year;
• A repayment of, or income from, a qualified disaster • You made a repayment of a qualified disaster
distribution and the time for filing the Form 8915-F for that
distribution reported on Part I of a Form 8915-F from this
repayment has not expired.
or an earlier year; or

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

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Which Lines Should I Complete? • The qualified 2023 disaster distributions for qualified
2023 disasters reported on 2023 Form 8915-F (2023
If you e-file your return, the software you use may disasters).
TIP determine which lines you need.
Qualified disaster distributions for 2024 and later years
Fill in your name and social security number at the top are the distributions reported, like those for other years, in
of page 1 of your Form 8915-F. As indicated earlier, Part I of a Form 8915-F for the year because they meet the
complete items A and B, selecting the item A tax year and criteria in the next section. In all cases, the year checked
the item B disaster year. Also, complete items C and D, as in item B of your Form 8915-F is the year in which the
applicable. disaster began. There are always qualified disaster
You might not need to enter amounts on each line of distributions that can be made for a disaster in the year
your Form 8915-F. Parts I and II of Appendix A, Which the disaster began and, for certain disasters, in the year or
Lines Should I Use, later, provide the lines you need to 2 after the disaster began.

complete on Form 8915-F for each year relating to your Qualified Disaster Distribution
disasters. The lines you use will depend on:
• Whether qualified disaster distributions were made to How Is a Qualified Disaster Distribution Taxed?
you,
Generally, a qualified disaster distribution is included in
• Whether you have received qualified distributions,
your income in equal amounts over 3 years, beginning
• Whether you are recognizing income from distributions,
with the year in which the distribution was made. However,
and
if you elect, you can include the entire distribution in your
• Whether you are repaying distributions.
income in the year the distribution was made.
When and Where To File
Any repayments made before you file your return, by
File your Form 8915-F with your Form 1040, 1040-SR, or the due date (including extensions), and no later than 3
1040-NR for the year checked in item A at the top of years and 1 day after the distribution was received, reduce
page 1 of your Form 8915-F. For example, you will file your the amount of the distribution included in your income.
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
The timing of your distributions and repayments will additional 10% tax (or the 25% additional tax for certain
determine whether you need to file an amended return to distributions from traditional SIMPLE and Roth SIMPLE
claim them. To determine whether you need to amend IRAs) on early distributions.
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 CAUTION! before the last tax year of that 3-year period, the
Distribution? distribution may no longer be spread over 3 years. The
The distributions that are a qualified disaster distributions remainder of the distribution must be reported on the
for tax years 2021 or later follow. return of the deceased taxpayer. Include the remainder in
the line 13 and/or line 24 totals, as applicable, of the Form
For 2021, qualified disaster distributions are: 8915-F for the year of their last tax return.
• The qualified 2019 disaster distributions for the Puerto
Rico Earthquakes (DR-4473-PR) reported on 2021 Form Qualified Disaster Distribution Requirements
8915-D,
• The qualified 2020 disaster distributions for qualified A coronavirus-related distribution can't be made
2020 disasters reported on 2021 Form 8915-F (2020 ! after 2020. See Qualified disaster distribution
disasters), and CAUTION period, later, to figure when your qualified disaster
• The qualified 2021 disaster distributions for qualified distribution can be made. Also, a distribution is not a
2021 disasters reported on 2021 Form 8915-F (2021 qualified disaster distribution if it is listed in Distributions
disasters). that are not qualified disaster distributions, later. See
Limit, later, for the dollar limit on qualified disaster
For 2022, qualified disaster distributions are: distributions.
• The qualified 2021 disaster distributions for qualified
2021 disasters reported on 2022 Form 8915-F (2021 Qualified disaster distribution requirements.
disasters), or Qualified disaster distributions must meet the following
• The qualified 2022 disaster distributions for qualified criteria. (Coronavirus-related distributions can't be made
2022 disasters reported on 2022 Form 8915-F (2022 in 2021 or later years.) You must meet these requirements
disasters). separately for each of your disasters that you are reporting
For 2023, qualified disaster distributions are: in item C on Form 8915-F.
• The qualified 2021 disaster distributions for qualified 1. The distribution was made:
2020 disasters reported on 2023 Form 8915-F (2021 • For 2020 disasters (other than the coronavirus), no later
disasters), than June 24, 2021; or
• The qualified 2022 disaster distributions for qualified • For 2021 and later disasters, within the disaster's
2022 disasters reported on 2023 Form 8915-F (2022 qualified disaster distribution period. See Qualified
disasters), and disaster distribution period, later.

Instructions for Form 8915-F (Rev. 1-2024) 3

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2. Your main home was located in a qualified disaster All other disasters, including some 2022 disasters.
area at any time during the disaster period shown for that For all other disasters (including 2022 disasters not
area. See Main home, later. The qualified disaster area is described in Most, but not all, 2021 and 2022 disasters),
the state, territory, or tribal government in which the the qualified disaster distribution period will end 179 days
disaster occurs. after the disaster beginning date or the disaster
3. You sustained an economic loss because of the declaration date, whichever is later. If this section applies
disaster(s) in (2) above. Examples of an economic loss to your disaster, see Appendix C, Last Day To Make
include, but aren't limited to: (a) loss, damage to, or Qualified Disaster Distributions for Your Disaster, later, for
destruction of real or personal property from fire, flooding, the last date on which a qualified disaster distribution can
looting, vandalism, theft, wind, or other cause; (b) loss be made for your disaster.
related to displacement from your home; or (c) loss of Example 1. Mosley was eligible for qualified 2022
livelihood due to temporary or permanent layoffs. disaster distributions for the Washington Severe Winter
Storm, Straight-line Winds, Flooding, Landslides, and
If (1) through (3) apply, you can generally designate any
Mudslides disaster (DR-4682-WA) (beginning date
distribution (including periodic payments and required
November 3, 2022) (declaration date January 12, 2023).
minimum distributions) from an eligible retirement plan as
Qualified disaster distributions can be made for this
a qualified disaster distribution, regardless of whether the
disaster through July 10, 2023, even though this is a 2022
distribution was made on account of a qualified disaster.
disaster. July 10, 2023, is exactly 179 days after January
Qualified disaster distributions are permitted without
12, 2023. See also Appendix C, later.
regard to your need or the actual amount of your
economic loss. See Eligible retirement plan, later, for the Example 2. Alex was eligible for qualified 2022
list of plans from which qualified disaster distributions can disaster distributions for the Havasupai Tribe Flooding
be made. Event disaster (DR-4681) (beginning date October 1,
A reduction or offset of your account balance in an 2022) (declaration date December 30, 2022). Qualified
eligible retirement plan (other than an IRA) in order to disaster distributions can be made for this disaster
repay a loan can also be designated as a qualified through June 27, 2023, even though this is a 2022
disaster distribution. See Distribution of plan loan offsets, disaster. June 27, 2023, is exactly 179 days after
later. December 30, 2022. See also Appendix C, later.
Example 3. Sam was eligible for qualified 2023
Qualified disaster distribution period. As a result of
disaster distributions for the Georgia Severe Weather
the SECURE 2.0 Act of 2022, enacted December 29,
disaster (DR-4685-GA) (beginning date January 12, 2023)
2022, the period for making qualified disaster distributions
(declaration date January 16, 2023). Qualified disaster
for qualified disasters that begin after 2020 does not have
distributions can be made for this disaster through July 14,
a set ending date based on the year of the disaster, but
2023. July 14, 2023, is exactly 179 days after January 16,
must be separately calculated for each of your qualified
disasters. The qualified disaster distribution period for a 2023. See also Appendix C, later.
qualified disaster will begin on the date the disaster Distributions that are not qualified disaster distribu-
begins and will end 179 days after whichever of the tions. The following distributions are not qualified
following occurs the latest. disaster distributions.
• Disaster beginning date. • Corrective distributions of elective deferrals and
• Disaster declaration date. employee contributions that are returned to the employee
• December 29, 2022. (together with the income allocable thereto) in order to
All 2020 disasters. For 2020 disasters, these comply with the section 415 limitations.
instructions replace Form 8915-E for 2021 and later tax • Excess elective deferrals under section 402(g), excess
years. The distribution period for all qualified 2020 contributions under section 401(k), and excess aggregate
disasters (other than coronavirus-related distributions) contributions under section 401(m).
ended on June 24, 2021. The distribution period for • Loans that are treated as deemed distributions
coronavirus-related distributions ended December 30, pursuant to section 72(p).
2020. • Dividends paid on applicable employer securities under
Most, but not all, 2021 and 2022 disasters. If your section 404(k).
disaster began in 2021 (or 2022 on or before December • The cost of current life insurance protection.
29, 2022) and your disaster was declared as a major • Prohibited allocations that are treated as deemed
disaster on or before December 29, 2022, then the period distributions pursuant to section 409(p).
for making qualified disaster distributions for that disaster • Distributions that are permissible withdrawals from an
will end on June 26, 2023. June 26, 2023, is exactly 179 eligible automatic contribution arrangement within the
days after December 29, 2022. meaning of section 414(w).
• Distributions of premiums for accident or health
Example. Mosley was eligible for qualified 2022
insurance under Treasury Regulations section
disaster distributions for the following 2022 disaster.
1.402(a)-1(e)(1)(i).
Disaster: Virginia Severe Winter Storm and Snowstorm
disaster (DR-4644-VA) (beginning date January 2, 2022) Limit. For each qualified 2020 disaster, the total of your
(declaration date March 11, 2022). Qualified disaster qualified disaster distributions from all plans is limited to
distributions can be made through June 26, 2023, for that $100,000. For each qualified 2021 or later disaster, the
disaster. total of your qualified disaster distributions from all plans is

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

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limited to $22,000. You may allocate the amount among a qualified disaster and you can't include that disaster on
the plans by any reasonable method when determining a Form 8915-F.
the amounts on lines 2, 3, and 4 of column (b) if all three
of the following apply. 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
3. The total on line 5, column (a), of your Form 8915-F Year (Start) Year (End)
exceeds your total available qualified disaster distribution –Any– –Any–
amount from line 1e of your Form 8915-F.
Distribution of plan loan offsets. A distribution of a TIP: Modify the start and end year(s) to broaden search.
plan loan offset is a distribution that occurs when, under
Declaration Type Incident Type
the terms of a plan, the participant’s accrued benefit is
–Any– ▲ –Any– ▲
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 State/Tribe
offsets are treated as actual distributions and are reported –Choose some options– ▲
in box 1 of Form 1099-R. ▼
Main home. Generally, your main home is the home
where you live most of the time. A temporary absence due Search and Filter Disasters
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 Additional Tax and Qualified Disaster
the list of qualified disaster areas is in Appendix B in the Distributions
Instructions for Form 8915-F (Rev. February 2022). For Qualified disaster distributions aren’t subject to the
qualified 2021 and later disasters, the qualified disaster additional 10% tax (or the 25% additional tax for certain
area is the state, territory, or tribal government in which a distributions from traditional SIMPLE and Roth SIMPLE
qualified disaster, described next, occurred. IRAs) on early distributions and aren’t required to be
Qualified disaster. A qualified disaster is a disaster reported on Form 5329. However, the amount on line 7 of
that the President has declared as a major disaster. It is your Form 8915-F may be subject to the additional tax.
also known as a federally declared major disaster. The See the Instructions for Form 5329 on how to figure the
FEMA numbers for these major disasters include the additional tax on your distributions.
letters "DR" in capital letters. To determine whether the
President has declared a disaster as a major disaster, go Note. If you choose to treat a distribution as a qualified
to FEMA.gov/disaster/declarations. On that page, make disaster distribution, it is not eligible for the 20% capital
the four selections below and then click the Search and gain election or the 10-year tax option. For information on
Filter Disasters box. The Declared Disasters table in these those options, see the instructions for Form 4972.
instructions displays how that FEMA page appears.
Repayment of a Qualified Disaster Distribution
1. In the Declaration Date box:
If you choose, you can generally repay any portion of a
• Under Year (Start), enter the year before your disaster
qualified disaster distribution that is eligible for tax-free
began;
rollover treatment to an eligible retirement plan. Also, you
• Under Year (End), enter a year that is 2 years after the
can repay a qualified disaster distribution made on
year in which your disaster began, if available. Otherwise,
account of hardship from a retirement plan. However, see
enter the year after the disaster began.
Exceptions, later, for qualified disaster distributions you
2. In the Declaration Type box, select Major Disaster can’t repay.
Declaration.
Your repayment can't be made any earlier than the day
3. In the Incident Type box, select Any, or the type of after the date you received the qualified disaster
disaster if you want to be more specific. distribution. You have 3 years from the day after the date
4. In the State/Tribe box, select or enter the state, you received the distribution to make a repayment. The
territory, or tribal government in which your disaster amount of your repayment cannot be more than the
occurred. amount of the original distribution. Amounts that are
repaid are treated as a trustee-to-trustee transfer and are
If your disaster is among the results for that search, place
not included in income. Also, for purposes of the
the FEMA number for your qualified disaster in item C on
one-rollover-per-year limitation for IRAs, a repayment to
page 1 of your Form 8915-F, and in the table at the top of
an IRA is not considered a rollover.
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

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distributions reported on this year's return. Do not include Qualified Distribution for the
on this year's Form 8915-F any repayments you made
later than the due date (including extensions) for filing this Purchase or Construction of a Main
year's return. However, you may report those repayments
Home in Qualified Disaster Areas
on next year's return or carry the repayments back to an
earlier year, as applicable. See Carrybacks under How Is a Qualified Distribution Taxed?
Amending Form 8915-F, later. As noted above, amounts
paid later than 3 years and 1 day after you received the A qualified distribution is included in your income in the
distribution can't be repayments. year of the distribution. Any repayments made before you
timely file your return for that year (including extensions)
Example 1. In 2022, Rudy made a qualified 2022 reduce the amount of the distribution included in your
disaster distribution from their traditional IRA. Rudy did not income on that return. Repayments made during the
check the box on line 22, choosing instead to spread the qualified distribution repayment period for the disaster, but
income from the distribution over 3 years (2022, 2023, and after the year of the distribution, can be carried back to
2024). Rudy didn't repay any portion of the distribution reduce the income from the distribution. Unlike with
until 2024 when Rudy made a repayment of that qualified disaster distributions, the income can't be spread
distribution before timely filing their 2023 return. Rudy over 3 years and the repayment period is much shorter
includes those repayments on their 2023 Form 8915-F than 3 years. See Qualified Distribution Repayment
(2022 disasters). Those repayments reduced the amount Period, later.
of qualified 2022 disaster distributions reported on Rudy's
return for 2023 and any excess may be carried back to Also, qualified distributions aren't subject to the
2022 on an amended 2022 Form 8915-F or forward to additional 10% tax (or the 25% additional tax for certain
2024. 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 Qualified Distribution Requirements
date (including extensions) of Rudy's 2023 return. Rudy
cannot include those repayments on their 2023 Form Qualified 2020 disaster areas. The earliest tax year in
8915-F (2022 disasters). The repayments will reduce the item A on Form 8915-F is 2021. Qualified distributions for
amount of Rudy’s qualified 2022 disaster distributions only one 2020 disaster can be made in 2021, the Alaska
made for 2024 and included in income on their 2024 Severe Storm, Flooding, Landslides, and Mudslides
return and any excess may be carried back on an (4585-DR-AK). To be a qualified distribution on 2021 Form
amended 2022 or 2023 Form 8915-F to reduce income on 8915-F (2020 disasters) for the purchase or construction
their 2022 or 2023 return. of a main home in a qualified 2020 disaster area, the
Eligible retirement plan. An eligible retirement plan distribution must meet all of the following requirements.
can be any of the following. 1. The disaster was the Alaska Severe Storm,
• A qualified pension, profit-sharing, or stock bonus plan Flooding, Landslides, and Mudslides (4585-DR-AK).
(including a 401(k) plan). Leave 2021 Form 8915-F (2020 disasters), Part IV, blank if
• A qualified annuity plan. your only qualified 2020 disaster was any other 2020
• A tax-sheltered annuity contract. disaster (including the coronavirus).
• A governmental section 457 deferred compensation 2. The distribution is a hardship distribution from a
plan. 401(k) plan, a hardship distribution from a tax-sheltered
• An IRA. annuity contract, or a qualified first-time homebuyer
Exceptions. You cannot repay the following types of distribution from an IRA.
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
beneficiary (other than a surviving spouse). construct a main home in Alaska and the main home was
2. Required minimum distributions. not purchased or constructed because of the disaster.
3. Any distribution (other than from an IRA) that is one See Main home, earlier. The disaster area is the state,
of a series of substantially equal periodic payments made territory, or tribal government in which the disaster occurs.
(at least annually) for:
Qualified 2021 and later disaster areas. A qualified
a. A period of 10 years or more, distribution for the purchase or construction of a main
b. Your life or life expectancy, or home in a qualified 2021 or later disaster area must meet
c. The joint lives or joint life expectancies of you and all of the following requirements. See Main home and
your beneficiary. Qualified disaster area, earlier.
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)

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3. The distribution was received no more than 180 • December 29, 2022.
days before the first day of the disaster and no later than Most, but not all, 2021 and 2022 disasters. If your
30 days after the last day of the disaster. disaster began in 2021 or 2022 (on or before December
4. The distribution was to be used to purchase or 29, 2022) and your disaster was declared as a major
construct a main home in the disaster's qualified disaster disaster on or before December 29, 2022, then the period
area and the main home must not have been purchased for repaying qualified distributions for that disaster will end
or constructed because of the disaster. See Main home on June 27, 2023. June 27, 2023, is exactly 180 days after
and Qualified disaster area, earlier. December 29, 2022.
Example. Taylor was eligible for qualified distributions
The Additional Tax and Qualified Distributions for the Virginia Severe Winter Storm and Snowstorm
Qualified distributions aren't subject to the additional 10% (DR-4644-VA) disaster (beginning date January 2, 2022).
tax (or the 25% additional tax for certain distributions from Taylor made a qualified distribution on December 5, 2021.
traditional SIMPLE and Roth SIMPLE IRAs) on early Taylor has until June 27, 2023, to repay the qualified
distributions and aren't required to be reported on Form distribution.
5329. However, the amount on line 32 of your Form All other 2021 and later disasters. For all other
8915-F may be subject to the additional tax. See the disasters, the qualified distribution repayment period will
Instructions for Form 5329 on how to figure the additional end 180 days after the disaster beginning date or the
tax on your distributions. disaster declaration date, whichever is later. If this section
If the qualified distribution was received in 2020 applies to your disaster, see Appendix D, Last Day To
Repay Your Part IV Qualified Distribution, later, for the last
CAUTION later.
! for a 2021 disaster, see Amending Form 8915-F, date on which you can repay a qualified distribution for
your disaster.
Repayment of a Qualified Distribution for the Example 1. Mosley was eligible for qualified
Purchase or Construction of a Main Home distributions for the Washington Severe Winter Storm,
Straight-line Winds, Flooding, Landslides, and Mudslides
You can choose to repay your qualified distribution to an
(DR-4682-WA) disaster (beginning date November 3,
eligible retirement plan at any time during the qualified
2022) (declaration date January 12, 2023). Qualified
disaster repayment period for the disaster. See Eligible
distributions can be repaid for this disaster through July
retirement plan, earlier and Qualified Distribution
11, 2023, even though this is a 2022 disaster. July 11,
Repayment Period below. Amounts that are repaid, during
2023, is exactly 180 days after January 12, 2023. See
the qualified distribution repayment period for the disaster,
Appendix D, later.
are treated as a trustee-to-trustee transfer and are not
included in income. For purposes of the Example 2. Alex was eligible for qualified distributions
one-rollover-per-year limitation for IRAs, a repayment to for the Havasupai Tribe Flooding Event (DR-4681)
an IRA is not considered a rollover. disaster (beginning date October 1, 2022) (declaration
date December 30, 2022). Qualified distributions can be
If the qualified distribution (or any portion thereof) is not repaid for this disaster through June 28, 2023, even
repaid on or before the last day of the qualified distribution though this is a 2022 disaster. June 28, 2023, is exactly
repayment period for the disaster, it may be taxable and 180 days after December 30, 2022. See Appendix D,
may be subject to the additional 10% tax (or the additional later.
25% tax for certain traditional SIMPLE and Roth SIMPLE
IRAs) on early distributions. See the Instructions for Form Example 3. Sam was eligible for qualified distributions
5329 to figure any tax. for the Georgia Severe Weather (DR-4685-GA) disaster
(beginning date January 12, 2023) (declaration date
January 16, 2023). Qualified distributions can be repaid
Qualified Distribution Repayment Period
for this disaster through July 15, 2023. July 15, 2023, is
The last day of the repayment period for 2020 and later exactly 180 days after January 16, 2023. See Appendix D,
disasters is below. later.

2020 disasters. The repayment period for a qualified Designating qualified distribution as qualified
distribution for the Alaska Severe Storm, Flooding, disaster distribution
Landslides, and Mudslides (4585-DR-AK) disaster, to You may be able to designate a qualified distribution for a
purchase or construct a main home in Alaska ended on disaster as a qualified disaster distribution if all of the
June 25, 2021. following apply.
2021 and later disasters. As a result of the SECURE 1. The distribution (or any portion thereof) is not repaid
2.0 Act of 2022, enacted December 29, 2022, the period on or before the last day of the qualified distribution
for repaying a qualified distribution for a disaster that repayment period for the disaster.
begins after 2020 does not have a set ending date, but
2. The distribution can otherwise be treated as a
must be calculated. The qualified distribution repayment
qualified disaster distribution. See Qualified disaster
period for each of those qualified disasters will begin on
distribution requirements, earlier.
the date the disaster begins and will end 180 days after
whichever of the following occurs the latest.
• Disaster beginning date.
• Disaster declaration date.

Instructions for Form 8915-F (Rev. 1-2024) 7

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Amending Form 8915-F • 2021 or later, include the carried back amount on
line 14 of the Form 8915-F back to which you are carrying
File Form 1040-X, Amended U.S. Individual Income Tax the excess payment.
Return, to amend a return you have already filed.
Generally, Form 1040-X must be filed for a credit or refund If the original distribution was an IRA distribution and
within 3 years after the date the original return was filed, or you are carrying an excess repayment back to:
within 2 years after the date the tax was paid, whichever is • 2020, include the carried back amount on 2020 Form
later. 8915-E, line 18;
• 2021 or later, include the carried back amount on
Qualified disaster distributions. Depending on when a line 25 of the Form 8915-F back to which you are carrying
repayment is made, you may need to file an amended tax the excess payment.
return to refigure your taxable income. Step 2. Add this sentence. Enter "$_______
Include on this year's Form 8915-F any timely carryback from [enter here the year the excess carryback
repayments you made before filing this year's tax return. occurred] Form 8915-[E or F, as applicable]" on the dotted
Do not include on that Form 8915-F any repayments you line to the left of the line on which you are including the
made later than the due date (including extensions) for carried back amount.
filing that return. Example 1. On your 2020 Form 8915-E, you reported
If you make a timely repayment after timely filing this a coronavirus-related distribution of $9,000 made to you
year's tax return but by the due date of that return from your traditional IRA on April 14, 2020. You spread the
(including extensions), include the repayment on an income over 3 years ($3,000 in each of 2020, 2021, and
original or amended, as applicable, Form 8915-F for this 2022). You made no repayments of the distribution in 2020
year. or 2021. On March 14, 2023, you made a repayment of
If you make a timely repayment after the due date of $4,500. The entire $4,500 is an excess repayment that
this year's return (including extensions) but before the due can be carried back to 2020, 2021, or 2022. You carry
date of next year's return (including extensions), include back $3,000 to 2022, reporting $3,000 of the repayment
the repayment on next year's Form 8915-F. However, you on your 2022 Form 8915-F (2020 disasters), line 25. The
may file a Form 1040-X amending this year's or an earlier excess repayment of $1,500 can be carried back to 2021
year's Form 8915-F or a 2020 Form 8915-E, as applicable. and reported on your 2021 Form 8915-F (2020 disasters),
line 25, or carried back to 2020 and reported on your 2020
Example 1. You received a coronavirus-related
Form 8915-E, line 18. On the dotted line to the left of your
distribution in the amount of $9,000 on November 19,
2022 Form 8915-F (2020 disasters), line 25, you enter
2020. You choose to spread the $9,000 over 3 years
"$3,000 excess repayment from 2023 Form 8915-F (2020
($3,000 in income for 2020, 2021, and 2022). On
disasters)." On the dotted line to the left of your 2021
November 6, 2023, you make a repayment of $4,500. For
Form 8915-F (2020 disasters), line 25, or your 2020 Form
2023, all of the $4,500 is an excess repayment. You carry
8915-E, line 18, whichever is applicable, you enter
back $3,000 to 2022. The remaining excess repayment of
"$1,500 excess repayment from 2023 Form 8915-F (2020
$1,500 ($4,500 − $3,000) can be carried back to 2021.
disasters)."
Also, instead of carrying that portion of the excess
repayment back to 2021, you can choose to carry it back Example 2. You suffered economic losses in 2022 as
to 2020. the result of DR-4649-PR. Your main home was in Puerto
Rico when that disaster occurred. You received a qualified
Example 2. You received a qualified 2020 disaster
2022 disaster distribution from your traditional IRA in the
distribution in the amount of $90,000 in 2021. You elected
amount of $18,000 on April 29, 2022, spreading the
to have the full income from the distribution recognized in
income over 3 years (2022, 2023, and 2024). You filed
2021. On November 6, 2023, you make a repayment of
your 2023 tax return on April 10, 2024. You made a
$45,000. The entire $45,000 is carried back to 2021.
repayment of $15,000 on April 29, 2024. You report
Example 3. You received a qualified 2021 disaster $6,000 of the repayment on your 2024 Form 8915-F (2022
distribution in the amount of $21,000 in December 2022. disasters). You report the excess repayment of $9,000 as
You choose to spread the $21,000 over 3 years ($7,000 in follows. You carry back $6,000 to 2023 Form 8915-F
income for 2022, 2023, and 2024). On November 6, 2024, (2022 disasters), line 25, and $3,000 back to 2022 Form
you make a repayment of $10,000. For 2024, none of the 8915-F (2022 disasters), line 25. On the dotted line to the
qualified 2021 disaster distribution is included in income. left of line 25 of your:
The excess repayment of $3,000 ($10,000 − $7,000) can • 2023 Form 8915-F (2022 disasters), you enter "$6,000
be carried back to 2023 or 2022. excess repayment from 2024 Form 8915-F (2022
Carrybacks. Follow Step 1 and Step 2 below when disasters)"; and
carrying back amounts. These steps are followed by • 2022 Form 8915-F (2022 disasters), you enter "$3,000
examples. excess repayment from 2024 Form 8915-F (2022
Step 1. Determine the line(s) to use. If the original disasters)."
distribution was not an IRA distribution and you are Example 3. You suffered economic losses in 2022 as
carrying an excess repayment back to: the result of DR-4649-PR. Your main home was in Puerto
• 2020, include the carried back amount on 2020 Form Rico when that disaster occurred. You received a qualified
8915-E, line 10; 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

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

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$15,000 in 2023, checking the check box on line 11 of that 1040-X, you enter "2020" on the line for the calendar year
form. You filed your 2023 tax return on April 10, 2024. You at the top of page 1 because you are a calendar year filer
made a repayment of $11,000 on April 29, 2024. You and, in parentheses in column B of line 1, you enter the
report the full $11,000 of the repayment on your 2024 amount of the repayment. In the Explanation of Changes
Form 8915-F (2022 disasters). It is all excess repayment, section of your amended return, enter "The amount I
as you have no income from the distribution for that year. reported on 2020 Form 1040, line 4b, is being reduced by
You carry back the full $11,000 to 2023 Form 8915-F a contribution made 04/14/2023 to an eligible retirement
(2022 disasters), line 14. On the dotted line to the left of plan in repayment of a qualified distribution made
2023 Form 8915-F (2022 disasters), line 14, you enter 12/14/2020 under section 331(b) of the SECURE 2.0 Act
"$11,000 excess repayment from 2024 Form 8915-F of 2022. The disaster was the Mississippi Severe Winter
(2022 disasters)." Storms (DR-4598-MS) disaster."
Qualified distributions for qualified 2021 and later Other qualified distributions received for qualified
disasters. You may reduce the amount of a qualified 2021 disasters and qualified distributions received
distribution included in income for a qualified disaster by for qualified 2022 and later disasters. Because a
the amount of a repayment made during the qualified qualified distribution can be received up to 180 days
distribution repayment period. (See Part IV—Qualified before the disaster began, you may have a qualified
Distributions for the Purchase or Construction of a Main distribution received in the year before the disaster began.
Home in Qualified Disaster Areas, later, for details on If that happens, you will use a Form 8915-F on which the
qualified distributions for qualified 2021 and later year in which the tax year of the qualified distribution was
disasters.) made is checked in item A, and the year in which the
disaster began is checked in item B. If you need to report
Qualified distributions received in 2020 for
repayments of the distribution, you will not need to follow
qualified 2021 disasters. If, in 2020, you received a
the special steps in Qualified distributions received in
qualified distribution for a qualified 2021 disaster, you may
2020 for qualified 2021 disasters, earlier, to file an
reduce the amount of a qualified distribution included in
amended return. However, you will need to make the
income in 2020 by the amount of a repayment made
repayments during the qualified distribution repayment
before June 28, 2023. (See Part IV—Qualified
period for the disaster. See Repayment of a Qualified
Distributions for the Purchase or Construction of a Main
Distribution for the Purchase or Construction of a Main
Home in Qualified Disaster Areas, later, for details on
Home, earlier.
2020 qualified distributions for qualified 2021 disasters.)
Because a qualified distribution can be received up to 180 Form 1040-NR. If you are amending a Form 1040-NR,
days before the disaster began and repayments for that see the Instructions for Form 1040-X for which portions of
distribution can be made from the beginning date of the Form 1040-X you will need to complete.
disaster and through June 27, 2023, you may have a
qualified distribution received in 2020 for which you are Specific Instructions
making repayments in 2021, 2022, or 2023. If you have
already filed your 2020 return on which you reported the Married filers. If both you and your spouse are required
distribution, you should file an amended 2020 return to to file Form 8915-F, file a separate Form 8915-F for each
report the repayment. On your amended return (Form of you. If you and your spouse are both filing Forms
1040-X), you will enter 2020 as the calendar year (or the 8915-F, the $22,000 limit on qualified 2021 and later
2020 fiscal year) at the top of page 1 and enter, in disaster distributions and the elections on lines 11 and 22
parentheses in column B of line 1, the amount of the to include all qualified disaster distributions in income
repayment. In the Explanation of Changes section enter: (and not spread them over 3 years) are determined
"The amount I reported on [2020 Form 1040 or 1040-NR, separately for each spouse. Similarly, if you and your
line 4b, as applicable] is being reduced by a contribution spouse are both filing Forms 8915-F, the $100,000 limit on
made [mm/dd/2021, 2022, or 2023] to an eligible qualified 2020 disaster distributions made in 2021 and the
retirement plan in repayment of a qualified distribution elections on lines 11 and 22 to include all those qualified
made [mm/dd/2020] under section 331(b) of the SECURE disaster distributions in income in the year of the
2.0 Act of 2022. The disaster was the [name of the distribution (and not spread them over 3 years) are
qualified 2021 disaster from FEMA.gov/disaster/ determined separately for each spouse.
declarations.] " Use the full name of the disaster. Include Name and social security number (SSN). If you file a
the state, territory, or tribal government and the FEMA DR joint return, enter only the name and SSN of the spouse
number from FEMA.gov/disaster/declarations. whose information is being reported on the Form 8915-F.
Example. You received a distribution from a traditional Attach your completed worksheets. There are a total
IRA on December 14, 2020, to construct a home in the of 6, applicable worksheets in these instructions. Blank
Mississippi Severe Winter Storms (DR-4598-MS) disaster worksheets are in Appendix B, Worksheets, at the end of
area which you did not construct because of that disaster. these instructions.
The disaster began February 11, 2021, and the Worksheet 1A-1 in Part I.
•
distribution now qualifies as a qualified distribution. On Worksheet 1B in Part I.
•
April 14, 2023, you made a contribution that qualifies as a Worksheet 2 in Part II.
•
repayment of the distribution. You have already filed your Worksheet 3 in Part II.
•
2020 return, a Form 1040. You will need to file a Form Worksheet 4 in Part III.
•
1040-X for 2020 to claim the repayment. On your Form Worksheet 5 in Part III.
•

Instructions for Form 8915-F (Rev. 1-2024) 9

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Complete each worksheet on the last pages of these Lines 1a through 1d. You may not need to complete
instructions that you use in determining amounts on your lines 1a through 1d. See Form 8915-F, line 1; also see
Form 8915-F. In the spaces provided at the top of each When to leave lines 1a through 1d blank next.
worksheet you complete, be sure to enter your name and When to leave lines 1a through 1d blank. Leave
social security number as they appear on your Form lines 1a through 1d blank on:
8915-F. Attach your completed worksheet(s) to the back of • Your 2021 Form 8915-F (2020 disasters) if either you
your Form 8915-F. didn’t file 2020 Form 8915-E or the only disaster you
Required General Information reported on 2020 Form 8915-E was the coronavirus;
• 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 later disaster in the table at the top of Part I and a prior
return to which you will be attaching your Form 8915-F. year's Form 8915-F doesn't list that disaster in item C;
You can only check one box in item A. If the tax year of the • This year's Form 8915-F if you have listed 2021 or later
return to which you are attaching your Form 8915-F is disasters in the table at the top of Part I and no prior year's
2023, check the "2023" box in item A on your Form Form 8915-F lists any of those disasters in item C. For
8915-F. example, when you have checked the same year in item A
Item B. Check the box that describes the calendar year in and item B; or
which the disaster(s) for which you are reporting • This year's Form 8915-F if you are using Worksheet 1B.
distributions on your Form 8915-F began. You can only Otherwise, enter amounts on lines 1a through 1d as
check one box in item B. The disasters for which you are indicated later.
reporting distributions, repayments, and/or income on Example. You have checked 2023 in item A and item
your Form 8915-F must have all started in the same B of your Form 8915-F. You have listed only these two
calendar year. If the disasters all started in 2023, check disasters both starting in 2023, Florida Severe Storms,
the box for "2023" in item B of your Form 8915-F. Tornadoes, and Flooding (DR-4709-FL) and Florida
Item C. Enter the FEMA DR number from Major Disasters Hurricane Idalia (DR-4734-FL), as your disasters in item
Declarations at FEMA.gov/disaster/declarations. See C. You will leave lines 1a through 1d blank.
Qualified disaster, earlier, for details. For example, for the Line 1a. If you are required to complete line 1a,
2023 Kansas Severe Storms, Straight-line Winds, complete line 1a as follows.
Tornadoes, and Flooding disaster, you would enter • For 2020 disasters, multiply $100,000 by the disasters
DR-4747-KS. reported on your 2020 Form 8915-E that you are reporting
Do not enter the coronavirus in item C. in the table at the top of Part I on your 2021 Form 8915-F
(2020 disasters). Enter that product on line 1a.
CAUTION! • For 2021 and later disasters:
Item D. Check the box in item D if the coronavirus is a 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
disaster you are reporting on your Form 8915-F.
also reported in item C of a prior year's Form 8915-F,
Part I—Total Distributions From All enter, on line 1a, $22,000.
Retirement Plans (Including IRAs) If you list more that one disaster in the table at the top
of Part I and all of your distributions for this year
Coronavirus-related distributions. You can only report occurred within the qualified disaster distribution
qualified disaster distributions for disasters listed in item period (see Qualified disaster distribution period,
C. Coronavirus-related distributions can’t be made after earlier) for each of the disasters listed in the table at
December 30, 2020. the top of Part I, enter, on line 1a, $22,000 times the
number of disasters you entered both in the table at
Part I disasters. List in the table at the top of Part I all the
the top of Part I and in item C on a prior year's Form
qualified disasters in item C for which qualified disaster
8915-F.
distributions have been made to you this year. Only those
disasters and those distributions can be considered in Line 1b. If you are required to complete line 1b, complete
Part I. line 1b as follows.
List of disasters. If you are reporting no more than two • For 2020 disasters, enter, on line 1b, the amount on
2020 Form 8915-E, line 4, column (c), if you completed
disasters, list the FEMA number, the disaster declaration
that line (otherwise from the amount on 2020 Form
date, and the disaster beginning date for each disaster in
8915-E, line 4, column (b)) that reflects the distributions
the spaces provided under the Part I header. If you have
for the disasters you reported on 2020 Form 8915-E that
more than two disasters, attach to the back of your Form
you are now reporting in the table at the top of Part I of
8915-F a statement with your name and SSN, and, for
your 2021 Form 8915-F (2020 disasters). If you used
each disaster, the FEMA number, the disaster declaration
Worksheet 2 in your 2020 Instructions for Form 8915-E,
date, and the disaster beginning date.
the amount for line 1b is figured by adding together the
If you are using Worksheet 1B, leave lines 1a amounts in column (X), line 4, of that worksheet for the
! through 1e blank and complete lines 2 through 5 disasters you reported on 2020 Form 8915-E that you are
CAUTION as that worksheet directs. See Worksheet 1B. reporting in item C of your 2021 Form 8915-F (2020
disasters).

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

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• For 2021 and later disasters, enter on line 1b, the Example 3. You had an economic loss as the result of
amount of the total qualified disaster distributions made to Remnants of Tropical Storm Fred (DR-4625-NY)
you in prior year(s) for all disasters in the table at the top of (beginning August 18, 2021). Qualified disaster
Part I. distributions can be made through June 26, 2023, for that
disaster. In May of 2023, qualified disaster distributions
Line 1d. If you are required to complete line 1d, complete
were made to you totalling $9,000 that you report on a
line 1d as follows.
2023 Form 8915-F (2021 disasters) listing the Remnants
• Count the disasters reported in the table at the top of
of Tropical Storm Fred as your only disaster in the table at
Part I on your 2021 Form 8915-F (2020 disasters) that
the top of Part I. Earlier, in September of 2021, qualified
were not reported on your 2020 Form 8915-E. Enter, on
disaster distributions were made to you totalling $10,000
line 1d, the product of that number and $100,000.
that you report on a 2021 Form 8915-F (2021 disasters)
• For 2021 and later disasters, count the disasters
again listing the Remnants of Tropical Storm Fred as your
reported in the table at the top of Part I of this year's Form
only disaster in the table at the top of Part I. On line 1a of
8915-F that were not reported on an earlier Form 8915-F.
your 2023 Form 8915-F (2021 disasters), you enter
Enter, on line 1d, the product of that number and $22,000.
$22,000. On line 1b, you enter $10,000. On line 1c, you
Line 1e. Complete line 1e as follows. enter $12,000 ($22,000 minus $10,000). On line 1d, you
• If you have been instructed above to leave lines 1a enter -0- and, on line 1e, you enter $12,000.
through 1d blank, enter on line 1e the product of $22,000
Example 4. You've only had an economic loss as the
($100,000 if you checked 2020 in item B on Form 8915-F)
result of one qualified disaster: Remnants of Tropical
times the number of disasters you reported in the table at
Storm Fred (DR-4625-NY) (beginning August 18, 2021).
the top of Part I of this year’s Form 8915-F.
Qualified disaster distributions can be made through June
• Otherwise, enter the sum of lines 1c and 1d on line 1e.
26, 2023, for that disaster. In May of 2023, qualified
Examples for lines 1a through 1e. disaster distributions were made to you totalling $9,000
Example 1. You had an economic loss as the result of that you report on a 2023 Form 8915-F (2021 disasters).
Remnants of Tropical Storm Fred (DR-4625-NY) You also made qualified disaster distributions in 2021 and
(beginning August 18, 2021). Qualified disaster 2022 for this disaster. The qualified disaster distributions
distributions can be made through June 26, 2023, for that made to you for 2021 and 2022 for $5,000 and $2,000 are
disaster. In May of 2023, qualified disaster distributions on line 6 of your 2021 Form 8915-F (2021 disasters) and
were made to you totalling $9,000 that you report on a 2022 Form 8915-F (2021 disasters), respectively. On
2023 Form 8915-F (2021 disasters). Earlier, in January of line 1a of your 2023 Form 8915-F (2021 disasters), you
2022, qualified disaster distributions were made to you enter $22,000. On line 1b, you enter $7,000 ($5,000 +
totalling $10,000 that you report on a 2022 Form 8915-F $2,000). On line 1c, you enter $15,000 ($22,000 minus
(2021 disasters). On line 1a of your 2023 Form 8915-F $7,000). On line 1d, you enter -0- and, on line 1e, you
(2021 disasters), you enter $22,000. On line 1b, you enter enter $15,000.
$10,000. On line 1c, you enter $12,000 ($22,000 minus Column (a). Your available distributions for this year are
$10,000). On line 1d, you enter -0- and on line 1e you the distributions you received for a retirement plan
enter $12,000. (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) TIP line 3 mentions traditional SEP and traditional
(beginning August 18, 2021) and Severe Winter Storm SIMPLE IRAs and line 4 lists Roth SEP and Roth
and Snowstorm (DR-4694-NY) (beginning December 23, SIMPLE IRAs. Section 601 of the SECURE 2.0 Act of
2022). Qualified disaster distributions can be made from 2022 allows for the creation of Roth accounts for SEP
August 18, 2021, through June 26, 2023, for the first IRAs and SIMPLE IRAs beginning January 1, 2023. As a
disaster and December 23, 2022, through September 10, result, accounts we had previously referred to as "SEP
2023, for the second disaster. You had an economic loss IRAs" and "SIMPLE IRAs" in these instructions and on
as the result of each of these disasters. In April of 2023 Form 8915-F, line 3, will now be called traditional SEP and
and May of 2023, an $8,000 and a $21,000 qualified traditional SIMPLE IRAs, respectively. In the instructions
disaster distribution were made to you, respectively. The and on Form 8915-F, line 4, we refer to the newly enacted
distributions both occurred within the qualified disaster Roth accounts as "Roth SEP IRAs" and "Roth SIMPLE
distribution period of each disaster and, therefore, could IRAs," respectively.
be qualified disaster distributions of either disaster. Earlier,
in January of 2022, qualified disaster distributions were Lines 2 through 4 in column (a). If you received a
made to you totalling $10,000 that you report on a 2022 distribution from a retirement plan (including an IRA), you
Form 8915-F (2021 disasters). You had listed one should receive a Form 1099-R. The amount of the
disaster, the Remnants of Tropical Storm Fred, as the distribution should be shown in box 1 of Form 1099-R.
disaster in the table at the top of Part I of your 2022 form. Enter the amounts from box 1 of all your Forms 1099-R on
On line 1a of your 2023 Form 8915-F (2021 disasters), the lines 2 through 4 in column (a), as applicable.
you enter $22,000 for DR-4625-NY. On line 1b, you enter Column (b). The disasters in item C that are relevant to
$10,000. On line 1c, you enter $12,000 ($22,000 minus column (b) and to all of Part I are only the disasters you
$10,000). On line 1d, you enter $22,000 for DR-4694-NY. listed in the table at the top of Part I .
On line 1e, you enter $34,000.

Instructions for Form 8915-F (Rev. 1-2024) 11

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Beginning with Form 8915-F (Rev. January 2024), of 2021 Form 8915-D. See Line 7, later, for the amount to
TIP line 3 mentions traditional SEP and traditional place on line 7 of your 2021 Form 8915-F.
SIMPLE IRAs and line 4 lists Roth SEP and Roth
See the Filled-in Worksheet 1A-1 example below for
SIMPLE IRAs. Section 601 of the SECURE 2.0 Act of
guidance. A blank Worksheet 1A-1 is at the end of the
2022 allows for the creation of Roth accounts for SEP
instructions under Appendix B, Worksheets.
IRAs and SIMPLE IRAs beginning January 1, 2023. As a
result, accounts we had previously referred to as "SEP Example 1A-1. You suffered an economic loss as the
IRAs" and "SIMPLE IRAs" in these instructions and on result of Maine Severe Storm and Flooding (DR-4696-ME)
Form 8915-F, line 3, will now be called traditional SEP and (beginning date December 23, 2022; declaration date
traditional SIMPLE IRAs, respectively. In the instructions March 22, 2023) and Maine Severe Storm and Flooding
and on Form 8915-F, line 4, we refer to the newly enacted (DR-4719-ME) (beginning date April 30, 2023; declaration
Roth accounts as "Roth SEP IRAs" and "Roth SIMPLE date July 6, 2023). Your main home was in Maine during
IRAs," respectively. the disaster period for each disaster. Qualified disaster
distributions can be made from December 23, 2022,
Lines 2 through 5 in column (b). If you are using through September 17, 2023, for the first disaster and
Worksheet 1B, follow the instructions for the worksheet April 30, 2023, through January 1, 2024, for the second
when completing these lines. disaster. No distributions were made until May 9, 2023,
The amounts entered on lines 2 through 5 in column (b) when a $40,000 qualified disaster distribution from your
depend on whether the amount on line 5 in column (a) is traditional IRA was made to you. The distribution occurred
more than the amount on line 1e. The amount on line 5, within the qualified disaster distribution period of each
column (a), is the sum of lines 2 through 4 in column (a) disaster and, therefore, could be a qualified disaster
reduced by the total distributions from lines 2 through 4 in distribution of either disaster. You are completing 2023
column (a) that aren’t qualified disaster distributions. Form 8915-F (2022 disasters) and 2023 Form 8915-F
• If the amount on line 5 in column (a) is equal to or less (2023 disasters). You complete your Form 8915-F
than the amount on line 1e, enter the amounts on lines 2 reporting the older disaster first: 2023 Form 8915-F (2022
through 5 in column (a) on lines 2 through 5 in column (b). disasters). You report $22,000 from the distribution as a
• If the amount on line 5 in column (a) is more than the qualified 2022 disaster distribution on 2023 Form 8915-F
amount on line 1e, enter on lines 2 through 4 in column (b) (2022 disasters). You report the remaining $18,000 from
the amounts on line 5 in column (a) adjusted by any the distribution as qualified 2023 disaster distributions in
reasonable means so that their sum on line 5 in column the 2023 Form 8915-F (2023 disasters) portion of your
(b) equals the amount on line 1e. 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
Are You Claiming Qualified Disaster (2022 disasters), you enter the amounts shown in column
Distributions on Part I of more than one Form (a), lines 2 through 4, of 2023 Form 8915-F (2022
8915 for this year? disasters) from your Filled-in Worksheet 1A-1 for
Example 1A-1. Because the $18,000 is being used on
This section does not apply to you unless you are
2023 Form 8915-F (2023 disasters), it should not be
! completing Part I of Forms 8915-F having the counted on line 7 of your 2023 Form 8915-F (2022
CAUTION same date checked in item A but different dates
disasters) in determining the taxable amount of
checked in item B, or you are completing Part I of both a
distributions on that form.
2021 Form 8915-D and a 2021 Form 8915-F.
The numbers on the left border of the Filled-in
Have you completed Part I of more than one Form
TIP Worksheet are line numbers that correspond to
8915-F for this year? For example, you are completing a
the lines on the indicated forms.
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 Worksheet 1B
ending with the Form 8915-F for the most recent
disasters. Your available distributions for Part I of your 2nd If you use Worksheet 1B, you will leave lines 1a
Form 8915-F for this year are the distributions left after TIP through 1e of this year's Form 8915-F blank, but
completing Part I of the first Form 8915-F. If you are filing you will fill in the amounts for lines 2 through 4 in
three Forms 8915-F for this year, which could possibly column (a) and for line 5 in column (b) on that form.
happen in 2023, your available distributions for your 3rd Beginning with Form 8915-F (Rev. January 2024), line 3
Form 8915-F for this year are the distributions left after mentions traditional SEP and traditional SIMPLE IRAs and
completing Part I of the first two Forms 8915-F. See Line 7, line 4 lists Roth SEP and Roth SIMPLE IRAs. Section 601
later, for the amount to place on line 7 of your 1st Form of the SECURE 2.0 Act of 2022 allows for the creation of
8915-F (or your 1st and 2nd Form 8915-F if you are filing Roth accounts for SEP IRAs and SIMPLE IRAs beginning
three Forms 8915-F for this year). January 1, 2023. As a result, accounts we had previously
referred to as "SEP IRAs" and "SIMPLE IRAs" in these
Are you completing Part I of both a 2021 Form 8915-D instructions and on Form 8915-F, line 3, will now be called
and a 2021 Form 8915-F? If so, complete your forms in traditional SEP and traditional SIMPLE IRAs, respectively.
this order. First, complete 2021 Form 8915-D. Your In the instructions and on Form 8915-F, line 4, we refer to
available distributions for your 2021 Form 8915-F (2020 the newly enacted Roth accounts as "Roth SEP IRAs" and
disasters) are the distributions left after completing Part I "Roth SIMPLE IRAs," respectively.

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

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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 Distributions from retirement plans (other than
IRAs) made this year. -0- -0- -0-
3 Distributions from traditional, traditional SEP,
and traditional SIMPLE IRAs made this year. $40,000 $22,000 -0-
4 Distributions from Roth, Roth SEP, and Roth
SIMPLE IRAs made this year. -0- -0- -0-

(a)
Second Form 8915-F
Available distributions for this year
2 Enter, in column (a), distributions from retirement plans (other -0-
than IRAs) made this year.
3 Enter, in column (a), distributions from traditional, traditional $18,000
SEP, and traditional SIMPLE IRAs made this year.
4 Enter, in column (a), distributions from Roth, Roth SEP, and -0-
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,
disasters began in 2021 or later years. However, you must 2023, through January 1, 2024, for Disaster 1 and June
use Worksheet 1B to determine the amounts to place on 26, 2023, to March 3, 2024, for Disaster 2. In 2023, you
lines 1 through 5 of this year's Form 8915-F if your received a traditional IRA distribution of $30,000. The
qualified disasters began in 2021 or later years unless: distribution was made on September 8. You had no other
• You listed only one disaster in the table at the top of Part distribution for 2023. You complete Worksheet 1B. You
I; or apply the distributions up to the $22,000 limit against each
• All of the distributions for this year occurred within the available disaster. You apply $22,000 of the September 8
qualified disaster distribution period (see Qualified distribution to Disaster 1 and $8,000 of the September
disaster distribution period, earlier) for each of the distribution to Disaster 2. In column (b), lines 2 through 5,
disasters listed in the table at the top of Part I. of your 2023 Form 8915-F (2023 disasters), you enter the
Line 1a of Form 8915-F provides the instructions for those amounts from lines 2 through 5 of your filled-in Worksheet
situations. 1B, column (b). See the Filled-in Worksheet 1B for
Example 1.
In Worksheet 1B, column (a), enter your available Example 2. You have the same disasters as in
distributions for this year for lines 2 through 4 from this Example 1. You are filing 2023 Form 8915-F (2023
year's Form 8915-F. In Worksheet 1B, column (X), start by disasters). In 2023, two traditional IRA distributions were
entering the amounts you are planning to claim as made to you: one on May 1 for $30,000 and one on
qualified disaster distributions for each disaster listed in September 17 for $14,000. You had no other distributions
the table at the top of Part I on this year's Form 8915-F. A in 2023. You complete Worksheet 1B. You apply the
distribution will not be a qualified disaster distribution for distribution up to the $22,000 limit against each available
this year unless the distribution is made within the disaster. You apply $22,000 of the May distribution to
qualified disaster distribution period for a disaster listed in Disaster 1 and the entire $14,000 of the September
the table at the top of Part I. Enter this year's distributions distribution to Disaster 2. You can't apply any of the May
for each qualified disaster, from the table at the top of Part distribution to Disaster 2 as it was not made during the
I, in a separate column. Your total qualified disaster qualified disaster distribution period for that disaster. In
distributions for each disaster can't exceed $22,000. For column (b), lines 2 through 5, of your 2023 Form 8915-F
simplicity, apply your distributions in $22,000 amounts as (2023 disasters), you enter the amounts from lines 2
available to each available disaster, beginning with the through 5 of your filled-in Worksheet 1B, column (b). See
disaster with the earliest ending date for qualified disaster the Filled-in Worksheet 1B for Example 2.
distributions. Examples 1 through 3, later, provide
guidance. A blank Worksheet 1B is in Appendix B, Example 3. You were eligible for qualified 2023
Worksheets, at the end of the instructions. disaster distributions for the following disasters. Disaster
1: Puerto Rico Severe Storm, Flooding and Landslides
Example 1. You were eligible for qualified 2023 (DR-4649-PR) (beginning date February 4, 2022;
disaster distributions for the following disasters. Disaster declaration date March 29, 2022). Disaster 2: Puerto Rico
1: Maine Severe Storm and Flooding (DR-4719-ME) Hurricane Fiona (DR-4671-PR) beginning date
(beginning date April 30, 2023; declaration date July 6, September 17, 2022; declaration date September 21,
2023). Disaster 2: Maine Severe Storm and Flooding 2022). Your main home was in Puerto Rico during the
(DR-4737-ME) (beginning date June 26, 2023; disaster period for each disaster. Qualified disaster
declaration date September 6, 2023). Your main home distributions can be made from February 4, 2022, through
was in Maine during the disaster period for each disaster.

Instructions for Form 8915-F (Rev. 1-2024) 13

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June 26, 2023, for Disaster 1 and September 17, 2022,                                                                                                                                                                                       You apply the distributions up to the $22,000 limit against 
through June 26, 2023, for Disaster 2. You had a $20,000                                                                                                                                                                                    each available disaster. You apply $2,000 of the May 9, 
qualified 2022 disaster distribution from your 2022 Form                                                                                                                                                                                    2023, distribution to Disaster 1, as $20,000 of the $22,000 
8915-F (2022 disasters) for Disaster 1. No other                                                                                                                                                                                            limit was used in 2022. You apply $22,000 of the May 9, 
distributions were made until May 9, 2023, when a                                                                                                                                                                                           2023, distribution to Disaster 2. In column (b), lines 2 
$40,000 qualified disaster distribution from your traditional                                                                                                                                                                               through 5, of your 2023 Form 8915-F (2023 disasters), 
IRA was made to you. The 2023 distribution occurred                                                                                                                                                                                         you enter the amounts from lines 2 through 5 of your 
within the qualified disaster distribution period of each                                                                                                                                                                                   filled-in Worksheet 1B, column (b). See the Filled-in 
disaster and, therefore, could be a qualified disaster                                                                                                                                                                                      Worksheet 1B for Example 3.
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 2023  disaster distributions made in 20232 1 Qualified 2
                                                                                                                                                                                                                                 available                                                         2023   
                                                                                                                                                                                                                                 distributi                                                        disaster 
                                                                                                                                                                                                                                 ons in 1                                                          distribution
                                                                                                                                                                                                                                 _____                                                             s made in 1
                                                                                                                                                                                                                                                                                                   2023
                                                                                                                                                                                                                                            Disaster  1 Disaster 2   Disaster 3 Disaster 4  (Total for all 
                                                                                                                                                                                                                                                                   3 ________3  ________3          disasters)
                                                                                                                                                                                                                                            DR-4719-ME DR-4737-ME3
                                                                                                                                                                                                                                            04/30/20234 06/26/20234  ________4  ________4
                                                                                                                                                                                                                                            01/01/20245 03/03/20245  ________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-
2    Distributions from retirement plans (other than IRAs)                                                                                                                                                                                  -0-         -0-                                               -0-
     Distributions from traditional, traditional SEP, and                                                                                                                                                                        $30,000
3    traditional SIMPLE IRAs                                                                                                                                                                                                     09/08/23   $22,000     $8,000                                     $30,000
     Distributions from Roth, Roth SEP, and Roth SIMPLE 
4    IRAs                                                                                                                                                                                                                                   -0-         -0-                                               -0-
5    Totals. Add lines 2 through 4.                                                                                                                                                                                              $30,000    $22,000     $8,000                                     $30,000

45123 Enter the date the distribution period for the disaster begins. Enter the date the distribution period for the disaster ends. Enter year checked in item A. Enter year checked in item B. Enter the disaster's FEMA number.

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

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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 2023  disaster distributions made in 20232 1 Qualified 2
                                                                                                                                                                                                                                 available                                                         2023   
                                                                                                                                                                                                                                                                                                   disaster 
                                                                                                                                                                                                                                 distributi                                                        distribution
                                                                                                                                                                                                                                 ons in 1                                                          s made in 1
                                                                                                                                                                                                                                 _____                                                             2023
                                                                                                                                                                                                                                            Disaster  1 Disaster 2  Disaster 3 Disaster 4          (Total for 
                                                                                                                                                                                                                                                      3 DR-4737-ME3 ________3  ________3           all 
                                                                                                                                                                                                                                            DR-4719-ME                                             disasters)
                                                                                                                                                                                                                                            04/30/20234 06/26/20234 ________4  ________4
                                                                                                                                                                                                                                            01/01/20245 03/03/20245 ________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-
2    Distributions from retirement plans (other than IRAs)                                                                                                                                                                                                                                             -0-
                                                                                                                                                                                                                                 $30,000
                                                                                                                                                                                                                                 05/01/23
                                                                                                                                                                                                                                         
     Distributions from traditional, traditional SEP, and                                                                                                                                                                        $14,000
3    traditional SIMPLE IRAs                                                                                                                                                                                                     09/17/23   $22,000     $14,000                                    $36,000
     Distributions from Roth, Roth SEP, and Roth SIMPLE 
4    IRAs                                                                                                                                                                                                                                                                                              -0-
5    Totals. Add lines 2 through 4.                                                                                                                                                                                                         $22,000     $14,000                                    $36,000

45123 Enter the date the distribution period for the disaster begins. Enter the date the distribution period for the disaster ends. Enter year checked in item A. Enter year checked in item B. Enter the disaster's FEMA number.

Instructions for Form 8915-F (Rev. 1-2024)                                                                                                                                                                                                                                                                15

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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 2022  disaster distributions made in 20232 1 Qualified 2
                                                                                                                                                                                                                                 available                                                         2022   
                                                                                                                                                                                                                                 distributi                                                        disaster 
                                                                                                                                                                                                                                 ons in 1                                                          distribution
                                                                                                                                                                                                                                 _____                                                             s made in 1
                                                                                                                                                                                                                                                                                                   2023
                                                                                                                                                                                                                                            Disaster  1 Disaster 2  Disaster 3 Disaster 4          (Total for 
                                                                                                                                                                                                                                                      3 DR-4671-PR3 ________3  ________3           all 
                                                                                                                                                                                                                                            DR-4649-PR                                             disasters)
                                                                                                                                                                                                                                            02/04/20224 09/17/20224 ________4  ________4
                                                                                                                                                                                                                                            06/26/20235 06/26/20235 ________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
2    Distributions from retirement plans (other than IRAs)                                                                                                                                                                                                                                                -0-
     Distributions from traditional, traditional SEP, and                                                                                                                                                                        $40,000 
3    traditional SIMPLE IRAs                                                                                                                                                                                                     05/09/23   $2,000      $22,000                                    $24,000
     Distributions from Roth, Roth SEP, and Roth SIMPLE 
4    IRAs                                                                                                                                                                                                                                                                                                 -0-
5    Totals. Add lines 2 through 4.                                                                                                                                                                                              $44,000    $2,000      $22,000                                    $24,000

45123 Enter the date the distribution period for the disaster begins. Enter the date the distribution period for the disaster ends. Enter year checked in item A. Enter year checked in item B. Enter the disaster's FEMA number.

                                                                                                                                                                                                                                            the instructions for your tax return for reporting the 
Line 7. On line 7, enter the excess of the sum of lines 2 
                                                                                                                                                                                                                                            distributions included on line 7. See also the Instructions 
through 4 in column (a) over the amount on line 6, except 
                                                                                                                                                                                                                                            for Form 5329 for this year.
if you are also completing Part IV, or are claiming qualified 
disaster distributions on Part I of more than one Form                                                                                                                                                                                      Example.    You reported a total of $40,000 in 
8915 for this year. See If completing both Part I and Part IV                                                                                                                                                                               distributions in 2023 on lines 3 and 5 in column (a). The 
or filing more than one Form 8915, later. The amount on                                                                                                                                                                                     entire $40,000 in distributions were traditional IRA 
line 7 should generally be apportioned into IRA and                                                                                                                                                                                         distributions. You reported $22,000 of those distributions 
pension and annuity amounts, as applicable, and reported                                                                                                                                                                                    on lines 3 and 5 in column (b) of your 2023 Form 8915-F. 
on your tax return as taxable distributions in accordance                                                                                                                                                                                   On line 7, you reported $18,000 ($40,000 minus $22,000). 
with Form 5329 and the instructions for that return. See                                                                                                                                                                                    You are not completing Part IV. You will refer to your tax 

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

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return, Form 5329, and their instructions for directions on If there is no amount in box 2a of Form 1099-R and the
how to treat this $18,000 in IRA distributions. first box in box 2b is checked, the issuer of Form 1099-R
If completing both Part I and Part IV or filing more may not have had all the facts needed to figure the taxable
than one Form 8915. amount. You may want to get Pub. 575, Pension and
Step 1. If you are completing both Part I and Part IV on this Annuity Income, to help figure your taxable amount.
year's Form 8915-F: Also see Pub. 575 if you use the Simplified Method
• On line 7, enter the excess of the sum of lines 2 through Worksheet to figure the taxable amount of your periodic
4 in column (a) over the amount on line 6 reduced by the payments and you designated some of these payments as
amount from line 7 that is included on line 28 in Part IV. qualified disaster distributions on the Form 8915-F you are
• On the dotted line to the left of line 7, enter "$________ completing.
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 ! disaster distributions and nonqualified
distributions on Part I of more than one Form 8915 for this CAUTION distributions, you must separately figure the cost
year and you aren't completing Part IV on this year's Form attributable to each distribution.
8915:
• 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
available distributions on the other Form 8915 you are spread the amount on line 10 over 3 years. By checking
filing for this year. the box, you elect to include the entire amount in income
• On the dotted line to the left of line 7, enter "$________ in the year of distribution. You cannot make or change this
used as available distribution on Part I of **** Form 8915-F election after the due date (including extensions) for your
(**** disasters)." tax return. If you checked the box on line 22, you must
Step 3. If you are claiming qualified disaster check the box on line 11.
distributions on Part I of more than one Form 8915-F for If the taxpayer died after receiving a qualified disaster
this year and you are completing Part IV on this year's distribution, the taxable amount of the distribution may not
Form 8915-F for the earliest disasters. be spread beyond the year in which they died. The
• If, on the Form 8915-F for this year with the earliest remainder of the distribution must be reported on the tax
disasters, the amount on line 30 reduced by the amount return of the deceased taxpayer.
on line 31 is -0-, you don't have any available distributions
for the other Forms 8915-F you are filing this year. Line 12. Use Worksheet 2 to figure the amount to enter
However, if the amount on line 30 reduced by the amount on line 12 of your Form 8915-F.
on line 31 is a positive dollar amount, enter -0- on line 32
and use that dollar amount as your available distributions
on the other Form 8915-F you are filing for this year. Worksheet 2 for Line 12. Total Income From
Other-Than-IRA Distributions Made in Prior
• On the dotted line to the left of line 32, enter Years
"$________ used as available distribution on Part I of **** Keep for Your Records
Form 8915-F (**** disasters)."
Before you begin.
Example. You reported a total of $40,000 in From this year's form:
distributions in 2023 on lines 3 and 5 in column (a). The • Enter the disaster year you checked in item B _________
entire $40,000 in distributions were traditional IRA • Enter the tax return year you checked in item A _________
distributions. You reported $22,000 of those distributions 1. Enter the amount from column (c) of
on lines 3 and 5 in column (b) of your 2023 Form 8915-F. Worksheet 2: Supplemental
On line 7, you would report $18,000 ($40,000 minus Information . . . . . . . . . . . . . . . . . . . . . . . 1.
$22,000), except you are also completing Part IV. In Part 2. Enter the amount from column (d) of
IV, you are claiming, as qualified distributions, $10,000 of Worksheet 2: Supplemental
the traditional IRA distributions that you reported in Part I. Information . . . . . . . . . . . . . . . . . . . . . . . . 2.
On line 7, you will only report $8,000 ($18,000 minus 3. Enter the total of lines 1 and 2 here and on
$10,000). On the dotted line to the left of line 7, you will line 12 of this year’s Form 8915-F . . . . . . . . 3.
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.

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

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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  Worksheet 2, line 1: Enter amount, if any, from your:           Worksheet 2, line 2: Enter amount, if any, from your:
                       A)
                                 2021                2020 Form 8915-E, line 9 (if you checked the box on that                        0
                                                     line, enter -0-)
                                 2022                2021 Form 8915-F (2020 disasters), line 11 (if you       2020 Form 8915-E, line 9 (if you checked the box on that 
   2020                                              checked the box on that line, enter -0-)                 line, enter -0-)
                                 2023                                0                                        2021 Form 8915-F (2020 disasters), line 11 (if you 
                                                                                                              checked the box on that line, enter -0-)
                                 2024                                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                                0                                                               0
                                 2022                                2021                                                            0
                                 2023                                2022                                                            2021
   2021
                                 2024                                2023                                                            2022
                                 2025                                0                                                               2023
                                 2026                                0                                                               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                                0                                                               0
                                 2023                                2022                                                            0
                                 2024                                2023                                                            2022
   2022
                                 2025                                2024                                                            2023
                                 2026                                0                                                               2024
                                 2027                                0                                                               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                                0                                                               0
                                 2024                                2023                                                            0
                                 2025                                2024                                                            2023
   2023
                                 2026                                2025                                                            2024
                                 2027                                0                                                               2025
                                 2028                                0                                                               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                                0                                                               0
                                 2025                                2024                                                            0
                                 2026                                2025                                                            2024
   2024
                                 2027                                2026                                                            2025
                                 2028                                0                                                               2026
                                 2029                                0                                                               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 
Disaster Year (item B)           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.

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

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Line 14. Enter on line 14 of your Form 8915-F your total            Part III—Qualified Disaster 
repayments—the sum of your excess repayments carried 
to this year and your repayments made for this year. See            Distributions From IRAs
Worksheet 3, later. A repayment is made in this year if it is       Line 22. If you don’t check the box on line 22, you must 
made before you filed your return for this year, and not            spread the amount on line 21 over 3 years. By checking 
later than the due date (including extensions).                     the box, you elect to include the entire amount in income 
At any time during the 3-year period that begins the day            in the year of distribution. You cannot make or change this 
after the date you received a qualified disaster distribution,      election after the due date (including extensions) for your 
you can repay any portion of the distribution to an eligible        tax return. If you checked the box on line 11, you must 
retirement plan that accepts rollover contributions. You            check the box on line 22.
cannot, however, repay more than the amount of the                   If the taxpayer died after receiving a qualified disaster 
original distribution. See Repayment of a Qualified                 distribution, the taxable amount of the distribution may not 
Disaster Distribution, earlier, for details.                        be spread beyond the year in which they died. The 
Worksheet 3. Use Worksheet 3 to figure the total                    remainder of the distribution must be reported on the tax 
repayment to enter on line 14 of your Form 8915-F.                  return of the deceased taxpayer.
        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 
Worksheet 3.                                                        IRA Distributions Made in Prior Years
                                                                    Keep for Your Records
Keep for Your Records
                                                                     Before you begin.
1. Enter the amount, if any, from last year's Form                   From this year's form:
8915-F, line 14, except as follows.                                  • 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                      1. Enter the amount from column (c) of 
2020 Form 8915-E, line 10.                                             Worksheet 4: Supplemental 
                                                                       Information . . . . . . . . . . . . . . . . . . . . . . .   1.  
If you are completing 2023 Form 8915-F (2021                         2. Enter the amount from column (d) of 
disasters), enter the amount, if any, from your                        Worksheet 4: Supplemental 
2022 Form 8915-F (2021 disasters), line 14, if                         Information . . . . . . . . . . . . . . . . . . . . . . . . 2.  
you completed that form. If you didn't complete 
that form, enter the amount, if any, from your                       3. Enter the total of lines 1 and 2 here and on 
2021 Form 8915-F (2021 disasters),                                     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

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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  Worksheet 4, line 1: Enter amount, if any, from your:            Worksheet 4, line 2: Enter amount, if any, from your:
                       A)
                                  2021               2020 Form 8915-E, line 17 (if you checked the box on that                      0
                                                     line, enter -0-)
                                  2022               2021 Form 8915-F (2020 disasters), line 22 (if you        2020 Form 8915-E, line 17 (if you checked the box on 
   2020                                              checked the box on that line, enter -0-)                  that line, enter -0-)
                                  2023                               0                                         2021 Form 8915-F (2020 disasters), line 22 (if you 
                                                                                                               checked the box on that line, enter -0-) 
                                  2024                               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                               0                                                              0
                                  2022                               2021                                                           0
                                  2023                               2022                                                           2021
   2021
                                  2024                               2023                                                           2022
                                  2025                               0                                                              2023
                                  2026                               0                                                              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                               0                                                              0
                                  2023                               2022                                                           0
                                  2024                               2023                                                           2022
   2022
                                  2025                               2024                                                           2023
                                  2026                               0                                                              2024
                                  2027                               0                                                              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                               0                                                              0
                                  2024                               2023                                                           0
                                  2025                               2024                                                           2023
   2023
                                  2026                               2025                                                           2024
                                  2027                               0                                                              2025
                                  2028                               0                                                              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                               0                                                              0
                                  2025                               2024                                                           0
                                  2026                               2025                                                           2024
   2024
                                  2027                               2026                                                           2025
                                  2028                               0                                                              2026
                                  2029                               0                                                              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 
Disaster Year (item B)            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.

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

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Line 25. Enter on line 25 of this year’s Form 8915-F your Part IV—Qualified Distributions for
total repayments—the sum of your excess repayments
carried to this year and your repayments made for this the Purchase or Construction of a
year. See Worksheet 5, later. A repayment is made in this Main Home in Qualified Disaster
year if it is made before you filed your return for this year,
and not later than the due date (including extensions). Areas
At any time during the 3-year period that begins the day 2021 Form 8915-F (2020 disasters). On 2021 Form
after the date you received a qualified disaster distribution, 8915-F (2020 disasters), qualified distributions can only
you can repay any portion of the distribution to an eligible be reported for the Alaska (4585-DR-AK) disaster.
retirement plan that accepts rollover contributions. You Complete Part IV of 2021 Form 8915-F (2020
cannot, however, repay more than the amount of the disasters) if, on January 1, 2021, you received a qualified
original distribution. See Repayment of a Qualified distribution described in Qualified 2020 disaster areas
Disaster Distribution, earlier, for details. under Qualified Distribution for the Purchase or
Worksheet 5. Use Worksheet 5 to figure the total Construction of a Main Home in Qualified Disaster Areas,
repayment to enter on line 25 of your Form 8915-F. earlier, for the Alaska (4585-DR-AK) disaster. You must
Don’t use Worksheet 5 to report repayments of complete the required lines of Part IV if you received a
qualified distribution for the Alaska (4585-DR-AK) disaster
! qualified 2018 or 2019 disaster distributions. on January 1, 2021, even if you made no repayments in
CAUTION
2021. Any portion of the qualified distribution not repaid
Worksheet 5 before June 26, 2021, for the Alaska (4585-DR-AK)
disaster will not be allowed the special tax benefits
1. Enter the amount, if any, from last year's Form available to qualified distributions.
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 that form before you complete Part IV.
disasters), enter the amount, if any, from your
2020 Form 8915-E, line 18. Note. A distribution for the purchase or construction of a
main home may be treated as a qualified 2020 disaster
If you are completing 2023 Form 8915-F (2021
disasters), enter the amount, if any, from your distribution in certain circumstances. See Qualified 2020
2022 Form 8915-F (2021 disasters), line 25, if disaster areas under Qualified Distribution for the
you completed that form. If you didn't complete Purchase or Construction of a Main Home in Qualified
that form, enter the amount, if any, from your Disaster Areas, earlier.
2021 Form 8915-F (2021 disasters),
line 25. . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. Qualified distributions for 2021 and later disasters.
2. Enter the amount, if any, from last year's Form Qualified distributions can be reported for qualified 2021
8915-F, line 24, except as follows. and later disasters. Complete Part IV of this year's Form
8915-F for your disasters in item C if, this year, you
If you are completing 2021 Form 8915-F (2020 received a qualified distribution described in Qualified
disasters), enter the amount, if any, from your
2020 Form 8915-E, line 17. Distribution for the Purchase or Construction of a Main
Home in Qualified Disaster Areas, earlier, for the disasters
If you are completing 2023 Form 8915-F (2021 you listed in the table at the top of Part IV on page 4 of this
disasters), enter the amount, if any, from your year's Form 8915-F. You must complete the required lines
2022 Form 8915-F (2021 disasters), line 24, if of Part IV if you received a qualified distribution, even if
you completed that form. If you didn't complete you made no repayments this year. Any portion of the
that form, enter the amount, if any, from your
2021 Form 8915-F (2021 disasters), qualified distribution not repaid by the end of the disaster's
line 24. . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. qualified distribution repayment period will not be allowed
3a. Subtract line 2 from line 1. If zero or less, the special tax benefits available to qualified distributions.
enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . 3a. If the repayment period for a qualified distribution for a
b. Enter the amount from line 3a that you have disaster ends next year, repayments for that qualified
already carried back to a prior year . . . . . . . b. distribution can be made in the next year and will be
c. Subtract line 3b from line 3a . . . . . . . . . . . . c. reported on an amended return for this year.
4. Enter the total amount of any repayments you Example 1. A distribution Mosley received in February
made, with respect to this year's Form 8915-F,
before filing this year's tax return . . . . . . . . . 4. 2022 is a qualified distribution for the following 2022
5. Enter the total of lines 3c and 4 here and on disaster: the Virginia Severe Winter Storm and Snowstorm
line 25 of this year's Form 8915-F . . . . . . . . 5. 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.
Worksheet 5, line 4: Don't include these amounts. Mosley reports the distribution on Form 8915-F, Part IV, as
On line 4 of Worksheet 5, don't include any repayments a qualified distribution. Mosley doesn't make a repayment
made later than the due date (including extensions) for until May 2023. The repayment must be reported on an
this year’s return or any repayments of nontaxable original or amended 2022 Form 8915-F, as applicable.
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

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following 2023 disaster: the Montana Flooding disaster You can't, however, repay more than the amount of the
(DR-4745-MT) (beginning date June 1, 2023) (declaration original distribution.
date October 11, 2023). Mosley can make repayments for Enter on line 31 the amount of any repayments you
this disaster through April 8, 2024. Mosley reports the make within the time frame specified. Don't include any
distribution on Form 8915-F, Part IV, as a qualified repayments treated as rollovers on this year’s Form 8606
distribution. Mosley doesn't make a repayment until March or any repayments of nontaxable amounts.
2024. The repayment must be reported on an original or
amended 2023 Form 8915-F, as applicable. Line 32. Most distributions from qualified retirement
If you are required to file this year's Form 8606, plans (including IRAs) made to you before you reach age
complete that form before you complete Part IV. 59 / are subject to an additional tax on early distributions 1 2
and are reported on Form 5329. Qualified distributions for
Note. A distribution for the purchase or construction of a the purchase or construction of a main home in a qualified
main home may be treated as a qualified disaster disaster area that were not repaid to an eligible retirement
distribution made in this year in certain circumstances. plan within the time frame specified in Qualified
See Qualified 2020 disaster areas and Qualified 2021 and Distribution Repayment Period under Repayment of a
later disaster areas under Qualified Distribution for the Qualified Distribution for the Purchase or Construction of a
Purchase or Construction of a Main Home in Qualified Main Home, earlier, may be subject to this additional tax
Disaster Areas, earlier. unless you qualify for an exception. See the Instructions
for Form 5329 for information on exceptions to this tax. If
Lines 27 Through 32 you have not repaid the distribution before the specified
You must complete lines 27 and 28 and all other end date, you may be able to designate the qualified
applicable lines of Part IV for your qualified distribution(s). distribution as a qualified disaster distribution. See
Qualified 2020 disaster areas and Qualified 2021 and
Line 27. If you check the “Yes” box, but are not required later disaster areas under Qualified Distribution for the
to complete lines 28 through 32, you must still file the Purchase or Construction of a Main Home in Qualified
required Form 8915-F to show that you received a Disaster Areas, earlier.
qualified distribution.
Line 28. Enter on line 28 your qualified distributions. See Privacy Act and Paperwork Reduction
Qualified Distribution for the Purchase or Construction of a Act Notice
Main Home in Qualified Disaster Areas, earlier. We ask for the information on this form to carry out the
Don't include any distributions you designated as Internal Revenue laws of the United States. We need this
qualified disaster distributions reported on line 8 or line 20 information to ensure that you are complying with these
of your Form 8915-F. Also, don't include any amounts laws and to allow us to figure and collect the right amount
reported on this year’s Form 8606. of tax. You are required to give us this information if you
If you are completing both Part I and Part IV on made certain contributions or received certain
distributions from qualified plans, including IRAs, and
! this year's Form 8915-F, see Line 7, earlier. other tax-favored accounts. Our legal right to ask for the
CAUTION
information requested on this form is sections 6001, 6011,
Line 29. Enter on line 29 your cost, if any. Your cost is 6012(a), and 6109 and their regulations. If you don’t
generally your net investment in the plan. It does not provide this information, or you provide incomplete or false
include pre-tax contributions. If there is an amount in information, you may be subject to penalties. You are not
box 2a of Form 1099-R, the difference between box 1 and required to provide the information requested on a form
box 2a of Form 1099-R is usually your cost. See Pub. 575 that is subject to the Paperwork Reduction Act unless the
for more information about figuring your cost in the plan. form displays a valid OMB control number. Books or
In many cases, a hardship distribution from a 401(k) records relating to a form or its instructions must be
plan or a tax-sheltered annuity contract will not have any retained as long as their contents may become material in
cost. the administration of any Internal Revenue law. Generally,
If you received a first-time homebuyer distribution from tax returns and return information are confidential, as
an IRA, don't enter any amount on line 29. Any cost or required by section 6103. However, we may give this
basis in an IRA is figured on this year’s Form 8606 if you information to the Department of Justice for civil and
made nondeductible contributions. criminal litigation, and to cities, states, the District of
Columbia, and U.S. commonwealths and possessions to
If you have a Form 1099-R with both qualified carry out their tax laws. We may also disclose this
! distributions and nonqualified distributions, you information to other countries under a tax treaty, to federal
CAUTION must separately figure the cost attributable to and state agencies to enforce federal nontax criminal
each distribution. laws, or to federal law enforcement and intelligence
agencies to combat terrorism.
Line 31. You can repay any portion of a qualified
distribution to an eligible retirement plan that accepts The average time and expenses required to complete
rollovers but the repayments must be made within the time and file this form will vary depending on individual
frame specified in Repayment of a Qualified Distribution circumstances. For the estimated averages, see the
for the Purchase or Construction of a Main Home, earlier. instructions for your income tax return.

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

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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

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Appendix A, Which Lines Should I Use?

Part I. Form 8915-F (2020 See Qualified disaster
Disasters): Lines To Use TIP distribution requirements,
earlier, under Qualified
Look for the year of the form you are
Disaster Distribution Requirements
filing.
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 received a qualified 2020 disaster distribution in 2021 from a traditional,
you in 2021
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 Complete lines 12 through 15 and lines 23 through 26, as applicable, of your 2021
on line 9 or 17 on the 2020 Form 8915-F (2020 disasters). If you received qualified distributions for the Alaska
Form 8915-E (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
You claimed coronavirus-related or other qualified your 2021 Form 8915-F (2020 disasters). If you received qualified distributions for the
2020 disaster distributions on a 2020 Form 8915-E Alaska (4585-DR-AK) disaster on January 1, 2021, complete Part IV.
(2020 disasters), but qualified 2020 disaster You checked the box on If you aren’t repaying those distributions, but you received qualified distributions for
distributions were NOT made to you in 2021 line 9 or 17 on the 2020 the Alaska (DR-4585-AK) disaster on January 1, 2021, complete Part IV.
Form 8915-E
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 received qualified Complete Part IV.
distributions for the Alaska
(4585-DR-AK) disaster on
Qualified 2020 disaster distributions were not January 1, 2021
made to you in 2021 AND you did not file a 2020 You did NOT receive STOP. You can’t use 2021 Form 8915-F.
Form 8915-E qualified distributions on
January 1, 2021, for
4585-DR-AK

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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). 
                                                     Form 8915-F (2020 
                                                     disasters) AND/OR on 
You claimed qualified 2020 disaster distributions    line 9 or 17 on the 2020 
on a 2021 Form 8915-F (2020 disasters) AND you       Form 8915-E
claimed coronavirus-related distributions or other 
qualified 2020 disaster distributions on a 2020      You checked the box on      If you are repaying those distributions, complete lines 14 and 25, as applicable, of your 
Form 8915-E                                          line 11 or 22 on the 2021   2022 Form 8915-F.
                                                     Form 8915-F (2020           If you aren’t repaying those distributions, you can’t use 2022 Form 8915-F (2020 
                                                     disasters) AND on line 9 or disasters).
                                                     17 on the 2020 Form 
                                                     8915-E
You claimed qualified 2020 disaster distributions    You didn’t check the box on Complete lines 12 through 15 and lines 23 through 26, as applicable, of your 2022 
on a 2021 Form 8915-F (2020 disasters) but you       line 11 or 22 on the 2021   Form 8915-F (2020 disasters). 
did not claim coronavirus-related distributions or   Form 8915-F (2020 
other qualified 2020 disaster distributions on a     disasters)
2020 Form 8915-E
                                                     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     Form 8915-E
other qualified 2020 disaster distributions on a                                 If you are repaying those distributions, complete lines 14 and 25, as applicable, of your 
2020 Form 8915-E but not on a 2021 Form 8915-F       You checked the box on      2023 Form 8915-F (2020 disasters).
(2020 disasters)                                     line 9 or 17 on the 2020 
                                                     Form 8915-E                 If you aren’t repaying those distributions, STOP. You can’t use 2023 Form 
                                                                                 8915-F.
You did NOT claim qualified 2020 disaster                                        STOP. You can’t use 2023 Form 8915-F (2020 disasters).
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

2023 Form 8915-F (2020 Disasters)
IF . . .                                                              AND . . .                            THEN . . .
                                                                      You did not check the box on line 11 Complete lines 12 through 15 and lines 23 through 26, as 
                                                                      or 22 on that form                   applicable, of your 2023 Form 8915-F (2020 disasters). 
                                                                                                           If you are repaying qualified 2020 disaster distributions 
You claimed qualified 2020 disaster distributions on a 2021 Form                                           made in 2020 or in 2021, complete lines 14 and 25, as 
8915-F (2020 disasters)                                               You checked the box on line 11 or 22  applicable, of your 2023 Form 8915-F (2020 disasters). .
                                                                      on that form                         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). 
                                                                                                           If you are repaying coronavirus-related distributions or 
                                                                                                           other qualified 2020 disaster distributions, complete lines 
You claimed coronavirus-related distributions or other qualified 2020                                      14 and 25, as applicable, of your 2023 Form 8915-F (2020 
                                                                                                           disasters).
disaster distributions on a 2020 Form 8915-E and you did NOT claim                 —
qualified 2020 disaster distributions on a 2021 Form 8915-F (2020                                          If you aren’t repaying coronavirus-related 
disasters)                                                                                                 distributions or other qualified 2020 disaster 
                                                                                                           distributions, STOP. You can’t use 2023 Form 8915-F 
                                                                                                           (2020 disasters).
You did NOT claim qualified 2020 disaster distributions on a 2021                                          STOP. You can’t use 2023 Form 8915-F (2020 
Form 8915-F (2020 disasters) AND you did not claim                                 —                       disasters).
coronavirus-related distributions or other qualified 2020 disaster 
distributions on a 2020 Form 8915-E
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.

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2024 Form 8915-F (2020 Disasters)
IF . . .                                                             AND . . .   THEN . . .
You claimed qualified 2020 disaster distributions other than                     If you are repaying qualified 2020 disaster distributions 
coronavirus-related distributions on a 2020 Form 8915-E and you did              other than coronavirus-related distributions, complete lines 
NOT claim qualified 2020 disaster distributions on a 2021 Form                   14 and 25, as applicable, of your 2024 Form 8915-F (2020 
8915-F (2020 disasters)                                                          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                STOP. You can’t use 2024 Form 8915-F (2020 
Form 8915-F (2020 disasters) AND you did not claim                             — disasters).
coronavirus-related distributions or other qualified 2020 disaster 
distributions on a 2020 Form 8915-E
Note: Coronavirus-related distributions can NOT be repaid after 2023.

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Part II. Form 8915-F (2021 and 3. Complete lines 23 through 26 • It can also occur no qualified if
Later Disasters): Lines To Use if: disaster distributions were made to
For qualified 2021 and later • No qualified disaster distributions you this year; on, an earlier Form
were made to you this year. 8915-F, you did not check the box on
disasters, follow the instructions in
the numerical bullet below that best • On an earlier Form 8915-F, you did line 11 and/or 22 (thus spreading the
not check the box on line 22 (thus income over 3 years); the 3 years for
describe your situation.
spreading the income over 3 years) reporting income on your
1. Complete Part I and, as and, on line 23 of this year’s Form distributions has passed; the
applicable, Parts II, III, and IV if 8915-F, you must report income from repayment period for the qualified
qualified disaster distributions were those distributions. disaster distributions has not ended;
made to you this year for a disaster • You received no qualified and you received no qualified
listed in item C of this year’s Form distributions this year. distributions this year.
8915-F.
4. Complete line 14 and/or 25, as 5. Complete Part IV also in any of
2. Complete lines 12 through 15 applicable, you are only making if the scenarios above you received if
if: repayments this year. qualified distributions this year.
• No qualified disaster distributions • This can occur no qualified if 6. Complete Part IV if you
were made to you this year. disaster distributions were made to received qualified distributions this
• On an earlier Form 8915-F, you did you this year; on, an earlier Form year and if you are not completing
not check the box on line 11 (thus 8915-F, you checked the box on Part I, and are not required to
spreading the income over 3 years) line 11 and/or 22 (thus not spreading complete any lines in Part II or III, on
and, on line 12 of this year’s Form the income over 3 years); the this year’s Form 8915-F.
8915-F, you must report income from repayment period for the disaster has
those distributions. not ended; and you received no
• You received no qualified qualified distributions this year.
distributions this year.

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Appendix B, Worksheets

Blank Worksheets 1A-1,1B, 2, 3, 4,  determining amounts to enter on        the page(s) with the completed 
and 5 are in this appendix. If you  lines 1a through 5, 12, 14, 23, and    worksheet(s) to this year’s Form 
complete any of these worksheets in 25, of this year’s Form 8915-F, attach 8915-F.

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Worksheet 1A-1.                                                                                                      Keep for Your Records
Name                                                                   Social Security No.
                                                                   (a) (b)                                           (c)
       First Form 8915-F 
                                                  Total distributions in this year  Qualified disaster distributions Allocation of column (b)
2 Distributions from retirement plans (other than 
  IRAs) made this year
3 Distributions from traditional, SEP, and SIMPLE 
  IRAs made this year
4 Distributions from Roth IRAs made this year

                                                                                          (a)
                Second Form 8915-F 
                                                                       Available distributions for this year
2 Enter, in column (a), distributions from retirement plans (other 
  than IRAs) made this year.
3 Enter, in column (a), distributions from traditional, SEP, and 
  SIMPLE IRAs made this year. 
4 Enter, in column (a), distributions from Roth IRAs made this 
  year.

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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.
Worksheet 1B for Form 8915-F                                                                                                                                                                                                     (a)                           (X)                                  (b)
                                                                                                                                                                                                                                 Total      Qualified _____ disaster distributions made in _____2 1 Qualified 2
                                                                                                                                                                                                                                 available                                                          _____ disaster 
                                                                                                                                                                                                                                                                                                    distributions  1
                                                                                                                                                                                                                                 distributi                                                         made in _____
                                                                                                                                                                                                                                 ons in 1   Disaster 1 Disaster 2 Disaster 3 Disaster 4             (Total for all 
                                                                                                                                                                                                                                 _____                                                              disasters)
                                                                                                                                                                                                                                            ________3  ________3  ________3  ________3
                                                                                                                                                                                                                                            ________4  ________4  ________4  ________4
                                                                                                                                                                                                                                            ________5  ________5  ________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. 
2    Distributions from retirement plans (other than IRAs) 
3    Distributions from traditional, SEP, and SIMPLE IRAs
4    Distributions from Roth IRAs
5    Totals. Add lines 2 through 4.

45123 Enter the date the distribution period for the disaster begins. Enter the date the distribution period for the disaster ends. Enter year checked in item A. Enter year checked in item B. Enter the disaster's FEMA number.

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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.   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.

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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      2020 Form 8915-E, line 9 (if you checked the box on that line,                         0
                                                          enter -0-)
                                                2022      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, 
2020                                                      on that line, enter -0-)                                       enter -0-)
                                                2023                               0                                     2021 Form 8915-F (2020 disasters), line 11 (if you checked the box 
                                                                                                                         on that line, enter -0-)
                                                2024                               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                               0                                                             0
                                                2022                               2021                                                          0
                                                2023                               2022                                                          2021
2021
                                                2024                               2023                                                          2022
                                                2025                               0                                                             2023
                                                2026                               0                                                             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                               0                                                             0
                                                2023                               2022                                                          0
                                                2024                               2023                                                          2022
2022
                                                2025                               2024                                                          2023
                                                2026                               0                                                             2024
                                                2027                               0                                                             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                               0                                                             0
                                                2024                               2023                                                          0
                                                2025                               2024                                                          2023
2023
                                                2026                               2025                                                          2024
                                                2027                               0                                                             2025
                                                2028                               0                                                             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                               0                                                             0
                                                2025                               2024                                                          0
                                                2026                               2025                                                          2024
2024
                                                2027                               2026                                                          2025
                                                2028                               0                                                             2026
                                                2029                               0                                                             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.

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Worksheet 3                                                                                                                                        Keep for Your Records
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. 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.

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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. Enter the amount from column (c) of Worksheet 4: Supplemental Information  . . . . . . . . . . . .          1.  
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.

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Worksheet 4: Supplemental Information                                                                                                Keep for Your Records
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                   2020 Form 8915-E, line 17 (if you checked the box on that line,                          0
                                                           enter -0-)
                                                 2022      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, 
2020                                                       on that line, enter -0-)                                        enter -0-)
                                                 2023                               0                                      2021 Form 8915-F (2020 disasters), line 22 (if you checked the box 
                                                                                                                           on that line, enter -0-) 
                                                 2024                               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                                            0                                                               0
                                                 2022                               2021                                                            0
                                                 2023                               2022                                                            2021
2021
                                                 2024                               2023                                                            2022
                                                 2025                               0                                                               2023
                                                 2026                               0                                                               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                                            0                                                               0
                                                 2023                               2022                                                            0
                                                 2024                               2023                                                            2022
2022
                                                 2025                               2024                                                            2023
                                                 2026                               0                                                               2024
                                                 2027                               0                                                               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                                            0                                                               0
                                                 2024                               2023                                                            0
                                                 2025                               2024                                                            2023
2023
                                                 2026                               2025                                                            2024
                                                 2027                               0                                                               2025
                                                 2028                               0                                                               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                                            0                                                               0
                                                 2025                               2024                                                            0
                                                 2026                               2025                                                            2024
2024
                                                 2027                               2026                                                            2025
                                                 2028                               0                                                               2026
                                                 2029                               0                                                               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.

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Worksheet 5                                                                                                                                    Keep for Your Records
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     . . . . . . . . . . . . . . .                      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.

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Appendix C, Last Day To                disaster declaration date. Scan down     disaster distributions for your disaster 
                                       to that date in the "Later of            was August 27, 2023.
Make Qualified Disaster                Declaration and Beginning Date" 
                                                                                   We add here the two dates not in 
                                       column. The last day on which you 
Distributions for Your                                                          the table below. For a disaster for 
                                       can make qualified disaster 
                                                                                which the later of the disaster 
Disaster                               distributions for your disaster will be 
                                                                                declaration date and disaster 
This is the appendix referenced in All the corresponding date in the "Last 
                                                                                beginning date was:
other disasters, including some 2022   Day To Make Qualified Disaster 
disasters under Qualified disaster     Distribution for Disaster" column. For   • December 30, 2022, the last day to 
                                                                                make qualified disaster distributions 
distribution period, earlier. This     example, if the later of your disaster's 
                                                                                for the disaster was June 27, 2023; 
appendix counts the 179 days for       declaration or beginning date was 
                                                                                or
you. To use this appendix, you must    March 1, 2023, the table below 
first determine which is later, your   shows the last day to make qualified     • December 31, 2022, the last day to 
                                                                                make qualified disaster distributions 
disaster beginning date or your                                                 for the disaster was June 28, 2023.

Last Day To Make Qualified Disaster Distributions for Your Disaster

Later of        Last Day To Make       Later of       Last Day To Make          Later of       Last Day To Make 
Declaration or  Qualified Disaster     Declaration or Qualified Disaster        Declaration or Qualified Disaster 
Beginning Date  Distribution for       Beginning Date Distribution for          Beginning Date Distribution for Disaster
                Disaster                              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              8                      10             8                         10             5
11              9                      11             9                         11             6
12              10                     12             10                        12             7
13              11                     13             11                        13             8
14              12                     14             12                        14             9
15              13                     15             13                        15             10
16              14                     16             14                        16             11
17              15                     17             15                        17             12
18              16                     18             16                        18             13
19              17                     19             17                        19             14
20              18                     20             18                        20             15
21              19                     21             19                        21             16
22              20                     22             20                        22             17
23              21                     23             21                        23             18
24              22                     24             22                        24             19
25              23                     25             23                        25             20
26              24                     26             24                        26             21
27              25                     27             25                        27             22
28              26                     28             26                        28             23
29              27                                                              29             24
30              28                                                              30             25
31              29                                                              31             26

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Last Day To Make Qualified Disaster Distributions for Your Disaster (continued)

Later of       Last Day To Make   Later of       Last Day To Make          Later of       Last Day To Make 
Declaration or Qualified Disaster Declaration or Qualified Disaster        Declaration or Qualified Disaster 
Beginning Date Distribution for   Beginning Date Distribution for Disaster Beginning Date Distribution for Disaster
               Disaster
April 2023                        May 2023                                 June 2023
1              September 27, 2023 1              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             6                  10             5                         10             6
11             7                  11             6                         11             7
12             8                  12             7                         12             8
13             9                  13             8                         13             9
14             10                 14             9                         14             10
15             11                 15             10                        15             11
16             12                 16             11                        16             12
17             13                 17             12                        17             13
18             14                 18             13                        18             14
19             15                 19             14                        19             15
20             16                 20             15                        20             16
21             17                 21             16                        21             17
22             18                 22             17                        22             18
23             19                 23             18                        23             19
24             20                 24             19                        24             20
25             21                 25             20                        25             21
26             22                 26             21                        26             22
27             23                 27             22                        27             23
28             24                 28             23                        28             24
29             25                 29             24                        29             25
30             26                 30             25                        30             26
                                  31             26

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Last Day To Make Qualified Disaster Distributions for Your Disaster (continued)
Later of       Last Day To Make   Later of       Last Day To Make   Later of       Last Day To Make 
Declaration or Qualified Disaster Declaration or Qualified Disaster Declaration or Qualified Disaster 
Beginning Date Distribution for   Beginning Date Distribution for   Beginning Date Distribution for Disaster
               Disaster                          Disaster
July 2023                         August 2023                       September 2023
1              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             5                  10             5                  10             7
11             6                  11             6                  11             8
12             7                  12             7                  12             9
13             8                  13             8                  13             10
14             9                  14             9                  14             11
15             10                 15             10                 15             12
16             11                 16             11                 16             13
17             12                 17             12                 17             14
18             13                 18             13                 18             15
19             14                 19             14                 19             16
20             15                 20             15                 20             17
21             16                 21             16                 21             18
22             17                 22             17                 22             19
23             18                 23             18                 23             20
24             19                 24             19                 24             21
25             20                 25             20                 25             22
26             21                 26             21                 26             23
27             22                 27             22                 27             24
28             23                 28             23                 28             25
29             24                 29             24                 29             26
30             25                 30             25                 30             27
31             26                 31             26

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Last Day To Make Qualified Disaster Distributions for Your Disaster (continued)
Later of       Last Day To Make   Later of       Last Day To Make   Later of       Last Day To Make 
Declaration or Qualified Disaster Declaration or Qualified Disaster Declaration or Qualified Disaster 
Beginning Date Distribution for   Beginning Date Distribution for   Beginning Date Distribution for Disaster
               Disaster                          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             6                  10             7                  10             6
11             7                  11             8                  11             7
12             8                  12             9                  12             8
13             9                  13             10                 13             9
14             10                 14             11                 14             10
15             11                 15             12                 15             11
16             12                 16             13                 16             12
17             13                 17             14                 17             13
18             14                 18             15                 18             14
19             15                 19             16                 19             15
20             16                 20             17                 20             16
21             17                 21             18                 21             17
22             18                 22             19                 22             18
23             19                 23             20                 23             19
24             20                 24             21                 24             20
25             21                 25             22                 25             21
26             22                 26             23                 26             22
27             23                 27             24                 27             23
28             24                 28             25                 28             24
29             25                 29             26                 29             25
30             26                 30             27                 30             26
31             27                                                   31             27

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Last Day To Make Qualified Disaster Distributions for Your Disaster (continued)
Later of       Last Day To Make   Later of       Last Day To Make   Later of       Last Day To Make 
Declaration or Qualified Disaster Declaration or Qualified Disaster Declaration or Qualified Disaster 
Beginning Date Distribution for   Beginning Date Distribution for   Beginning Date Distribution for Disaster
               Disaster                          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             7                  10             7                  10             5
11             8                  11             8                  11             6
12             9                  12             9                  12             7
13             10                 13             10                 13             8
14             11                 14             11                 14             9
15             12                 15             12                 15             10
16             13                 16             13                 16             11
17             14                 17             14                 17             12
18             15                 18             15                 18             13
19             16                 19             16                 19             14
20             17                 20             17                 20             15
21             18                 21             18                 21             16
22             19                 22             19                 22             17
23             20                 23             20                 23             18
24             21                 24             21                 24             19
25             22                 25             22                 25             20
26             23                 26             23                 26             21
27             24                 27             24                 27             22
28             25                 28             25                 28             23
29             26                 29             26                 29             24
30             27                                                   30             25
31             28                                                   31             26

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Last Day To Make Qualified Disaster Distributions for Your Disaster (continued)
Later of       Last Day To Make   Later of       Last Day To Make   Later of       Last Day To Make 
Declaration or Qualified Disaster Declaration or Qualified Disaster Declaration or Qualified Disaster 
Beginning Date Distribution for   Beginning Date Distribution for   Beginning Date Distribution for Disaster
               Disaster                          Disaster
April 2024                        May 2024                          June 2024
1              September 27, 2024 1              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             6                  10             5                  10             6
11             7                  11             6                  11             7
12             8                  12             7                  12             8
13             9                  13             8                  13             9
14             10                 14             9                  14             10
15             11                 15             10                 15             11
16             12                 16             11                 16             12
17             13                 17             12                 17             13
18             14                 18             13                 18             14
19             15                 19             14                 19             15
20             16                 20             15                 20             16
21             17                 21             16                 21             17
22             18                 22             17                 22             18
23             19                 23             18                 23             19
24             20                 24             19                 24             20
25             21                 25             20                 25             21
26             22                 26             21                 26             22
27             23                 27             22                 27             23
28             24                 28             23                 28             24
29             25                 29             24                 29             25
30             26                 30             25                 30             26
                                  31             26

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Last Day To Make Qualified Disaster Distributions for Your Disaster (continued)
Later of       Last Day To Make   Later of       Last Day To Make   Later of       Last Day To Make 
Declaration or Qualified Disaster Declaration or Qualified Disaster Declaration or Qualified Disaster 
Beginning Date Distribution for   Beginning Date Distribution for   Beginning Date Distribution for Disaster
               Disaster                          Disaster
July 2024                         August 2023                       September 2024
1              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             5                  10             5                  10             8
11             6                  11             6                  11             9
12             7                  12             7                  12             10
13             8                  13             8                  13             11
14             9                  14             9                  14             12
15             10                 15             10                 15             13
16             11                 16             11                 16             14
17             12                 17             12                 17             15
18             13                 18             13                 18             16
19             14                 19             14                 19             17
20             15                 20             15                 20             18
21             16                 21             16                 21             19
22             17                 22             17                 22             20
23             18                 23             18                 23             21
24             19                 24             19                 24             22
25             20                 25             20                 25             23
26             21                 26             21                 26             24
27             22                 27             22                 27             25
28             23                 28             23                 28             26
29             24                 29             24                 29             27
30             25                 30             25                 30             28
31             26                 31             26

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Last Day To Make Qualified Disaster Distributions for Your Disaster (continued)
Later of       Last Day To Make   Later of       Last Day To Make   Later of       Last Day To Make 
Declaration or Qualified Disaster Declaration or Qualified Disaster Declaration or Qualified Disaster 
Beginning Date Distribution for   Beginning Date Distribution for   Beginning Date Distribution for Disaster
               Disaster                          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             7                  10             8                  10             7
11             8                  11             9                  11             8
12             9                  12             10                 12             9
13             10                 13             11                 13             10
14             11                 14             12                 14             11
15             12                 15             13                 15             12
16             13                 16             14                 16             13
17             14                 17             15                 17             14
18             15                 18             16                 18             15
19             16                 19             17                 19             16
20             17                 20             18                 20             17
21             18                 21             19                 21             18
22             19                 22             20                 22             19
23             20                 23             21                 23             20
24             21                 24             22                 24             21
25             22                 25             23                 25             22
26             23                 26             24                 26             23
27             24                 27             25                 27             24
28             25                 28             26                 28             25
29             26                 29             27                 29             26
30             27                 30             28                 30             27
31             28                                                   31             28

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Appendix D, Last Day To                 date. Scan down to that date in the       We add here the two dates not in 
                                        "Later of declaration and beginning     the table below. For a disaster for 
Repay Your Part IV                      date" column. The last day on which     which the later of the disaster 
                                        you can repay your Part IV qualified    declaration date and disaster 
Qualified Distribution
                                        distribution will be the corresponding  beginning date was:
This is the appendix referenced in All  date in the "Last day to repay your     • December 30, 2022, the last day to 
other 2021 and later disasters under    Part IV qualified distribution" column. repay qualified distributions for the 
Qualified Distribution Repayment        For example, if the later of your       disaster was June 28, 2023; or
Period, earlier. This appendix counts   disaster's declaration or beginning     • December 31, 2022, the last day to 
the 180 days for you. To use this       date was March 1, 2023, the table       repay qualified distributions for the 
appendix, you must first determine      below shows the last day to make        disaster was June 29, 2023.
which is later, your disaster beginning qualified disaster distributions for 
date or your disaster declaration       your disaster was August 28, 2023.

Last Day To Repay Your Part IV Qualified Distribution
Later of       Last Day To Repay        Later of       Last Day To Repay        Later of       Last Day To Repay 
Declaration or Your Part IV Qualified   Declaration or Your Part IV Qualified   Declaration or Your Part IV Qualified 
Beginning Date Distribution             Beginning Date Distribution             Beginning Date Distribution
January 2023                            February 2023                           March 2023
1              June 30, 2023            1              July 31, 2023            1              August 28, 2023
2              July 1, 2023             2              August 1, 2023           2              29
3              2                        3              2                        3              30
4              3                        4              3                        4              31
5              4                        5              4                        5              September 1, 2023
6              5                        6              5                        6              2
7              6                        7              6                        7              3
8              7                        8              7                        8              4
9              8                        9              8                        9              5
10             9                        10             9                        10             6
11             10                       11             10                       11             7
12             11                       12             11                       12             8
13             12                       13             12                       13             9
14             13                       14             13                       14             10
15             14                       15             14                       15             11
16             15                       16             15                       16             12
17             16                       17             16                       17             13
18             17                       18             17                       18             14
19             18                       19             18                       19             15
20             19                       20             19                       20             16
21             20                       21             20                       21             17
22             21                       22             21                       22             18
23             22                       23             22                       23             19
24             23                       24             23                       24             20
25             24                       25             24                       25             21
26             25                       26             25                       26             22
27             26                       27             26                       27             23
28             27                       28             27                       28             24
29             28                                                               29             25
30             29                                                               30             26
31             30                                                               31             27

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Last Day To Repay Your Part IV Qualified Distribution (continued)
Later of       Last Day To Repay      Later of       Last Day To Repay      Later of       Last Day To Repay 
Declaration or Your Part IV Qualified Declaration or Your Part IV Qualified Declaration or Your Part IV Qualified 
Beginning Date Distribution           Beginning Date Distribution           Beginning Date Distribution
April 2023                            May 2023                              June 2023
1              September 28, 2023     1              October 28, 2023       1              November 28, 2023
2              29                     2              29                     2              29
3              30                     3              30                     3              30
4              October 1, 2023        4              31                     4              December 1, 2023
5              2                      5              November 1, 2023       5              2
6              3                      6              2                      6              3
7              4                      7              3                      7              4
8              5                      8              4                      8              5
9              6                      9              5                      9              6
10             7                      10             6                      10             7
11             8                      11             7                      11             8
12             9                      12             8                      12             9
13             10                     13             9                      13             10
14             11                     14             10                     14             11
15             12                     15             11                     15             12
16             13                     16             12                     16             13
17             14                     17             13                     17             14
18             15                     18             14                     18             15
19             16                     19             15                     19             16
20             17                     20             16                     20             17
21             18                     21             17                     21             18
22             19                     22             18                     22             19
23             20                     23             19                     23             20
24             21                     24             20                     24             21
25             22                     25             21                     25             22
26             23                     26             22                     26             23
27             24                     27             23                     27             24
28             25                     28             24                     28             25
29             26                     29             25                     29             26
30             27                     30             26                     30             27
                                      31             27

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Last Day To Repay Your Part IV Qualified Distribution (continued)
Later of       Last Day To Repay      Later of       Last Day To Repay      Later of       Last Day To Repay Your 
Declaration or Your Part IV Qualified Declaration or Your Part IV Qualified Declaration or Part IV Qualified 
Beginning Date Distribution           Beginning Date Distribution           Beginning Date Distribution
July 2023                             August 2023                           September 2023
1              December 28, 2023      1              January 28, 2024       1              February 28, 2024
2              29                     2              29                     2              29
3              30                     3              30                     3              March 1, 2024
4              31                     4              31                     4              2
5              January 1, 2024        5              February 1, 2024       5              3
6              2                      6              2                      6              4
7              3                      7              3                      7              5
8              4                      8              4                      8              6
9              5                      9              5                      9              7
10             6                      10             6                      10             8
11             7                      11             7                      11             9
12             8                      12             8                      12             10
13             9                      13             9                      13             11
14             10                     14             10                     14             12
15             11                     15             11                     15             13
16             12                     16             12                     16             14
17             13                     17             13                     17             15
18             14                     18             14                     18             16
19             15                     19             15                     19             17
20             16                     20             16                     20             18
21             17                     21             17                     21             19
22             18                     22             18                     22             20
23             19                     23             19                     23             21
24             20                     24             20                     24             22
25             21                     25             21                     25             23
26             22                     26             22                     26             24
27             23                     27             23                     27             25
28             24                     28             24                     28             26
29             25                     29             25                     29             27
30             26                     30             26                     30             28
31             27                     31             27

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Last Day To Repay Your Part IV Qualified Distribution (continued)
Later of       Last Day To Repay      Later of       Last Day To Repay      Later of       Last Day To Repay Your 
Declaration or Your Part IV Qualified Declaration or Your Part IV Qualified Declaration or Part IV Qualified 
Beginning Date Distribution           Beginning Date Distribution           Beginning Date Distribution
October 2023                          November 2023                         December 2023
1              March 29, 2024         1              April 29, 2024         1              May 29, 2024
2              30                     2              30                     2              30
3              31                     3              May 1, 2024            3              31
4              April 1, 2024          4              2                      4              June 1, 2024
5              2                      5              3                      5              2
6              3                      6              4                      6              3
7              4                      7              5                      7              4
8              5                      8              6                      8              5
9              6                      9              7                      9              6
10             7                      10             8                      10             7
11             8                      11             9                      11             8
12             9                      12             10                     12             9
13             10                     13             11                     13             10
14             11                     14             12                     14             11
15             12                     15             13                     15             12
16             13                     16             14                     16             13
17             14                     17             15                     17             14
18             15                     18             16                     18             15
19             16                     19             17                     19             16
20             17                     20             18                     20             17
21             18                     21             19                     21             18
22             19                     22             20                     22             19
23             20                     23             21                     23             20
24             21                     24             22                     24             21
25             22                     25             23                     25             22
26             23                     26             24                     26             23
27             24                     27             25                     27             24
28             25                     28             26                     28             25
29             26                     29             27                     29             26
30             27                     30             28                     30             27
31             28                                                           31             28

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Last Day To Repay Your Part IV Qualified Distribution (continued)
Later of       Last Day To Repay      Later of       Last Day To Repay      Later of       Last Day To Repay Your 
Declaration or Your Part IV Qualified Declaration or Your Part IV Qualified Declaration or Part IV Qualified 
Beginning Date Distribution           Beginning Date Distribution           Beginning Date Distribution
January 2024                          February 2024                         March 2024
1              June 29, 2024          1              July 30, 2024          1              August 28, 2024
2              30                     2              31                     2              29
3              July 1, 2024           3              August 1, 2024         3              30
4              2                      4              2                      4              31
5              3                      5              3                      5              September 1, 2024
6              4                      6              4                      6              2
7              5                      7              5                      7              3
8              6                      8              6                      8              4
9              7                      9              7                      9              5
10             8                      10             8                      10             6
11             9                      11             9                      11             7
12             10                     12             10                     12             8
13             11                     13             11                     13             9
14             12                     14             12                     14             10
15             13                     15             13                     15             11
16             14                     16             14                     16             12
17             15                     17             15                     17             13
18             16                     18             16                     18             14
19             17                     19             17                     19             15
20             18                     20             18                     20             16
21             19                     21             19                     21             17
22             20                     22             20                     22             18
23             21                     23             21                     23             19
24             22                     24             22                     24             20
25             23                     25             23                     25             21
26             24                     26             24                     26             22
27             25                     27             25                     27             23
28             26                     28             26                     28             24
29             27                     29             27                     29             25
30             28                                                           30             26
31             29                                                           31             27

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Last Day To Repay Your Part IV Qualified Distribution (continued)
Later of       Last Day To Repay      Later of       Last Day To Repay      Later of       Last Day To Repay 
Declaration or Your Part IV Qualified Declaration or Your Part IV Qualified Declaration or Your Part IV Qualified 
Beginning Date Distribution           Beginning Date Distribution           Beginning Date Distribution
April 2024                            May 2024                              June 2024
1              September 28, 2024     1              October 28, 2024       1              November 28, 2024
2              29                     2              29                     2              29
3              30                     3              30                     3              30
4              October 1, 2024        4              31                     4              December 1, 2024
5              2                      5              November 1, 2024       5              2
6              3                      6              2                      6              3
7              4                      7              3                      7              4
8              5                      8              4                      8              5
9              6                      9              5                      9              6
10             7                      10             6                      10             7
11             8                      11             7                      11             8
12             9                      12             8                      12             9
13             10                     13             9                      13             10
14             11                     14             10                     14             11
15             12                     15             11                     15             12
16             13                     16             12                     16             13
17             14                     17             13                     17             14
18             15                     18             14                     18             15
19             16                     19             15                     19             16
20             17                     20             16                     20             17
21             18                     21             17                     21             18
22             19                     22             18                     22             19
23             20                     23             19                     23             20
24             21                     24             20                     24             21
25             22                     25             21                     25             22
26             23                     26             22                     26             23
27             24                     27             23                     27             24
28             25                     28             24                     28             25
29             26                     29             25                     29             26
30             27                     30             26                     30             27
                                      31             27

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Last Day To Repay Your Part IV Qualified Distribution (continued)
Later of       Last Day To Repay      Later of       Last Day To Repay      Later of       Last Day To Repay 
Declaration or Your Part IV Qualified Declaration or Your Part IV Qualified Declaration or Your Part IV Qualified 
Beginning Date Distribution           Beginning Date Distribution           Beginning Date Distribution
July 2024                             August 2024                           September 2024
1              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             5                      10             5                      10             8
11             6                      11             6                      11             9
12             7                      12             7                      12             10
13             8                      13             8                      13             11
14             9                      14             9                      14             12
15             10                     15             10                     15             13
16             11                     16             11                     16             14
17             12                     17             12                     17             15
18             13                     18             13                     18             16
19             14                     19             14                     19             17
20             15                     20             15                     20             18
21             16                     21             16                     21             19
22             17                     22             17                     22             20
23             18                     23             18                     23             21
24             19                     24             19                     24             22
25             20                     25             20                     25             23
26             21                     26             21                     26             24
27             22                     27             22                     27             25
28             23                     28             23                     28             26
29             24                     29             24                     29             27
30             25                     30             25                     30             28
31             26                     31             26

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Last Day To Repay Your Part IV Qualified Distribution (continued)
Later of       Last Day To Repay      Later of       Last Day To Repay      Later of       Last Day To Repay 
Declaration or Your Part IV Qualified Declaration or Your Part IV Qualified Declaration or Your Part IV Qualified 
Beginning Date Distribution           Beginning Date Distribution           Beginning Date Distribution
October 2024                          November 2023                         December 2024
1              March 29, 2025         1              April 29, 2025         1              May 29, 2025
2              30                     2              30                     2              30
3              31                     3              May 1, 2025            3              31
4              April 1, 2025          4              2                      4              June 1, 2025
5              2                      5              3                      5              2
6              3                      6              4                      6              3
7              4                      7              5                      7              4
8              5                      8              6                      8              5
9              6                      9              7                      9              6
10             7                      10             8                      10             7
11             8                      11             9                      11             8
12             9                      12             10                     12             9
13             10                     13             11                     13             10
14             11                     14             12                     14             11
15             12                     15             13                     15             12
16             13                     16             14                     16             13
17             14                     17             15                     17             14
18             15                     18             16                     18             15
19             16                     19             17                     19             16
20             17                     20             18                     20             17
21             18                     21             19                     21             18
22             19                     22             20                     22             19
23             20                     23             21                     23             20
24             21                     24             22                     24             21
25             22                     25             23                     25             22
26             23                     26             24                     26             23
27             24                     27             25                     27             24
28             25                     28             26                     28             25
29             26                     29             27                     29             26
30             27                     30             28                     30             27
31             28                                                           31             28

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