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                                                                                                                Department of the Treasury
                                                                                                                Internal Revenue Service
Instructions for Form 8915-F

(Rev. February 2022)
Qualified Disaster Retirement Plan Distributions and Repayments

Contents                                      Page  Congress that would elevate certain            • You received a qualified distribution 
General Instructions .  . . . . . . . . . . . . 1   2021 disasters and the 2020 Washington         described in Qualified 2020 disaster areas 
                                                    (4593-DR-WA) disaster to the status of         under Qualified Distribution for the Purchase 
Future Developments .           . . . . . . . . 1   qualified disasters. Go to Recent              or Construction of a Main Home in Qualified 
Helpful Hints . . . . . . . . . . . . . . 1         Developments under IRS.gov/Form8915F           Disaster Areas, later.
How Do I Distinguish My                             to see whether that legislation was            Your form will be called Form 8915-F (2020 
       Form 8915-F and Its                          enacted.                                       disasters).
       Disasters From Other 
       Forms 8915-F? .      . . . . . . . . . . 1                                                    The year of the form will be the year you 
Purpose of Form           . . . . . . . . . . . 1   Helpful Hints                                  checked in item A at the top of page 1 of your 
                                                                                                   Form 8915-F. If you checked the 2021 box in 
Purpose of These                                    Form 8915-F can be e-filed.   Form 8915-F      item A, your form will be called 2021 Form 
       Instructions .   . . . . . . . . . . . . 1   can be completed electronically and e-filed    8915-F (2020 disasters).
When Should I Not Use a                             with your tax return.                          Names of disasters and distributions. 
       Form 8915-F?       . . . . . . . . . . . 1
Who Must File           . . . . . . . . . . . . . 2 Form 8915-F is a forever form.  Form           Except when referring to them generally, 
When and Where To File              . . . . . . 2   8915-F is a redesigned Form 8915.              these instructions will refer to the different 
What Is a Qualified Disaster                        Beginning in 2021, additional alphabetical     qualified disasters and qualified disaster 
       Distribution? .  . . . . . . . . . . . . 2   Forms 8915 (that is, Form 8915-G, Form         distributions by their specific names using 
                                                    8915-H, etc.) will not be issued. The same     the year you checked in item B at the top of 
Qualified Disaster                                  Form 8915-F will be used for distributions for page 1 of your Form 8915-F.
       Distribution     . . . . . . . . . . . . . 2
                                                    qualified 2020 disasters (and qualified 2021 
Qualified Distribution for the                      and later disasters, if enacted) and for each  Purpose of Form
       Purchase or Construction                     year of reporting of income and repayments     Use Form 8915-F to report:
       of a Main Home in                                                                             Qualified 2020 disaster distributions made 
       Qualified Disaster Areas         . . . . 3   of those distributions. The boxes you check    •
                                                    in items A and B will help us determine the    in 2021 (coronavirus-related distributions 
Amending Form 8915-F                                exact year of the form you are filing, and the can't be made after December 30, 2020);
       (2020 Disasters)  .    . . . . . . . . . 4                                                    Repayments of qualified 2020 disaster 
                                                    year of the qualified disasters, qualified     •
Specific Instructions . . . . . . . . . . . . . 5   disaster distributions, and qualified          distributions;
Required General                                    distributions you are reporting. Earlier Forms • Income in 2021 and later years from 
       Information      . . . . . . . . . . . . . 5 8915 had a different alphabetical Form 8915    qualified 2020 and later disaster 
Part I—Total Distributions                          for each year of disasters and a different     distributions; and
       From All Retirement                          form for each year the alphabetical form       • Qualified distributions received on 
       Plans (Including IRAs) .       . . . . . 5   existed. See How Do I Distinguish My Form      January 1, 2021, for the Washington 
Part II—Qualified Disaster                          8915-F and Its Disasters From Other Forms      (8593-DR-WA) disaster.
       Distributions From                           8915-F and When Should I Not Use a Form 
       Retirement Plans (Other                      8915-F, later.                                 Note.  To the extent relevant legislation is 
       Than IRAs)       . . . . . . . . . . . . . 6                                                enacted, Form 8915-F will also be used to 
Part III—Qualified Disaster                         How Do I Distinguish My Form                   report:
       Distributions From                           8915-F and Its Disasters From                  • Qualified 2021 and later disaster 
       Traditional, SEP,                                                                           distributions;
       SIMPLE, and Roth IRAs .          . . . . 7   Other Forms 8915-F?                              Qualified 2020 disaster distributions that 
                                                                                                   •
Part IV—Qualified                                   Name of form.   These instructions will use    can be made in 2022;
       Distributions for the                        different names to refer to your Form 8915-F   • Repayments of qualified 2021 and later 
       Purchase or Construction                     depending on the boxes you check in items      disaster distributions; and
       of a Main Home in                                                                             Other qualified distributions received in 
       Qualified Disaster Areas .       . . . . 8   A and B at the top of page 1 of your Form      •
Worksheets .  . . . . . . . . . . . . . . 8         8915-F. For example, if you checked the        2021 and qualified distributions received in 
                                                    2021 box in item A and the 2020 box in item    2022 and later years.
Appendix A, Which Lines                             B, your form will be referred to in these 
       Should I Use? .    . . . . . . . . . .   10  instructions and elsewhere as 2021 Form        Purpose of These Instructions
Appendix B, Qualified                               8915-F (2020 disasters). See Form 8915-F       These instructions provide detailed 
       Disaster Areas by Year .       . . . .   12  (2020 disasters) next.                         information for use with your 2021 Form 
Section references are to the Internal Revenue Code                                                8915-F. For your convenience, Appendix A, 
unless otherwise noted.                                Form 8915-F (2020 disasters).      Check    Which Lines Should I Use, later, provides, as 
                                                    the 2020 box in item B of your Form 8915-F if  well, the lines you should complete on your 
General Instructions                                you were adversely affected by a qualified     Form 8915-F for all tax years applicable to 
                                                    2020 disaster listed in Table for Qualified    2020 disasters.
                                                    2020 Disaster Areas in Appendix B, 
Future Developments                                 Qualified Disaster Areas by Year at the end    When Should I Not Use a Form 
For the latest information about                    of these instructions, and:                    8915-F?
developments related to Form 8915-F and its         •  A qualified disaster distribution described 
instructions, such as legislation enacted after     in Qualified 2020 disaster distribution        Reporting coronavirus-related and other 
they were published, go to IRS.gov/                 requirements, later, was made to you;          distributions for qualified 2020 disasters 
Form8915F.                                          •  You are repaying, or have income from, a    made or received in 2020.  This form 
       When these instructions went to              coronavirus-related distribution or other      replaces Form 8915-E for tax years 
                                                    qualified 2020 disaster distribution reported  beginning after 2020. Do not use a Form 
!      print, legislation was pending in            on Part I of 2020 Form 8915-E; or              8915-F to report qualified 2020 disaster 
CAUTION

Feb 11, 2022                                                       Cat. No. 37509G

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distributions made in 2020 or qualified What Is a Qualified 1. The distribution was made no later
distributions received in 2020 for qualified than June 24, 2021.
2020 disasters. Disaster Distribution? 2. Your main home was located in a
For 2021, qualified disaster distributions are: qualified 2020 disaster area listed in Table
•
You will still use 2020 Form 8915-E The qualified 2019 disaster distributions for Qualified 2020 Disaster Areas in
CAUTION other qualified disaster distributions
! to report coronavirus-related and for the Puerto Rico Earthquakes Appendix B at any time during the disaster
(DR-4473-PR) reported on 2021 Form period shown for that area in that table. See
made in 2020 and to report qualified 8915-D, or Main home, later. The qualified 2020
2020 disasters. •
distributions received in 2020 for qualified The qualified 2020 disaster distributions disaster area is the state, territory, or tribal
for qualified 2020 disasters reported on 2021 government in which the disaster occurs.
Qualified 2019 and earlier disasters. Do Form 8915-F (2020 disasters).
3. You sustained an economic loss
not use Form 8915-F to do the following. Coronavirus-related distributions because of the disaster(s) in (2) above.
• Repay qualified 2017 disaster ! can't be made in 2021. Examples of an economic loss include, but
distributions. Use Form 8915-B for those CAUTION aren't limited to: (a) loss, damage to, or
repayments. destruction of real or personal property from
• Repay qualified 2018 disaster Qualified Disaster fire, flooding, looting, vandalism, theft, wind,
distributions. Use Form 8915-C for those or other cause; (b) loss related to
repayments. Distribution displacement from your home; or (c) loss of
• Repay, and report income from, qualified livelihood due to temporary or permanent
2019 disaster distributions. Use Form How Is a Qualified Disaster layoffs.
8915-D for those repayments and income. Distribution Taxed?
Which Lines Should I Generally, a qualified 2020 disaster If (1) through (3) apply, you can generally
distribution is included in your income in designate any distribution (including periodic
Complete? equal amounts over 3 years. However, if you payments and required minimum
If you e-file your return, the software elect, you can include the entire distribution distributions) from an eligible retirement plan
TIP you use may determine which lines in your income in the year of the distribution. as a qualified 2020 disaster distribution,
regardless of whether the distribution was
you need. On your 2021 Form 8915-F (2020 made on account of a qualified 2020
You might not need to enter amounts on disasters), lines 11 and 22, you must either disaster. Qualified 2020 disaster distributions
each line of your Form 8915-F (2020 spread all the income for all your qualified are permitted without regard to your need or
disasters). The tables in Form 8915-F (2020 2020 disaster distributions made for 2021 the actual amount of your economic loss.
Disasters): Lines To Use, later, provide the over 3 years or include all the income from See Eligible retirement plan, later, for the list
lines you need to complete on Form 8915-F those distributions in 2021. of plans from which qualified 2020 disaster
(2020 disasters) for each year of the form. distributions can be made.
The lines you use will depend on: Any repayments made before you file A reduction or offset of your account
• Whether qualified disaster distributions your return and by the due date (including balance in an eligible retirement plan (other
were made to you, extensions) reduce the amount of the than an IRA) in order to repay a loan can also
• Whether you have received qualified distribution included in your income. be designated as a qualified 2020 disaster
distribution. See Distribution of plan loan
distributions, Also, qualified 2020 disaster distributions offsets, later.
• Whether you are recognizing income from aren't subject to the additional 10% tax on
distributions, and early distributions. Distributions that are not qualified disas-
• Whether you are repaying distributions. ter distributions. The following
If a taxpayer who spread the income distributions are not qualified disaster
Who Must File ! from a qualified 2020 disaster distributions.
CAUTION distribution over 3 years dies before
• Corrective distributions of elective
File Form 8915- F (2020 disasters) for the the last tax year of that 3-year period, the deferrals and employee contributions that
year you checked in item A at the top of distribution may no longer be spread over 3 are returned to the employee (together with
page 1 of the form if any of the following years. The remainder of the distribution must the income allocable thereto) in order to
apply to you for 2021 for your 2020 disasters. be reported on the return of the deceased comply with the section 415 limitations.
• A qualified disaster distribution was made taxpayer. Include the remainder in the line 13 • Excess elective deferrals under section
to you from an eligible retirement plan. and/or line 24 totals, as applicable, of your 402(g), excess contributions under section
• You received a qualified distribution. 2021 Form 8915-F. 401(k), and excess aggregate contributions
• A qualified disaster distribution was made
to you in a prior year that you are including in under section 401(m).
income in equal amounts over 3 years and Qualified Disaster Distribution • Loans that are treated as deemed
the 3-year period has not yet lapsed. Requirements distributions pursuant to section 72(p).
• You made a repayment of a qualified • Dividends paid on applicable employer
disaster distribution. A coronavirus-related distribution securities under section 404(k).
! can't be made after 2020. Also, a • The cost of current life insurance
CAUTION distribution is not a qualified 2020
protection.
When and Where To File disaster distribution or a qualified 2021 • Prohibited allocations that are treated as
File your Form 8915-F with your Form 1040, disaster distribution if it is listed in deemed distributions pursuant to section
1040-SR, or 1040-NR for the year checked Distributions that are not qualified disaster 409(p).
in item A at the top of page 1 of your Form distributions, later. See Limit, later, for the • Distributions that are permissible
8915-F. You will file your 2021 Form 8915-F dollar limit on qualified disaster distributions. withdrawals from an eligible automatic
(2020 disasters) with your 2021 Form 1040, contribution arrangement within the meaning
1040-SR, or 1040-NR. Qualified 2020 disaster distribution re- of section 414(w).
quirements. Qualified 2020 disaster • Distributions of premiums for accident or
The timing of your distributions and distributions made in 2021 are reported on health insurance under Treasury Regulations
repayments will determine whether you need 2021 Form 8915-F (2020 disasters) and section 1.402(a)-1(e)(1)(i).
to file an amended return to claim them. To must meet the following criteria. You must
determine whether you need to amend your meet these requirements separately for each Limit. For each qualified 2020 disaster, the
Form 8915-F, see Amending Form 8915-F, of your disasters that you are reporting on total of your qualified disaster distributions
later. 2021 Form 8915-F (2020 disasters). from all plans is limited to $100,000. If you

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have distributions from more than one type cannot be more than the amount of the repayment of $65,000 on April 30, 2022. You
of plan, such as a 401(k) plan and an IRA, original distribution. Amounts that are repaid report $25,000 of the repayment on your
and the total on line 5, column (a), of your are treated as a trustee-to-trustee transfer 2022 Form 8915-F (2020 disasters). You
Form 8915-F exceeds your total available and are not included in income. Also, for report the excess repayment of $40,000 as
qualified disaster distribution amount from purposes of the one-rollover-per-year follows. You carry back $25,000 to 2021
line 1e of your Form 8915-F, you may limitation for IRAs, a repayment to an IRA is Form 8915-F (2020 disasters) and $15,000
allocate the amount among the plans by any not considered a rollover. forward to 2023 Form 8915-F (2020
reasonable method when determining the disasters).
amounts on lines 2, 3, and 4 of column (b). Include on 2021 Form 8915-F (2020
disasters) any repayments you made before Exceptions. You cannot repay the
Eligible retirement plan. An eligible filing your 2021 return. Any repayments you following types of distributions.
retirement plan can be any of the following. made will reduce the amount of qualified 1. Qualified disaster distributions
• A qualified pension, profit-sharing, or disaster distributions reported on your return received as a beneficiary (other than a
stock bonus plan (including a 401(k) plan). for 2021. Do not include on your 2021 Form surviving spouse).
• A qualified annuity plan. 8915-F (2020 disasters) any repayments you 2. Required minimum distributions.
• A tax-sheltered annuity contract. made later than the due date (including
• A governmental section 457 deferred extensions) for filing your 2021 return. If you 3. Any distribution (other than from an
compensation plan. made a repayment in 2022 after you filed IRA) that is one of a series of substantially
• A traditional, SEP, SIMPLE, or Roth IRA. your 2021 return, the repayment will reduce equal periodic payments made (at least
Distribution of plan loan offsets. A the amount of your qualified 2020 disaster annually) for:
distribution of a plan loan offset is a distributions made for 2020 or 2021 and a. A period of 10 years or more,
distribution that occurs when, under the included in full in income on your 2020 or b. Your life or life expectancy, or
terms of a plan, the participant’s accrued 2021 return, respectively. See Amending
benefit is reduced (offset) in order to repay a Form 8915-F, later. c. The joint lives or joint life
expectancies of you and your beneficiary.
loan. A distribution of a plan loan offset Also, if you have spread the income over
amount can occur for a variety of reasons, 3 years, any excess repayments you Qualified Distribution for
such as when a participant terminates reported on your 2022 Form 8915-F (2020
employment or doesn’t comply with the disasters) can be carried: the Purchase or
terms of repayment. Plan loan offsets are • Forward to your 2023 Form 8915-F (2020 Construction of a Main
treated as actual distributions and are disasters) to reduce income from qualified
reported in box 1 of Form 1099-R. 2020 disaster distributions made in 2021; Home in Qualified Disaster
Main home. Generally, your main home is • Back to your 2021 Form 8915-F (2020 Areas
the home where you live most of the time. A disasters) to reduce income from qualified
temporary absence due to special 2020 disaster distributions made in 2020 or Qualified Distribution
circumstances, such as illness, education, 2021; or Requirements
business, military service, evacuation, or • Back to your 2020 Form 8915-E if you
vacation, won’t change your main home. filed 2020 Form 8915-E and are eligible to Qualified 2020 disaster areas. To be a
amend your 2020 return. qualified distribution on 2021 Form 8915-F
(2020 disasters) for the purchase or
Additional Tax Example 1. On your 2020 Form 8915-E, construction of a main home in a qualified
Qualified 2020 disaster distributions aren’t you reported a coronavirus-related 2020 disaster area, the distribution must
subject to the additional 10% tax (or the 25% distribution of $9,000 made to you from your meet all of the following requirements.
additional tax for certain distributions from traditional IRA on April 14, 2020. You spread
SIMPLE IRAs) on early distributions and the income over 3 years ($3,000 in each of 1. The disaster was the Alaska Severe
aren’t required to be reported on Form 5329. 2020, 2021, and 2022). You made no Storm, Flooding, Landslides, and Mudslides
However, the amount on line 7 of your Form repayments of the distribution in 2020. In (4585-DR-AK). Leave 2021 Form 8915-F
8915-F may be subject to the additional tax. 2021, you made a repayment of $4,500. You (2020 disasters), Part IV, blank if your only
See the Instructions for Form 5329 on how to will report $3,000 of the repayment on your qualified 2020 disaster was any other 2020
figure the additional tax on your distributions. 2021 Form 8915-F (2020 disasters). The disaster (including the coronavirus).
excess repayment of $1,500 can be carried 2. The distribution is a hardship
Note. If you choose to treat a distribution as forward to 2022 and reported on your 2022 distribution from a 401(k) plan, a hardship
a qualified 2020 disaster distribution, it is not Form 8915-F (2020 disasters) or carried distribution from a tax-sheltered annuity
eligible for the 20% capital gain election or back to 2020 and reported on your 2020 contract, or a qualified first-time homebuyer
the 10-year tax option. For information on Form 8915-E. distribution from an IRA.
those options, see the instructions for Form
4972. Example 2. You suffered economic 3. The distribution was received on
losses in 2020 in Hawaii as the result of January 1, 2021.
Repayment of a Qualified DR-4549-HI. You received a qualified 2020 4. The distribution was to be used to
Disaster Distribution disaster distribution in the amount of $75,000 purchase or construct a main home in Alaska
on April 30, 2021, and $15,000 on May 30, and the main home was not purchased or
If you choose, you can generally repay any 2021. You wish to treat a contribution of constructed because of the disaster. See
portion of a qualified disaster distribution that $90,000 you made on May 19, 2021, as a Main home, earlier. The disaster area is the
is eligible for tax-free rollover treatment to an repayment of both distributions. Only state, territory, or tribal government in which
eligible retirement plan. Also, you can repay $75,000 can be reported as a qualified 2020 the disaster occurs.
a qualified disaster distribution made on disaster distribution repayment. Repayments
account of hardship from a retirement plan. can only be made after the date on which the If the distribution was received in
However, see Exceptions, later, for qualified distribution was received. TIP 2020 or 2019, see 2020 qualified
disaster distributions you can’t repay. distributions or 2019 qualified
Example 3. You suffered economic distributions, respectively, under Amending
Your repayment can't be made any earlier losses in 2020 as the result of DR-4549-HI. Form 8915-F (2020 Disasters), later.
than the day after the date you received the You received a qualified 2020 disaster
qualified disaster distribution. You have 3 distribution in the amount of $75,000 on April
years from the day after the date you 30, 2021, spreading the income over 3 years
received the distribution to make a (2021, 2022, and 2023). You filed your 2021
repayment. The amount of your repayment tax return on April 10, 2022. You made a

Instructions for Form 8915-F (Rev. 2-2022) -3-

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Repayment of a Qualified                          If you make a repayment of a qualified       Distributions for the Purchase or 
                                                2020 disaster distribution by the due date of  Construction of a Main Home in Qualified 
Distribution for the Purchase or                your 2021 return (including extensions),       2020 Disaster Areas in the 2020 Instructions 
Construction of a Main Home                     include the repayment on a Form 1040-X         for Form 8915-E for details on qualified 
                                                amending your 2021 Form 8915-F (2020           distributions received in 2020.) If you have 
Qualified 2020 disaster areas.   If you         disasters).                                    already filed your 2020 return on which you 
received a qualified distribution for the                                                      reported the distribution, you should file an 
Alaska (4585-DR-AK) disaster on January 1,        If you make the repayment after the due 
2021, to purchase or construct a main home      date of your 2021 return (including            amended 2020 return or an amended 2020 
in a qualified 2020 disaster area, you can      extensions) but before the due date of your    Form 8915-E to report the repayment 
choose to repay that distribution to an         2022 return (including extensions) and you     following the usual rules. See Part IV in the 
eligible retirement plan no later than June 25, have spread the income over 3 years,           Specific Instructions in the 2020 Instructions 
2021. For this purpose, an eligible retirement  include the repayment on your 2022 Form        for Form 8915-E.
plan is any plan, annuity, or IRA to which a    8915-F (2020 disasters). However, you may      2019 qualified distributions.  If the 
rollover can be made. Amounts that are          file a Form 1040-X amending your 2021          coronavirus is your only qualified 2020 
repaid no later than June 25, 2021, are         Form 8915-F (2020 disasters) if either of the  disaster, the discussion in the next 
treated as a trustee-to-trustee transfer and    following applies.                             paragraph and its example do not apply to 
are not included in income. For purposes of     • You elected on 2020 Form 8915-E, lines 9     you.
the one-rollover-per-year limitation for IRAs,  and 17, or 2021 Form 8915-F (2020 
a repayment to an IRA is not considered a       disasters), lines 11 and 22, as applicable, to You may reduce the amount of a qualified 
rollover.                                       include all of your qualified 2020 disaster    distribution for a qualified 2020 disaster 
                                                distributions in income in 2020 or 2021, as    included in income in 2019 by the amount of 
If the qualified distribution (or any portion   applicable (instead of over 3 years).          a repayment made in 2021 before June 26. 
thereof) is not repaid before June 26, 2021, it   You have spread the income over 3 years,     Because a qualified distribution can be 
may be taxable in 2021 and may be subject       •                                              received up to 180 days before the disaster 
                                                the amount of the repayment exceeds the 
to the additional 10% tax (or the additional    amount of your qualified 2020 disaster         began and repayments for that distribution 
25% tax for certain SIMPLE IRAs) on early       distributions that are included in income on   can be made from the beginning date of the 
distributions. See the Instructions for Form    your 2022 Form 8915-F (2020 disasters),        disaster and up to June 25, 2021, you may 
5329 to figure any tax.                         and you choose to carry the excess back to     have a qualified distribution received in 2019 
You may be able to designate a qualified        2021. See the examples below.                  for which you are making repayments in 
distribution for the Alaska (4585-DR-AK)                                                       2021. If you have already filed your 2019 
disaster as a qualified 2020 disaster             Example 1. You received a                    return on which you reported the distribution, 
distribution if all of the following apply.     coronavirus-related distribution in the        you should file an amended 2019 return to 
                                                amount of $9,000 in 2020. You choose to        report the repayment. On your amended 
1. The distribution was made on                 spread the $9,000 over 3 years ($3,000 in      return (Form 1040-X), you will write in "2019" 
January 1, 2021.                                income for 2020, 2021, and 2022). On           for the calendar year at the top of page 1 if 
2. The distribution (or any portion             November 19, 2022, you make a repayment        you are a calendar year filer and enter, in 
thereof) is not repaid before June 26, 2021.    of $4,500. For 2022, none of the qualified     parentheses in column B of line 1, the 
3. The distribution can otherwise be            2020 disaster distribution is included in      amount of the repayment. If the distribution 
treated as a qualified 2020 disaster            income. The excess repayment of $1,500         was from an IRA, in Part III of your amended 
distribution. See Qualified 2020 disaster       ($4,500 − $3,000) can be carried back to       return, enter: "The amount I reported on 
distribution requirements, earlier.             2021. Also, instead of carrying the excess     [2019 Form 1040 or 1040-SR, line 4b, or 
                                                repayment back to 2021, you can choose to      2019 Form 1040-NR, line 16b, as applicable] 
      If the distribution was received in       carry it back to 2020.                         is being reduced by a contribution made 
TIP   2019 or 2020 for any qualified 2020         Example 2.  You received a qualified         [mm/dd/2021] to an eligible retirement plan 
      disaster, see 2019 qualified              2020 disaster distribution in the amount of    in repayment of a qualified distribution made 
distributions or 2020 qualified distributions   $90,000 in 2021. You elected to have the full  [mm/dd/2019] under the Taxpayer Certainty 
under Amending Form 8915-F (2020                income from the distribution recognized in     and Disaster Tax Relief Act of 2020, sec. 
disasters), later.                              2021. On November 19, 2022, you make a         302(b). The disaster was the [name of the 
                                                repayment of $45,000. The entire $45,000 is    qualified 2020 disaster from Table for 
Amending Form 8915-F                            carried back to 2021.                          Qualified 2020 Disaster Areas] disaster." If 
                                                                                               the distribution was from a retirement plan 
(2020 Disasters)                                  Example 3. You received a qualified          other than an IRA, in Part III of your amended 
File Form 1040-X, Amended U.S. Individual       2020 disaster distribution in the amount of    return, enter: "The amount I reported on 
Income Tax Return, to amend a return you        $90,000 in 2021. You choose to spread the      [2019 Form 1040 or 1040-SR, line 4d, or 
have already filed. Generally, Form 1040-X      $90,000 over 3 years ($30,000 in income for    2019 Form 1040-NR, line 17b, as applicable] 
must be filed for a credit or refund within 3   2021, 2022, and 2023). On November 19,         is being reduced by a contribution made 
years after the date the original return was    2022, you make a repayment of $45,000. For     [mm/dd/2021] to an eligible retirement plan 
filed, or within 2 years after the date the tax 2022, none of the qualified 2020 disaster      in repayment of a qualified distribution made 
was paid, whichever is later.                   distribution is included in income. The        [mm/dd/2019] under the Taxpayer Certainty 
                                                excess repayment of $15,000 ($45,000 −         and Disaster Tax Relief Act of 2020, sec. 
Amending Form 8915-F (2020                      $30,000) can be carried back to 2021. Also,    302(b). The disaster was the [name of the 
                                                instead of carrying the excess repayment       qualified 2020 disaster from Table for 
Disasters)                                      back to 2021, you can choose to carry it       Qualified 2020 Disaster Areas] disaster." 
Qualified 2020 disaster distributions.      If, forward to 2023.                               Use the full name of the disaster. Include the 
after filing your 2021 return, you make a       2020 qualified distributions. If the           state, territory, or tribal government and the 
repayment of a qualified 2020 disaster          coronavirus is your only qualified 2020        FEMA DR number from Table for Qualified 
distribution, the repayment may reduce the      disaster, the discussion in the next           2020 Disaster Areas at the end of these 
amount of your qualified 2020 disaster          paragraph and its example do not apply to      instructions.
distributions reported on that return.          you.                                           Example.     You received a distribution 
Depending on when a repayment is made, 
you may need to file an amended tax return        You may reduce the amount of a qualified     from a traditional IRA on December 12, 
to refigure your taxable income.                distribution reported on 2020 Form 8915-E      2019, to construct a home in the Mississippi 
                                                by the amount of a repayment made in 2021      Severe Storms, Tornadoes, Straight-line 
                                                before June 26. (See Part IV—Qualified         Winds, and Flooding (DR-4478-MS) disaster 

                                                                    -4-                        Instructions for Form 8915-F (Rev. 2-2022)

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area which you did not construct because of which you are reporting distributions on your disasters) that were not reported on your
that disaster. The disaster began January Form 8915-F began. 2020 Form 8915-E. Enter, on line 1d, the
10, 2020, and the distribution now qualifies product of that number and $100,000.
as a qualified distribution. On June 14, 2021, Item C. Enter the FEMA DR number from
you made a contribution that qualifies as a Table for Qualified 2020 Disaster Areas. For Line 1e. Complete line 1e as follows.
repayment of the distribution. You have example, for the 2020 Louisiana Hurricane • If you have been instructed above to leave
already filed your 2019 return, a Form 1040. Delta, you would enter DR-4559-LA. lines 1a through 1d blank, enter on line 1e
the product of $100,000 times the number of
You will need to file a Form 1040-X for 2019 Do not enter the coronavirus in item disasters you reported in item C of your 2021
to claim the repayment. On your Form ! C. Form 8915-F (2020 disasters).
1040-X, you write in "2019" for the calendar CAUTION
year at the top of page 1 because you are a • Otherwise, enter the sum of lines 1c and
calendar year filer and, in parentheses in Item D. Check the box if the coronavirus is a 1d on line 1e.
column B of line 1, you enter the amount of disaster you are reporting on your Form Lines 2 through 4 in column (a). If you
the repayment. In Part III of your amended 8915-F. received a distribution from a retirement plan
return, enter: "The amount I reported on (including an IRA), you should receive a
2019 Form 1040, line 4b, is being reduced Part I—Total Distributions Form 1099-R. The amount of the distribution
by a contribution made 06/14/2021 to an From All Retirement Plans should be shown in box 1 of Form 1099-R.
eligible retirement plan in repayment of a Enter the amounts from box 1 of all your
qualified distribution made 12/12/2019 under (Including IRAs) Forms 1099-R on the lines 2 through 4 in
the Taxpayer Certainty and Disaster Tax Coronavirus-related distributions. You column (a), as applicable. But see Are You
Relief Act of 2020, sec. 302(b). The disaster can only report qualified disaster Claiming Qualified Disaster Distributions on
was the Mississippi Severe Storms, distributions for disasters listed in item C. Both 2021 Form 8915-D and 2021 Form
Tornadoes, Straight-line Winds, and Coronavirus-related distributions can’t be 8915-F (2020 Disasters), later, for the
Flooding (DR-4478-MS) disaster." made in 2021. limitations if you are completing Part I of both
2021 Form 8915-D and 2021 Form 8915-F
Form 1040-NR. If you are amending a List of disasters. If you are reporting no (2020 disasters).
Form 1040-NR, only complete the address more than 2 disasters, list the FEMA number,
block and Part III of your Form 1040-X. Make the disaster beginning date, and the disaster Lines 2 through 5 in column (b). The
your adjustments on a corrected Form ending date, for each disaster, in the spaces amounts entered on lines 2 through 5 in
1040-NR on which you have written provided under the Part I header. If you have column (b) depend on whether the amount
"Amended" at the top of page 1. more than 2 disasters, check the checkbox on line 5 in column (a) is more than the
in the asterisked footnote, and attach to the amount on line 1e.
back of your Form 8915-F (2020 disasters) a • If the amount on line 5 in column (a) is
Specific Instructions statement with your name and social security equal to or less than the amount on line 1e,
Married filers. If both you and your spouse number, and, for each disaster, the FEMA enter the amounts on lines 2 through 5 in
are required to file Form 8915-F, file a number, the disaster beginning date, and the column (a) on lines 2 through 5 in column
separate Form 8915-F for each of you. If you disaster ending date. (b).
• If the amount on line 5 in column (a) is
and your spouse are both filing Forms Lines 1a through 1d. You may not need to more than the amount on line 1e, enter on
8915-F, the $100,000 limits on qualified complete lines 1a through 1d. See below. lines 2 through 4 in column (b) the amounts
disaster distributions and the elections on
lines 11 and 22 to include all qualified When to leave lines 1a through 1d on line 5 in column (a) adjusted by any
disaster distributions in income (and not blank. Leave lines 1a through 1d blank on reasonable means so that their sum on line 5
spread them over 3 years) are determined your 2021 Form 8915-F (2020 disasters) if in column (b) equals the amount on line 1e.
separately for each spouse. either you didn’t file 2020 Form 8915-E or the Are You Claiming Qualified
Name and social security number (SSN). only disaster you reported on 2020 Form
If you file a joint return, enter only the name 8915-E was the coronavirus. Disaster Distributions on Both
2021 Form 8915-D and 2021
and SSN of the spouse whose information is When and how to complete lines 1a
being reported on that Form 8915-F. through 1d. Complete lines 1a through 1d, Form 8915-F (2020 Disasters)?
Attach your completed worksheets. as follows, if you are filing 2021 Form 8915-F This section does not apply to you
There are a total of 5 worksheets in these (2020 disasters) and you filed 2020 Form TIP unless you are completing Part I of
instructions. 8915-E for disasters other than the both 2021 Form 8915-F (2020
• Worksheet 1A in Part I. coronavirus. disasters) and 2021 Form 8915-D.
• Worksheet 2 in Part II. • Line 1a. Count the disasters reported on
• Worksheet 3 in Part II. your 2020 Form 8915-E that you are now Have you completed Part I of both 2021
• Worksheet 4 in Part III. reporting in item C. Enter, on line 1a, the Form 8915-D and 2021 Form 8915-F (2020
• Worksheet 5 in Part III. product of that number and $100,000. disasters)? If so, complete your forms in this
Attach to the back of your 2021 Form 8915-F • Line 1b. Enter, on line 1b, the amount on order.
(2020 disasters) each worksheet in these 2020 Form 8915-E, line 4, column (c), if you • First, complete 2021 Form 8915-D.
instructions you complete in determining completed that line (otherwise from the • Your available distributions for your 2021
amounts on your 2021 Form 8915-F (2020 amount on 2020 Form 8915-E, line 4, column Form 8915-F (2020 disasters) are the
disasters). (b)) that reflects the distributions for the distributions left after completing Part I of
disasters you reported on 2020 Form 8915-E 2021 Form 8915-D.
that you are now reporting in item C of your
Required General 2021 Form 8915-F. If you used Worksheet 2 See the Filled-in Worksheet 1A example
Information in your 2020 Instructions for Form 8915-E, below for guidance. A blank Worksheet 1A is
the amount for line 1b is figured by adding at the end of the instructions under
Item A. Check the box that describes the together the amounts in column (X), line 4, of Worksheets.
tax year of the return to which you will be that worksheet for the disasters you reported Example 1A. Arnell suffered economic
attaching your Form 8915-F. on 2020 Form 8915-E that you are now losses as a result of the Puerto Rico
Item B. Check the box that describes the reporting in item C of your 2021 Form Earthquakes (DR-4473-PR) disaster in 2019
calendar year in which the disaster(s) for 8915-F. and the Puerto Rico Hurricane Isaias
• Line 1d. Count the disasters reported in (DR-4560-PR) disaster in 2020. His main
item C of your 2021 Form 8915-F (2020 home was in Puerto Rico during the disaster

Instructions for Form 8915-F (Rev. 2-2022) -5-

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Filled-in Worksheet 1A. Use if you complete Part I of 2021 Form 8915-D and of 2021 Form 8915-F (2020 disasters). Example 1A
for Arnell column (a).
(a) (b) (c)
Form 8915-D Qualified 2019 disaster Allocation of column (b)
Total distributions in 2021 distributions
2 Distributions from retirement plans (other than
IRAs) made in 2021 -0- -0- -0-
3 Distributions from traditional, SEP, and SIMPLE
IRAs made in 2021 $140,000 $100,000 -0-
4 Distributions from Roth IRAs made in 2021 -0- -0- -0-

(a)
Form 8915-F (2020 disasters)
Available distributions for this year
2 Enter, in column (a), distributions from retirement plans -0-
(other than IRAs) made this year.
3 Enter, in column (a), distributions from traditional, SEP, and $40,000
SIMPLE IRAs made this year.
4 Enter, in column (a), distributions from Roth IRAs made this -0-
year.

period for each disaster. These events were and 5 in column (a). The entire $120,000 in box 1 and box 2a of Form 1099-R is usually
qualified 2019 and 2020 disasters, distributions were IRA distributions other your cost. Enter the difference on line 9.
respectively. In 2021, he received a than Roth distributions. You reported If there is no amount in box 2a of Form
traditional IRA distribution of $140,000. The $100,000 of those distributions on lines 3 1099-R and the first box in box 2b is
distribution was made on May 26. He and 5 in column (b). On line 7, you reported checked, the issuer of Form 1099-R may not
received no other distributions in 2019, 2020, $120,000 minus $100,000 (that is, $20,000). have had all the facts needed to figure the
or 2021. He is completing 2021 Form These distributions are IRA distributions. You taxable amount. You may want to get Pub.
8915-D, and 2021 Form 8915-F (2020 will refer to your tax return, Form 5329, and 575, Pension and Annuity Income, to help
disasters). He must complete his Form their instructions for directions on how to figure your taxable amount.
8915-D first. He reports $100,000 from the treat these IRA distributions.
distribution as a qualified 2019 disaster Also see Pub. 575 if you use the
distribution on Form 8915-D. He reports the If line 7 includes an amount Simplified Method Worksheet to figure the
remaining $40,000 from the distribution as TIP distributed for the purchase or taxable amount of your periodic payments
qualified 2020 disaster distributions in the construction of a main home in a and you designated some of these payments
2021 Form 8915-F (2020 disasters) portion qualified disaster area, see 2021 Form as qualified disaster distributions on the
of his Filled-in Worksheet 1A for 8915-F (2020 disasters) next. Form 8915-F you are completing.
Example 1A. On lines 2 through 4 of column If you have a Form 1099-R with both
(a) in Part I of his 2021 Form 8915-F (2020 2021 Form 8915-F (2020 disasters).
disasters), Arnell enters the amounts shown Reduce line 7 of your 2021 Form 8915-F ! qualified disaster distributions and
in column (a), lines 2 through 4, of 2021 (2020 disasters) by any amount distributed CAUTION nonqualified distributions, you must
Form 8915-F (2020 disasters) on his Filled-in for the purchase or construction of a main separately figure the cost attributable to each
Worksheet 1A for Example 1A. Because the home in Alaska that you did not purchase or distribution.
$40,000 is being used on 2021 Form 8915-F construct because of the Alaska
(2020 disasters), it should not be counted on (4585-DR-AK) disaster. Include this amount Line 11. If you don’t check the box on
line 7 of his 2021 Form 8915-D in on line 28 of your 2021 Form 8915-F (2020 line 11, you must spread the amount on
determining the taxable amount of his disasters). See Qualified Distribution for the line 10 over 3 years. By checking the box,
distributions on that form. Purchase or Construction of a Main Home in you elect to include the entire amount in
Qualified Disaster Areas, earlier. Also, see income in the year of distribution. You cannot
The numbers on the left border of Form 5329 and the instructions for your tax make or change this election after the due
TIP the Filled-in Worksheet are line return for reporting all other distributions date (including extensions) for your tax
numbers that correspond to the lines included on line 7. return. If you checked the box on line 22, you
on the indicated forms. must check the box on line 11.
If the taxpayer died after receiving a
Part II—Qualified Disaster
Line 7 qualified disaster distribution, the taxable
Distributions From amount of the distribution may not be spread
The amount on line 7 should generally be beyond the year in which they died. The
apportioned into IRA and pension & annuity Retirement Plans (Other
remainder of the distribution must be
amounts, as applicable, and reported on Than IRAs) reported on the tax return of the deceased
your tax return as taxable distributions in See the tables under Appendix A, later, for taxpayer.
accordance with Form 5329 and the the lines in Part II you should complete, if
instructions for that return. See the any. Line 12. Use Worksheet 2 to figure the
instructions for your tax return for reporting amount to enter on line 12 of your Form
the distributions included on line 7. See also Line 9. Enter on line 9 your cost, if any. Your 8915-F.
the Instructions for Form 5329. cost is generally your net investment in the
Example. You reported a total of plan. It does not include pre-tax
$120,000 in distributions in 2021 on lines 3 contributions. If there is an amount in box 2a
of Form 1099-R, the difference between

-6- Instructions for Form 8915-F (Rev. 2-2022)

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Worksheet 2. Total Income From Oth-                your 2021 return or any repayments of          At any time during the 3-year period that 
er-Than-IRA Distributions Made in Prior            nontaxable amounts.                            begins the day after the date you received a 
                                                                                                  qualified disaster distribution, you can repay 
Years                                               Repayments reported on later returns.         any portion of the distribution to an eligible 
1. If you are completing 2021 Form                 If you elected to spread the income over 3     retirement plan that accepts rollover 
   8915-F (2020 disasters), enter                  years and you repaid more than the amount      contributions. You cannot, however, repay 
   here and on line 12 of your 2021                on line 13 of your 2021 Form 8915-F (2020      more than the amount of the original 
   Form 8915-F (2020 disasters)                    disasters), the excess will be carried forward distribution. See Repayment of a Qualified 
   the amount, if any, from your                   to your 2022 tax return. Repayments made       Disaster Distribution, earlier, for details.
   2020 Form 8915-E, line 9. If you                after the due date of your 2021 return 
   checked the box on that line,                   (including extensions) but before the due      Worksheet 5.            Use Worksheet 5 to figure 
   enter -0- here and on line 12 of                date of your 2022 return (including            the total repayment to enter on line 25 of 
   your 2021 Form 8915-F (2020                     extensions) will generally be reported on      your Form 8915-F.
   disasters)  . . . . . . . . . . . . .   1.      your 2022 tax return if you elected to spread 
                                                   the income over 3 years. However, you may               Don’t use Worksheet 5 to report 
                                                   have to file an amended return in certain               repayments of qualified 2017, 2018, 
Line 14.   Enter on line 14 of your 2021 Form      situations. See Amending Form 8915-F           CAUTION! or 2019 disaster distributions.
8915-F (2020 disasters) your total                 (2020 Disasters), earlier.
repayments—the sum of your excess                                                                 Worksheet 5. Total Repayment of IRA 
repayments carried to 2021 and your                Part III—Qualified Disaster                    Distributions
repayments made for 2021. See Worksheet 
3, later. A repayment is made in 2021 if it is     Distributions From                             1. If you are completing 2021 Form 
made before you filed your 2021 return, and        Traditional, SEP, SIMPLE,                         8915-F (2020 disasters), enter 
                                                                                                     the amount, if any, from your 
not later than the due date (including             and Roth IRAs                                     2020 Form 8915-E, 
extensions).                                                                                         line 18 . . . . . . . . . . . . . . .  1. 
                                                   See the tables under Appendix A, later, for 
 At any time during the 3-year period that         the lines in Part III you should complete, if  2. If you are completing 2021 Form 
begins the day after the date you received a       any.                                              8915-F (2020 disasters), enter 
qualified disaster distribution, you can repay                                                       the amount, if any, from your 
any portion of the distribution to an eligible     Line 22. If you don’t check the box on            2020 Form 8915-E, 
retirement plan that accepts rollover              line 22, you must spread the amount on            line 17 . . . . . . . . . . . . . . .  2. 
contributions. You cannot, however, repay          line 21 over 3 years. By checking the box,     3. Subtract line 2 from 
more than the amount of the original               you elect to include the entire amount in         line 1 . . . . . . . . . . . . . . . . 3. 
distribution. See Repayment of a Qualified         income in the year of distribution. You cannot 4. If you are completing 2021 Form 
Disaster Distribution, earlier, for details.       make or change this election after the due        8915-F (2020 disasters), enter 
                                                   date (including extensions) for your tax          the total amount of any 
 Worksheet 3.            Use Worksheet 3 to figure return. If you checked the box on line 11, you    repayments you made, with 
the total repayment to enter on line 14 of         must check the box on line 22.                    respect to that form, before filing 
your Form 8915-F.                                   If the taxpayer died after receiving a           your 2021 tax return .   . . . . . .   4. 
        Don’t use Worksheet 3 to report            qualified disaster distribution, the taxable   5. Enter the total of lines 3 and 4 
 !      repayments of qualified 2017, 2018,        amount of the distribution may not be spread      here and on line 25 of your 2021 
CAUTION or 2019 disaster distributions.            beyond the year in which they died. The           Form 8915-F (2020 
                                                                                                     disasters) . . . . . . . . . . . . .   5.
                                                   remainder of the distribution must be 
                                                   reported on the tax return of the deceased 
Worksheet 3. Total Repayment of Oth-               taxpayer.
er-Than-IRA Distributions                                                                         Worksheet 5, line 4: Don't include 
                                                   Line 23. Use Worksheet 4 to figure the 
1. If you are completing 2021 Form                 amount to enter on line 23 of your Form        these amounts.        On line 4 of Worksheet 5, 
   8915-F (2020 disasters), enter                  8915-F.                                        don't include any repayments made later 
   the amount, if any, from your                                                                  than the due date (including extensions) for 
   2020 Form 8915-E,                                                                              your 2021 return or any repayments of 
   line 10   . . . . . . . . . . . . . . . 1.      Worksheet 4. Total Income From IRA             nontaxable amounts.
2. If you are completing 2021 Form                 Distributions Made in Prior Years
                                                                                                  Repayments reported on later returns. 
   8915-F (2020 disasters), enter                  1. If you are completing 2021 Form             If you elected to spread the income over 3 
   the amount, if any, from your                      8915-F (2020 disasters), enter              years and you repaid more than the amount 
   2020 Form 8915-E,                                  here and on line 23 of your 2021            on line 24 of your 2021 Form 8915-F (2020 
   line 9  . . . . . . . . . . . . . . . . 2. 
                                                      Form 8915-F (2020 disasters)                disasters), the excess will be carried forward 
3. Subtract line 2 from                               the amount, if any, from your               to your 2022 tax return. Repayments made 
   line 1 . . . . . . . . . . . . . . . .  3.         2020 Form 8915-E, line 17. If               after the due date of your 2021 return 
4. If you are completing 2021 Form                    you checked the box on that 
   8915-F (2020 disasters), enter                     line, enter -0- here and on                 (including extensions) but before the due 
   the total amount of any                            line 23 of your 2021 Form                   date (including extensions) of your 2022 
   repayments you made, with                          8915-F (2020                                return will generally be reported on your 
   respect to that form, before filing                disasters) . . . . . . . . . . . . . 1.     2022 tax return if you elected to spread the 
   your 2021 tax return  .   . . . . . .   4.                                                     income over 3 years. However, you may 
5. Enter the total of lines 3 and 4                                                               have to file an amended return in certain 
   here and on line 14 of your 2021                                                               situations. See Amending Form 8915-F 
   Form 8915-F (2020                               Line 25. Enter on line 25 of your 2021 Form    (2020 Disasters), earlier.
   disasters)  . . . . . . . . . . . . .   5.      8915-F (2020 disasters) your total 
                                                   repayments—the sum of your excess 
                                                   repayments carried to 2021 and your 
                                                   repayments made for 2021. See Worksheet 
 Worksheet 3, line 4: Don't include                5 below. A repayment is made in 2021 if it is 
these amounts.         On line 4 of Worksheet 3,   made before you filed your 2021 return, and 
don't include any repayments made later            not later than the due date (including 
than the due date (including extensions) for       extensions).

Instructions for Form 8915-F (Rev. 2-2022)                                   -7-

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Part IV—Qualified contributions. If there is an amount in box 2a United States. We need this information to
of Form 1099-R, the difference between ensure that you are complying with these
Distributions for the box 1 and box 2a of Form 1099-R is usually laws and to allow us to figure and collect the
Purchase or Construction your cost. See Pub. 575 for more information right amount of tax. You are required to give
about figuring your cost in the plan. us this information if you made certain
of a Main Home in contributions or received certain distributions
In many cases, a hardship distribution
Qualified Disaster Areas from a 401(k) plan or a tax-sheltered annuity from qualified plans, including IRAs, and
contract will not have any cost. other tax-favored accounts. Our legal right to
2021 Form 8915-F (2020 disasters). ask for the information requested on this
On 2021 Form 8915-F (2020 disasters), If you received a first-time homebuyer form is sections 6001, 6011, 6012(a), and
qualified distributions can only be reported distribution from an IRA, don't enter any 6109 and their regulations. If you don’t
for the Alaska (4585-DR-AK) disaster. amount on line 29. Any cost or basis in an provide this information, or you provide
IRA is figured on 2021 Form 8606 if you incomplete or false information, you may be
Complete Part IV of 2021 Form 8915-F made nondeductible contributions. subject to penalties. You are not required to
(2020 disasters) if, on January 1, 2021, you
received a qualified distribution described in If you have a Form 1099-R with both provide the information requested on a form
that is subject to the Paperwork Reduction
Repayment of a Qualified Distribution for the CAUTION nonqualified distributions, you must
Qualified 2020 disaster areas under ! qualified distributions and Act unless the form displays a valid OMB
Purchase or Construction of a Main Home, separately figure the cost attributable to each control number. Books or records relating to
earlier, for the Alaska (4585-DR-AK) distribution. a form or its instructions must be retained as
disaster. You must complete the required long as their contents may become material
lines of Part IV if you received a qualified Line 31. You can repay any portion of a in the administration of any Internal Revenue
distribution for the Alaska (4585-DR-AK) qualified distribution to an eligible retirement law. Generally, tax returns and return
disaster on January 1, 2021, even if you plan that accepts rollovers but the information are confidential, as required by
made no repayments in 2021. Any portion of repayments must be made within the time section 6103. However, we may give this
the qualified distribution not repaid before frame specified in 2021 Form 8915-F (2020 information to the Department of Justice for
June 26, 2021, for the Alaska (4585-DR-AK) disasters), earlier, in this part (also, see civil and criminal litigation, and to cities,
disaster will not be allowed the special tax Repayment of a Qualified Distribution for the states, the District of Columbia, and U.S.
benefits available to qualified distributions. Purchase or Construction of a Main Home, commonwealths and possessions to carry
For qualified distributions received in earlier). You can't, however, repay more than out their tax laws. We may also disclose this
2019 for a qualified 2020 disaster, see 2019 the amount of the original distribution. information to other countries under a tax
qualified distributions under Amending Form Enter on line 31 the amount of any treaty, to federal and state agencies to
8915-F (2020 Disasters), earlier. repayments you make within the time frame enforce federal nontax criminal laws, or to
If you are required to file 2021 Form 8606, specified. Don't include any repayments federal law enforcement and intelligence
complete that form before you complete Part treated as rollovers on 2021 Form 8606 or agencies to combat terrorism.
IV. any repayments of nontaxable amounts. The average time and expenses required
Line 32. Most distributions from qualified to complete and file this form will vary
Note. A distribution for the purchase or retirement plans (including IRAs) made to depending on individual circumstances. For
construction of a main home may be treated you before you reach age 59 / are subject to 1 2 the estimated averages, see the instructions
as a qualified 2020 disaster distribution in an additional tax on early distributions and for your income tax return.
certain circumstances. See Qualified 2020 are reported on Form 5329. Qualified If you have suggestions for making this
disaster areas under Repayment of a distributions for the purchase or construction form simpler, we would be happy to hear
Qualified Distribution for the Purchase or of a main home in a qualified 2020 disaster from you. See the instructions for your
Construction of a Main Home, earlier. area that were not repaid to an eligible income tax return.
Line 27. If you check the “Yes” box, but are retirement plan within the time frame
not required to complete lines 28 through 32, specified in 2021 Form 8915-F (2020
you must still file the required Form 8915-F disasters), earlier, in this part, may be Worksheets
to show that you received a qualified subject to this additional tax unless you A blank Worksheet 1A follows. The numbers
distribution. qualify for an exception. See the Instructions on the left border of Worksheet 1A are line
for Form 5329 for information on exceptions numbers that correspond to the lines on the
Line 28. Enter on line 28 your qualified to this tax. If you have not repaid the indicated forms. Blank Worksheets 2 and 3
distributions (see Qualified 2020 disaster distribution before the specified end date, and 4 and 5 are under Part II and Part III,
areas under Qualified Distribution for the you may be able to designate the qualified respectively, earlier.
Purchase or Construction of a Main Home in distribution as a qualified disaster
Qualified Disaster Areas, earlier). distribution. See Qualified 2020 disaster
Don't include any distributions you areas under Repayment of a Qualified
designated as qualified 2020 disaster Distribution for the Purchase or Construction
distributions reported on line 8 or line 20 of of a Main Home, earlier.
your Form 8915-F. Also, don't include any

amounts reported on 2021 Form 8606. Privacy Act and
Line 29. Enter on line 29 your cost, if any. Paperwork Reduction Act
Your cost is generally your net investment in
the plan. It does not include pre-tax Notice
We ask for the information on this form to
carry out the Internal Revenue laws of the

-8- Instructions for Form 8915-F (Rev. 2-2022)

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Worksheet 1A. Use if you complete Part I of 2021 Form 8915-D and of 2021 Form 8915-F (2020 disasters).
                                                                     (a)             (b)                                   (c)
                    Form 8915-D
                                                         Total distributions in 2021 Qualified 2019 disaster distributions Allocation of column (b)
2  Distributions from retirement plans (other than IRAs) 
   made in 2021
3  Distributions from traditional, SEP, and SIMPLE 
   IRAs made in 2021
4  Distributions from Roth IRAs made in 2021

                                                                                         (a)
               Form 8915-F (2020 disasters)
                                                                                     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.

Instructions for Form 8915-F (Rev. 2-2022)                               -9-

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Appendix A See Qualified 2020 disaster making these distributions and for other
TIP distribution requirements, earlier, criteria for these distributions.
Which Lines Should I Use? under Qualified Disaster Distribution
Requirements and also Qualified
Form 8915-F (2020 Disasters): Distributions, earlier, for the cutoff dates for
Lines To Use
Look for the year of the form you are filing.

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
2020 disaster distributions on a 2020 Form 8915-E the 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

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

-10- Instructions for Form 8915-F (Rev. 2-2022)

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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    applicable, of your 2023 Form 8915-F (2020 disasters). .
                                                                      22 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.

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 
NOT claim qualified 2020 disaster distributions on a 2021 Form                                             lines 14 and 25, as applicable, of your 2024 Form 8915-F 
8915-F (2020 disasters)                                                                                    (2020 disasters).
                                                                                      —
                                                                                                           If you aren’t repaying qualified 2020 disaster 
                                                                                                           distributions other than coronavirus-related 
                                                                                                           distributions, STOP. You can’t use 2024 Form 8915-F 
                                                                                                           (2020 disasters).
You did NOT claim qualified 2020 disaster distributions on a 2021                                          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.

Instructions for Form 8915-F (Rev. 2-2022)                                      -11-

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Appendix B
Qualified Disaster Areas 
by Year

Table for Qualified 2020 Disaster Areas. Use for Form 8915-F (2020 disasters).

Disaster Area         Qualified 2020 Disaster (includes the FEMA DR      Date of Declaration Disaster Period aka Incident Period
                      number (that is, FEMA’s major disaster 
                      declaration number))
Qualified Individuals Virus SARS-CoV-2 or coronavirus disease 2019       Not relevant        Not relevant
(see Qualified        (referred to collectively in these instructions as 
individuals, earlier) coronavirus) 
Alabama               Severe Storms and Flooding (DR-4546-AL)            May 21, 2020        February 5, 2020 - March 6, 2020
Alabama               Severe Thunderstorms (DR-4555-AL)                  July 10, 2020       April 12, 2020 - April 13, 2020
Alabama               Severe Storms, Straight-line Winds, and Tornadoes  July 10, 2020       April 19, 2020
                      (DR-4554-AL)
Alabama               Hurricane Sally (DR-4563-AL)                       September 20, 2020  September 14, 2020 - September 16, 2020
Alabama               Hurricane Zeta (DR-4573-AL)                        December 10, 2020   October 28, 2020 - October 29, 2020
Alaska                Severe Storm, Flooding, Landslides, and Mudslides  February 17, 2021   November 30, 2020 - December 2, 2020
                      (4585-DR-AK)
Arkansas              Severe Storms, Tornadoes, and Straight-line Winds  May 8, 2020         March 28, 2020
                      (DR-4544-AR)
Arkansas              Severe Storms and Straight-line Winds (DR-4556-AR) July 10, 2020       April 12, 2020
California            Wildfires (DR-4558-CA)                             August 22, 2020     August 14, 2020 - September 26, 2020
California            Wildfires (DR-4569-CA)                             October 16, 2020    September 4, 2020 - November 17, 2020
Colorado              Wildfires (4581-DR-CO)                             January 15, 2021    September 6, 2020 - November 5, 2020
Connecticut           Tropical Storm Isaias (4580-DR-CT)                 January 12, 2021    August 4, 2020
Delaware              Tropical Storm Isaias (DR-4566-DE)                 October 2, 2020     August 4, 2020 - August 7, 2020
Florida               Hurricane Sally (DR-4564-FL)                       September 23, 2020  September 14, 2020 - September 28, 2020
Georgia               Tropical Storm Zeta (4579-DR-GA)                   January 12, 2021    October 29, 2020 
Hawaii                Severe Storms and Flooding (DR-4549-HI)            July 9, 2020        March 27, 2020 - March 28, 2020
Iowa                  Severe Storms (DR-4557-IA)                         August 17, 2020     August 10, 2020
Kentucky              Severe Storms, Flooding, Landslides, and Mudslides April 24, 2020      February 3, 2020 - February 29, 2020
                      (DR-4540-KY)
Louisiana             Hurricane Laura (DR-4559-LA)                       August 28, 2020     August 22, 2020 - August 27, 2020
Louisiana             Hurricane Delta (DR-4570-LA)                       October 16, 2020    October 6, 2020 - October 10, 2020
Louisiana             Hurricane Zeta (4577-DR-LA)                        January 12, 2021    October 26, 2020 - October 29, 2020
Maryland              Tropical Storm Isaias (4583-DR-MD)                 February 4, 2021    August 3, 2020 - August 4, 2020
Michigan              Severe Storms and Flooding (DR-4547-MI)            July 9, 2020        May 16, 2020 - May 22, 2020
Mississippi           Severe Storms, Tornadoes, Straight-line Winds, and March 12, 2020      January 10, 2020 - January 11, 2020
                      Flooding (DR-4478-MS)
Mississippi           Severe Storms, Tornadoes, Straight-line Winds, and April 16, 2020      April 12, 2020
                      Flooding (DR-4536-MS)
Mississippi           Severe Storms, Flooding, and Mudslides             April 23, 2020      February 10, 2020 - February 18, 2020
                      (DR-4538-MS)
Mississippi           Severe Storms, Tornadoes, Straight-line Winds, and July 9, 2020        April 22, 2020 - April 23, 2020
                      Flooding (DR-4551-MS)
Mississippi           Hurricane Zeta (4576-DR-MS)                        December 31, 2020   October 28, 2020 - October 29, 2020
Missouri              Severe Storms, Tornadoes, Straight-line Winds, and July 9, 2020        May 3, 2020 - May 4, 2020
                      Flooding (DR-4552-MO)
New Jersey            Tropical Storm Isaias (DR-4574-NJ)                 December 11, 2020   August 4, 2020 

                                                                         -12-                Instructions for Form 8915-F (Rev. 2-2022)

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Table for Qualified 2020 Disaster Areas. Use for Form 8915-F (2020 disasters). continued

Disaster Area          Qualified 2020 Disaster (includes the FEMA DR      Date of Declaration Disaster Period aka Incident Period
                       number (that is, FEMA’s major disaster 
                       declaration number))
New York               Tropical Storm Isaias (DR-4567-NY)                 October 2, 2020     August 4, 2020
North Carolina         Severe Storms, Tornadoes, and Flooding             May 8, 2020         February 6, 2020 - February 19, 2020
                       (DR-4543-NC)
North Carolina         Hurricane Isaias (DR-4568-NC)                      October 14, 2020    July 31, 2020 - August 4, 2020
North Dakota           Flooding (DR-4553-ND)                              July 9, 2020        April 1, 2020 - April 25, 2020
North Dakota           Severe Storms and Flooding (DR-4565-ND)            October 2, 2020     June 29, 2020 - July 1, 2020
Oklahoma               Severe Winter Storm (4575-DR-OK)                   December 21, 2020   October 26, 2020 - October 29, 2020
Oregon                 Severe Storms, Flooding, Landslides, and Mudslides April 3, 2020       February 5, 2020 - February 9, 2020
                       (DR-4519-OR)
Oregon                 Wildfires and Straight-line Winds (DR-4562-OR)     September 15, 2020  September 7, 2020 - November 3, 2020
Puerto Rico            Hurricane Isaias (DR-4560-PR)                      September 9, 2020   July 29, 2020 - July 31, 2020
Puerto Rico            Severe Storm and Flooding (DR-4571-PR)             November 5, 2020    September 13, 2020 
Sac & Fox Tribe of The Derecho Midwest-Iowa (DR-4561)                     September 10, 2020  August 10, 2020
Mississippi of Iowa
South Carolina         Severe Storms, Tornadoes, Straight-line Winds, and March 17, 2020      February 6, 2020 - February 13, 2020
                       Flooding (DR-4479-SC)
South Carolina         Severe Storms, Tornadoes, and Straight-line Winds  May 1, 2020         April 12, 2020 - April 13, 2020
                       (DR-4542-SC)
Tennessee              Severe Storms, Tornadoes, Straight-line Winds, and March 5, 2020       March 3, 2020
                       Flooding (DR-4476-TN)
Tennessee              Severe Storms, Tornadoes, Straight-line Winds, and April 24, 2020      April 12, 2020 - April 13, 2020
                       Flooding (DR-4541-TN)
Tennessee              Severe Storms, Straight-line Winds, and Flooding   July 9, 2020        May 3, 2020 - May 4, 2020 
                       (DR-4550-TN)
Texas                  Hurricane Laura (DR-4572-TX)                       December 9, 2020    August 23, 2020 - August 27, 2020
Utah                   Earthquake and Aftershocks (DR-4548-UT)            July 9, 2020        March 18, 2020 - April 17, 2020
Utah                   Severe Storm (4578-DR-UT)                          January 12, 2021    September 7, 2020 - September 8, 2020
Washington             Severe Storms, Flooding, Landslides, and Mudslides April 23, 2020      January 20, 2020 - February 10, 2020
                       (DR-4539-WA)
Washington             Wildfires and Straight-line Winds (4584-DR-WA)     February 4, 2021    September 1, 2020 - September 19, 2020
Wisconsin              Severe Winter Storm and Flooding (DR-4477-WI)      March 11, 2020      January 10, 2020 - January 12, 2020

Instructions for Form 8915-F (Rev. 2-2022)                                -13-

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