U.S. Individual Income Tax Return Forms

U.S. Individual Income Tax Return

8915-D Instr

U.S. Individual Income Tax Return Forms

OMB: 1545-0074

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2019

Department of the Treasury
Internal Revenue Service

Instructions for Form 8915-D

Qualified 2019 Disaster Retirement Plan Distributions and Repayments
Section references are to the Internal Revenue Code
unless otherwise noted.

General Instructions
Future Developments

For the latest information about
developments related to Form 8915-D and
its instructions, such as legislation enacted
after they were published, go to IRS.gov/
Form8915D.

Purpose of Form

Use Form 8915-D if you were adversely
affected by a qualified 2019 disaster listed in
Table 1 at the end of these instructions and
you received a distribution described in
Qualified 2019 Disaster Distribution
Requirements or Qualified Distribution
Requirements, later, that qualifies for
favorable tax treatment.

CAUTION

If you need to complete Part I of
2019 Form 8915-C, complete that
form first.

Part I. Use Part I to figure your:
• Total distributions from all retirement
plans (including IRAs),
• Qualified 2019 disaster distributions, and
• Distributions other than qualified 2019
disaster distributions.
Parts II and III. Use Parts II and III to:
• Report your qualified 2019 disaster
distributions;
• Report any repayments of qualified 2019
disaster distributions; and
• Figure the taxable amount, if any, of your
qualified 2019 disaster distributions.
Note. Distributions from retirement plans
(other than IRAs) are reported in Part II and
distributions from IRAs are reported in Part
III.
Part IV. Use Part IV of Form 8915-D to:
• Report that you received qualified
distributions for the purchase or construction
of a main home in qualified 2019 disaster
areas that you repaid, in whole or in part, no
earlier than the first day of the disaster and
no later than June 17, 2020;
• Report any repayments of qualified
distributions (not reported on 2019 Form
8606, Nondeductible IRAs); and
• Figure the taxable amount, if any, of your
qualified distributions (not reported on 2019
Form 8606).
See Qualified Distribution for the Purchase or
Construction of a Main Home in Qualified
2019 Disaster Areas, and Part IV, later, for
more information.

Jul 01, 2020

Who Must File

File 2019 Form 8915-D if either of the
following applies.
• You received a qualified 2019 disaster
distribution from an eligible retirement plan,
and the distribution was made in 2019.
• You received a qualified distribution in
2019 for the purchase or construction of a
main home in qualified 2019 disaster areas
that you repaid, in whole or in part, no earlier
than the first day of the disaster and no later
than June 17, 2020.

When and Where To File

File 2019 Form 8915-D with your 2019 Form
1040, 1040-SR, or 1040-NR. If you are not
required to file an income tax return but are
required to file Form 8915-D, fill in the
address information on page 1 of Form
8915-D, sign the Form 8915-D, and send it
to the Internal Revenue Service at the same
time and place you would otherwise file Form
1040, 1040-SR, or 1040-NR.
The timing of your distributions and
repayments will determine whether you need
to file an amended return to claim them. If
you need to amend your 2019 Form 8915-D,
see Amending Form 8915-D, later.
If you have already filed your 2019
return, you may need to amend your
CAUTION 2019 return in order to claim
qualified 2019 disaster distributions or
qualified distributions on 2019 Form 8915-D.
You will do so by filing a Form 1040-X.
Check the 2019 box at the top of page 1 of
that form.

What Is a Qualified
Disaster Distribution?

For 2019, qualified disaster distributions are
the qualified 2019 disaster distributions
described in 2019 Form 8915-D and these
instructions; and the qualified 2018 disaster
distributions described in 2019 Form 8915-C
and its instructions.

Qualified 2019 Disaster
Distribution
What 2019 Disasters Are
Covered?

In order to have a qualified 2019 disaster
distribution, you must have been adversely
affected by a qualified 2019 disaster: that is,
a disaster that occurred in 2019 no later than
December 20th and that was declared as a
major disaster by the President no later than
February 18, 2020. See Table 1 at the end of
these instructions for the list of qualified 2019
disasters.
Cat. No. 73788N

How Is a Qualified 2019
Disaster Distribution Taxed?

Generally, a qualified 2019 disaster
distribution is included in your income in
equal amounts over 3 years. However, if you
elect, you can include the entire distribution
in your income in the year of the distribution.
If more than one distribution was made
during the year, you must treat all
distributions for that year the same way. Any
repayments made before you file your return
and by the due date (including extensions)
reduce the amount of the distribution
included in your income.
Also, qualified 2019 disaster distributions
aren’t subject to the additional 10% tax on
early distributions.
If a taxpayer who received a
qualified 2019 disaster distribution
CAUTION dies in 2019, the distribution may no
longer be spread over 3 years. The
remainder of the distribution must be
reported on the return of the deceased
taxpayer.

Qualified 2019 Disaster
Distribution Requirements

For 2019, a qualified 2019 disaster
distribution is any distribution you received
from an eligible retirement plan if all of the
following conditions are met. You must meet
these requirements separately for each of
your disasters that occurred in 2019. The
disaster must have started no later than
December 20, 2019.
1. The distribution was made in 2019 on
or after the first day of the disaster.
2. Your main home was located in a
qualified 2018 disaster area listed in Table 1
at any time during the disaster period shown
for that area in Table 1. The disaster area is
the state, territory, or tribal government in
which the disaster occurs. .
3. You sustained an economic loss
because of the disaster(s) in (2) above.
Examples of an economic loss include, but
aren’t limited to, (a) loss, damage to, or
destruction of real or personal property from
fire, flooding, looting, vandalism, theft, wind,
or other cause; (b) loss related to
displacement from your home; or (c) loss of
livelihood due to temporary or permanent
layoffs.
If (1) through (3) apply, you can generally
designate any distribution (including periodic
payments and required minimum
distributions) from an eligible retirement plan
as a qualified 2019 disaster distribution,
regardless of whether the distribution was
made on account of a qualified 2019

disaster. Qualified 2019 disaster distributions
are permitted without regard to your need or
the actual amount of your economic loss.
A reduction or offset (on or after the first
day of your 2019 disaster) of your account
balance in an eligible retirement plan in order
to repay a loan can also be designated as a
qualified 2019 disaster distribution. See
Distribution of plan loan offsets, later.
Limit. For each qualified 2019 disaster, the
total of your qualified 2019 disaster
distributions from all plans is limited to
$100,000. If you have distributions from
more than one type of plan, such as a 401(k)
plan and an IRA, and the total exceeds
$100,000 for a qualified 2019 disaster, you
may allocate the $100,000 limit among the
plans by any reasonable method. When
allocating, keep in mind that a qualified 2019
disaster distribution cannot be made earlier
than the first day of the disaster.
Eligible retirement plan. An eligible
retirement plan can be any of the following.
• A qualified pension, profit-sharing, or
stock bonus plan (including a 401(k) plan).
• A qualified annuity plan.
• A tax-sheltered annuity contract.
• A governmental section 457 deferred
compensation plan.
• A traditional, SEP, SIMPLE, or Roth IRA.
Distribution of plan loan offsets. A
distribution of a plan loan offset is a
distribution that occurs when, under the
terms of a plan, the participant’s accrued
benefit is reduced (offset) in order to repay a
loan. A distribution of a plan loan offset
amount can occur for a variety of reasons,
such as when a participant terminates
employment or doesn’t comply with the
terms of repayment. Plan loan offsets are
treated as actual distributions and are
reported in Form 1099-R, box 1.
Main home. Generally, your main home is
the home where you live most of the time. A
temporary absence due to special
circumstances, such as illness, education,
business, military service, evacuation, or
vacation, won’t change your main home.
Additional tax. Qualified 2019 disaster
distributions aren’t subject to the additional
10% tax (or the 25% additional tax for certain
distributions from SIMPLE IRAs) on early
distributions and aren’t required to be
reported on Form 5329. However, any
distributions you received in excess of the
$100,000 qualified 2019 disaster distribution
limit for a qualified 2019 disaster may be
subject to the additional tax.
Note. If you choose to treat a distribution as
a qualified 2019 disaster distribution, it is not
eligible for the 20% Capital Gain Election or
the 10-Year Tax Option. For information on
those options, see the instructions for Form
4972.

Repayment of a Qualified 2019
Disaster Distribution
Do not use this form to report
repayments of qualified 2016, 2017,
CAUTION or 2018 disaster distributions.
Instead see Forms 8915-A, 8915-B, or
8915-C, respectively, and their instructions.

If you choose, you can generally repay any
portion of a qualified 2019 disaster
distribution that is eligible for tax-free rollover
treatment to an eligible retirement plan. Also,
you can repay a qualified 2019 disaster
distribution made on account of hardship
from a retirement plan. However, see
Exceptions, later, for qualified 2019 disaster
distributions you can’t repay.
Your repayment can't be made any earlier
than the day after the date you received the
qualified 2019 disaster distribution. You have
3 years from the day after the date you
received the distribution to make a
repayment. The amount of your repayment
cannot be more than the amount of the
original distribution. Amounts that are repaid
are treated as a trustee-to-trustee transfer
and are not included in income. Also, for
purposes of the one-rollover-per-year
limitation for IRAs, a repayment to an IRA is
not considered a rollover.
Include on 2019 Form 8915-D any
repayments you make before filing your 2019
return. Any repayments you make will reduce
the amount of qualified 2019 disaster
distributions reported on your return for
2019. Do not include on your 2019 Form
8915-D any repayments you make later than
the due date (including extensions) for filing
your 2019 return. If you make a repayment in
2020 after you file your 2019 return, the
repayment will reduce the amount of your
qualified 2019 disaster distributions included
in income on your 2020 return if you have
spread the income over 3 years, unless you
are eligible to amend your 2019 return. See
Amending Form 8915-D, later. Also, if you
have spread the income over 3 years, any
excess repayments you make for 2019 will
be carried forward to your 2020 return.
Example. You suffered economic losses
in Louisiana as the result of a disaster that
began July 10, 2019. You received qualified
2019 disaster distributions in the amount of
$75,000 on September 30, 2019, and
$15,000 on November 30, 2019. You wish to
treat a contribution of $90,000 you made on
October 30, 2019, as a repayment of both
distributions. Only $75,000 can be reported
as a qualified 2019 disaster distribution
repayment. Repayments can only be made
after the date on which the distribution was
received.
Exceptions. You cannot repay the
following types of distributions.
1. Qualified 2019 disaster distributions
received as a beneficiary (other than a
surviving spouse).
2. Required minimum distributions.
3. Any distribution (other than from an
IRA) that is one of a series of substantially
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equal periodic payments made (at least
annually) for:
a. A period of 10 years or more,
b. Your life or life expectancy, or
c. The joint lives or joint life
expectancies of you and your beneficiary.

Qualified Distribution for
the Purchase or
Construction of a Main
Home in Qualified 2019
Disaster Areas
Qualified Distribution
Requirements

To be a qualified distribution for the purchase
or construction of a main home in a qualified
2019 disaster area, the distribution must
meet all of the following requirements.
1. The distribution is a hardship
distribution from a 401(k) plan, a hardship
distribution from a tax-sheltered annuity
contract, or a qualified first-time homebuyer
distribution from an IRA.
2. The distribution was received in 2019
no earlier than 180 days before the first day
of the qualified 2019 disaster and no later
than 30 days after the last day of the
qualified 2019 disaster. Table 1 at the end of
these instructions lists the qualified 2019
disasters and their beginning and ending
dates.
3. The distribution was to be used to
purchase or construct a main home in the
qualified 2019 disaster area and the main
home was not purchased or constructed
because of the disaster. The disaster area is
the state, territory, or tribal government in
which the disaster occurs.
If the distribution was received in

TIP 2018, see Qualified distributions

under Amending Form 8915-D, later.

Repayment of a Qualified
Distribution for the Purchase or
Construction of a Main Home

If you received a qualified distribution, in
2019, to purchase or construct a main home,
you can choose to repay that distribution to
an eligible retirement plan on or after the first
day of the disaster and no later than June 17,
2020. For this purpose, an eligible retirement
plan is any plan, annuity, or IRA to which a
rollover can be made.
Amounts that are repaid no later than
June 17, 2020, are treated as a
trustee-to-trustee transfer and are not
included in income. For purposes of the
one-rollover-per-year limitation for IRAs, a
repayment to an IRA is not considered a
rollover.
A qualified distribution (or any portion
thereof) not repaid before June 18, 2020,
may be taxable in the year of the distribution,
which may be 2019 (or even 2018, see
Qualified distributions under Amending Form

Instructions for Form 8915-D (2019)

8915-D, later) and may be subject to the
additional 10% tax (or the additional 25% tax
for certain SIMPLE IRAs) on early
distributions.

$30,000) can be carried back to 2019. Also,
instead of carrying the excess repayment
back to 2019, you can choose to carry it
forward to 2021.

You may be able to designate a qualified
distribution as a qualified 2019 disaster
distribution if all of the following apply.
1. The distribution was made in 2019 on
or after the first day of the disaster.
2. The distribution (or any portion
thereof) is not repaid before June 18, 2020.
3. The distribution can otherwise be
treated as a qualified 2019 disaster
distribution. See Qualified 2019 Disaster
Distribution Requirements, earlier.

Qualified distributions. You may reduce
the amount of a qualified distribution
included in income in 2018 by the amount of
a repayment made in 2019. Because a
qualified distribution can be received up to
180 days before the disaster began and
repayments for that distribution can be made
from the beginning date of the disaster and
up to June 17, 2020, you may have a
qualified distribution received in 2018 for
which you are making repayments in 2019. If
you have already filed your 2018 return on
which you reported the distribution, you
should file an amended 2018 return to report
the repayment. On your amended return
(Form 1040-X), you will check the 2018 box
at the top of page 1 and enter, in
parentheses in column B of line 1, the
amount of the repayment. In Part III of your
amended return, say: "The amount I reported
on [2018 Form 1040, line 4b, or 2018 Form
1040NR, line 17b, as applicable] is being
reduced by a contribution made mm/dd/2019
to an eligible retirement plan in repayment of
a qualified distribution made mm/dd/2018
under PL 116-94, sec. 202(b). The disaster
was the [name of the qualified 2019 disaster
from Table 1] disaster."

If the distribution was received in

TIP 2018, see Qualified distributions

under Amending Form 8915-D, later.

Amending Form 8915-D

File Form 1040-X, Amended U.S. Individual
Income Tax Return, to amend a return you
have already filed. Generally, Form 1040-X
must be filed within 3 years after the date the
original return was filed, or within 2 years
after the date the tax was paid, whichever is
later.

Qualified 2019 disaster distributions. If,
after filing your 2019 return, you make a
repayment, the repayment may reduce the
amount of your qualified 2019 disaster
distributions reported on that return.
Depending on when a repayment is made,
you may need to file an amended tax return
to refigure your taxable income.
If you make a repayment by the due date
of your 2019 return (including extensions),
include the repayment on your amended
2019 Form 8915-D.
If you make a repayment after the due
date of your 2019 return (including
extensions) but before the due date of your
2020 return (including extensions) and you
have spread the income over 3 years,
include the repayment on your 2020 Form
8915-D. However, you may file an amended
Form 8915-D for 2019 if either of the
following applies.
• You elected on 2019 Form 8915-D, lines 9
and 17, as applicable, to include all of your
qualified 2019 disaster distributions in
income in 2019 (instead of over 3 years).
• You have spread the income over 3 years,
the amount of the repayment exceeds the
amount of your qualified 2019 disaster
distributions that are included in income on
your 2020 Form 8915-D and you choose to
carry the excess back to your 2019 tax
return. See the example below.
Example. You received a qualified 2019
disaster distribution in the amount of $90,000
in 2019. The distribution was made on
October 16. You choose to spread the
$90,000 over 3 years ($30,000 in income for
2019, 2020, and 2021). On November 19,
2020, you make a repayment of $45,000. For
2020, none of the qualified 2019 disaster
distribution is included in income. The
excess repayment of $15,000 ($45,000 -

Instructions for Form 8915-D (2019)

Example. You received a distribution
from a traditional IRA on December 14,
2018, to construct a home in the Mississippi
Severe Storms, Tornadoes, Straight-line
Winds, And Flooding disaster area which
you did not construct because of that
disaster. The disaster began April 13, 2019,
and the distribution now qualifies as a
qualified distribution. On April 14, 2019, you
made a contribution that qualifies as a
repayment of the distribution. You have
already filed your 2018 return: a Form 1040.
You will need to file a Form 1040-X for 2018
to claim the repayment. On your Form
1040-X, you check the 2018 box at the top of
page 1 and, in parentheses in column B of
line 1, you enter the amount of the
repayment. In Part III of your amended
return, say: "The amount I reported on 2018
Form 1040, line 4b, is being reduced by a
contribution made 04/14/2019 to an eligible
retirement plan in repayment of a qualified
distribution made 12/14/2018 under PL
116-94, sec. 202(b). The disaster was the
Mississippi Severe Storms, Tornadoes,
Straight-line Winds, And Flooding disaster."

Specific Instructions
Married filers. If both you and your spouse
are required to file Form 8915-D, file a
separate Form 8915-D for each of you. If you
and your spouse are both filing Forms
8915-D, the $100,000 limits on qualified
2019 disaster distributions and the election
on lines 9 and 17 to include all qualified 2019
disaster distributions in income in 2019 (and
not spread them over 3 years) are
determined separately for each spouse.

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Name and social security number (SSN).
If you file a joint return, enter only the name
and SSN of the spouse whose information is
being reported on Form 8915-D.
Foreign address. If you have a foreign
address, enter the city name on the
appropriate line. Do not enter any other
information on that line, but also complete
the spaces below that line. Do not abbreviate
the country name. Follow the country's
practice for entering the postal code and the
name of the province, county, or state.
Names of disasters. Use the name(s) of
the disaster(s) in Table 1 at the end of these
instructions. Include the name of the state,
territory, or tribal government. If you are
reporting only one qualified 2019 disaster for
your qualified 2019 disaster distribution(s),
enter the name of the disaster on the line
provided in Part I of Form 8915-D.
Worksheet 2. If you use Worksheet 2, at
the top of page 1 of Form 8915-D write the
name of each disaster for which you are
reporting a qualified 2019 disaster
distribution.
Part IV. Enter the name of the disaster(s)
for which you are reporting qualified
distributions on the line provided on Form
8915-D.

Part I—Total Distributions
From All Retirement Plans
(Including IRAs)
Column (a). If you received a distribution
from a retirement plan (including an IRA),
you should receive a Form 1099-R. The
amount of the distribution should be shown
in Form 1099-R, box 1. Enter the amounts
from all your Forms 1099-R, box 1, on the
appropriate lines in column (a). For each
disaster, include only distributions made on
or after the date on which the disaster began.
If you are also filing 2019 Form
8915-C and have filled in Part I of
CAUTION that form, you must reduce the total
distributions for each type of plan in column
(a) of Form 8915-D by the qualified 2018
disaster distributions for the corresponding
plan on Form 8915-C, Part I, column (c) (or
column (b) if column (c) has not been
completed). Do not do this reduction without
considering the beginning date of the
qualified 2019 disaster(s) that you are
reporting. Keep in mind, on your Form
8915-D for each disaster, you will only be
reporting as qualified 2019 disaster
distributions those distributions made on or
after the date on which the disaster began.
See the Worksheet 1 examples below for
guidance. A blank Worksheet 1 is at the end
of the instructions under Worksheets.

Example 1. Arnell suffered economic
losses as a result of Texas Severe Storms
And Flooding in 2018 and Tropical Storm
Imelda (which began September 17, 2019).
His main home was in Texas during the
disaster period for each disaster. These

events were qualified 2018 and 2019
disasters, respectively. In 2019, he received
a traditional IRA distribution of $140,000 and
another traditional IRA distribution of
$60,000 for a total of $200,000 in
distributions. The distributions were made on
September 26 and October 4, respectively.
He received no other distributions in 2018 or
2019. He is completing both 2019 Form
8915-C and 2019 Form 8915-D. He must
complete his Form 8915-C first. Both
distributions were made after the 2019
Tropical Storm Imelda disaster. He reports
$100,000 from the September distribution as
a qualified 2018 disaster distribution on Form
8915-C. He reports the remaining $40,000

from the September distribution and the full
$60,000 of the October distribution for a total
of $100,000 in available distributions under
column (a) in the Form 8915-D portion of his
Filled-in Worksheet 1 for Example 1. On
lines 1 through 3 of column (a) in Part I of his
2019 Form 8915-D, Arnell enters the
amounts shown in column (a), lines 1
through 3, of Form 8915-D on his Filled-in
Worksheet 1 for Example 1.

February distribution as a qualified 2018
disaster distribution on Form 8915-C. No
part of the February distribution is an
available distribution on Form 8915-D for
2019 (even though $40,000 of the $140,000
is still unused) as that distribution was made
before the Tropical Storm Imelda disaster
began. He reports the full $60,000 of the
October distribution under column (a) in the
Form 8915-D portion of his Filled-in
Worksheet 1 for Example 2. On lines 1
through 3 of column (a) in Part I of his 2019
Form 8915-D, Arnell enters the amounts
shown in column (a), lines 1 through 3, of
Form 8915-D on his Filled-in Worksheet 1 for
Example 2.

Example 2. The facts are the same as in
Example 1, except the distribution made on
September 26, 2019, was made on February
26, 2019. Arnell must complete his Form
8915-C first. He reports $100,000 from the

Filled-in Worksheet 1. Use if you complete Part I of 2019 Form 8915-C. Example 1 for Arnell column (a).
Form 8915-C
1

column (a)

column (b)

column (c)

Total available distributions
in 2019

Qualified 2018 disaster
distributions

Allocation of column (b)

Enter in columns (b) and (c) the amount, if any,
from your 2018 Form 8915-C, line 4, column (b).
If this amount is $100,000 or more, do not
complete this worksheet, you have no qualified
2018 disaster distributions in 2019. If you used
Worksheet 2 in the 2018 Instructions for Form
8915-C, substitute the product of $100,000
times the number of disasters for $100,000 in
the prior sentence.

Distributions from retirement plans (other than
IRAs) made in 2019

Distributions from traditional, SEP, and SIMPLE
IRAs made in 2019

Distributions from Roth IRAs made in 2019

-0-

$140,000 Sept. 26,2019
$60,000 Oct. 4, 2019-0-

$100,000

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column (a)
Total available distributions in 2019
(Form 8915-C, column (a) minus Form 8915-C, column (c), if completed
(otherwise minus Form 8915-C, column (b))
You can only use a distribution if the date of the distribution is on or after the first day of the
qualified 2019 disaster with which you are matching it.

Form 8915-D

Distributions from retirement plans (other than IRAs)

-0-

Distributions from traditional, SEP, and SIMPLE IRAs

$100,000

Distributions from Roth IRAs

-0-

Filled-in Worksheet 1. Use if you complete Part I of 2019 Form 8915-C. Example 2 for Arnell column (a).
Form 8915-C
1

column (a)

column (b)

column (c)

Total available distributions
in 2019

Qualified 2018 disaster
distributions

Allocation of column (b)

-0-

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-0-

Instructions for Form 8915-D (2019)

Distributions from traditional, SEP, and SIMPLE
IRAs made in 2019

Distributions from Roth IRAs made in 2019

$140,000 (Feb. 26, 2019)
$60,000 (October 4, 2019)

$100,000

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Form 8915-D

Distributions from retirement plans (other than IRAs)

-0-

Distributions from traditional, SEP, and SIMPLE IRAs

$60,000

Distributions from Roth IRAs

Use If Reporting Only One 2019
Disaster
Column (b). Follow the instructions in this
section to complete, Part I, column (b), if you
have qualified 2019 disaster distributions for
only one disaster in 2019. If your qualified
2019 distributions available for qualified
2019 disasters total $100,000 or less, use
the entire total for the earliest disaster and
follow this section of the instructions even if
you were impacted by more than one
disaster.
If you have qualified 2019 disaster
distributions for more than one
CAUTION disaster, you must use Worksheet 2,
later, to figure your column (b) amounts
unless your 2019 distributions available for
qualified 2019 disasters total $100,000 or
less. See the paragraph immediately above
and the following example.

Example. In 2019, you received qualified
2019 disaster distributions totaling $90,000.
They were all made in October. You suffered
economic losses as a result of these two
qualified 2019 disasters. Disaster 1:
Louisiana Flooding (beginning date May 10,
2019). Disaster 2: Tropical Storm Imelda
(beginning date September 17, 2019). On
your 2019 Form 8915-D, you report the
entire $90,000 distribution under one
disaster: Disaster 1. You do not use
Worksheet 2. You follow the steps under Use
If Reporting Only One 2019 Disaster.
Enter on the appropriate lines, in column
(b), any qualified 2019 disaster distributions
(including periodic payments and required
minimum distributions) made in 2019 no
earlier than the first day of the disaster.
Include only those distributions you wish
to designate as qualified 2019 disaster
distributions. See Qualified 2019 Disaster
Distribution, earlier.
Also include in column (b), if you choose,
any qualified distribution that is eligible to be
designated as a qualified 2019 disaster
distribution (see Qualified Distribution for the
Purchase or Construction of a Main Home in
Qualified 2019 Disaster Areas, earlier).
Column (c). Complete column (c) only if the
total on line 4, column (b), is more than

Instructions for Form 8915-D (2019)

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$100,000 and you are not using Worksheet
2.
If the amount on line 4, column (b), is
more than $100,000, you will need to make
an allocation in column (c) of the
distribution(s) included in column (b). This is
because the total of your qualified 2019
disaster distributions cannot exceed the
$100,000 limit. If you have distributions from
more than one type of retirement plan, such
as an IRA and a 401(k) plan, you may
allocate the $100,000 limit among the plans
by any reasonable method.
Example 1. You received a distribution
from your Roth IRA in the amount of
$130,000 in 2019. The distribution was made
on June 28, 2019. You had an economic loss
due to Texas Severe Storms And Flooding
(which began June 24, 2019). You had a
main home in Texas during the period listed
in Table 1 for this disaster. This was your
only distribution made in 2019. You entered
$130,000 on line 3, columns (a) and (b). You
would then enter $100,000 on line 3, column
(c), since the distribution is in excess of the
$100,000 limit.
Example 2. Assume the same facts as in
Example 1, except you also received a
distribution from your 401(k) plan in the
amount of $20,000. This distribution was
made on October 16, 2019. You entered
$20,000 on line 1, columns (a) and (b). You
will now need to make an allocation in
column (c) between the two distributions
because the total on line 4, column (b), is
$150,000. You can choose to make the
allocation by any reasonable method, as
long as the total in column (c) does not
exceed $100,000. You choose to allocate
$80,000 to your Roth IRA distribution on
line 3, column (c), and the entire $20,000 to
your 401(k) plan distribution on line 1,
column (c).
Example 3. In 2019, Arnell suffered
economic losses as a result of only one
qualified 2019 disaster: Texas Severe
Storms And Flooding (beginning date June
24, 2019). In 2019, he received a traditional
IRA distribution of $40,000 and another
traditional IRA distribution of $70,000 for a
total of $110,000 in distributions. These
distributions were made on February 3 and
September 6, respectively. He reported no
-5-

qualified disaster distributions on any other
8915 form. No part of the February 2019
distribution can be a qualified 2019 disaster
distribution (even though that entire $40,000
is unused) as that distribution was made
before the Texas Severe Storms And
Flooding disaster began. He reports $70,000
on line 2 of column (b). He does not report
$110,000 on that line, and he does not need
to complete column (c).

Worksheet 2: Use if You Are
Reporting More Than One 2019
Disaster

Do not enter any amounts in column
(c) if you are using Worksheet 2.

CAUTION

Column (b). If you suffered economic
losses as the result of more than one
qualified 2019 disaster and your qualified
2019 disaster distributions made in 2019
total more than $100,000, you must use
Worksheet 2 to figure the amounts you are
entering in column (b).
In Worksheet 2, column (a), enter the
amounts you already have figured for lines 1
through 4 in Part I of 2019 Form 8915-D. In
Worksheet 2, column (X), start by entering
the amounts you are planning to claim as
qualified 2019 disaster distributions made in
2019. Enter the 2019 distributions for each
2019 disaster in a separate column. A
distribution can't be a qualified 2019 disaster
distribution for a disaster if it is made before
the disaster begins. For simplicity, apply your
distributions in $100,000 amounts as
available to each disaster, beginning with the
earliest disaster. Examples 1 through 4,
later, provide guidance. A blank Worksheet 2
is in Worksheets at the end of the
instructions.
See Use If Reporting Only One 2019
Disaster, earlier, if you have only one
CAUTION disaster, or your total distributions
available for qualified 2019 disasters is
$100,000 or less even if you had more than
one 2019 disaster. If you have total
distributions of more than $100,000 but no
more than $200,000, use $100,000 for the
earliest disaster and the remaining amount
for your second disaster. See the examples
below if you have two or three disasters. In

each of the examples, we have assumed
Mosley had a main home in Louisiana (the
qualified disaster area) during the period
listed in Table 1 for the disaster.
Example 1. Mosley suffered economic
losses as a result of these two qualified 2019
disasters. Disaster 1: Louisiana Severe
Storms And Tornadoes (beginning date April
24, 2019). Disaster 2: Louisiana Flooding
(beginning date May 10, 2019). In 2019, he
received a traditional IRA distribution of
$140,000. The distribution was made on
April 30. He reported no qualified disaster
distributions on any other 8915 form. He
completes Mosley's Filled-in Worksheet 2 for
Example 1. One by one, Mosley applies the
distribution up to the $100,000 limit against
each disaster, as possible. He applies
$100,000 of the April 30 distribution to
Disaster 1. He cannot apply any of the April
30 distribution to Disaster 2 as its starting
date is after the April 30 distribution date. In
column (b), lines 1 through 4, of his 2019
Form 8915-D, Mosley enters the amounts
from lines 1 through 4 of his Filled-in
Worksheet 2, column (b). He leaves column
(c) of his 2019 Form 8915-D blank.
Example 2. The facts are the same as in
Example 1 except the traditional IRA
distribution of $140,000 was made on
August 30, 2018, instead of April 30, 2018.
He completes the Mosley's Filled-in
Worksheet 2 for Example 2. One by one,
Mosley applies the distribution up to the
$100,000 limit against each disaster, as
possible. He applies $100,000 of the August
30 distribution to Disaster 1 and $40,000 of
the August 30 distribution to Disaster 2. In
column (b), lines 1 through 4, of his 2019
Form 8915-D, Mosley enters the amounts

from lines 1 through 4 of his Filled-in
Worksheet 2, column (b). He leaves column
(c) of his 2019 Form 8915-D blank.
Example 3. Mosley suffered economic
losses as a result of these three qualified
2019 disasters. Disaster 1: Louisiana Severe
Storms And Tornadoes (beginning date April
24, 2019). Disaster 2: Louisiana Flooding
(beginning date May 10, 2019). Disaster 3:
Hurricane Barry (July 10, 2019). In 2019, he
received a traditional IRA distribution of
$240,000 and a Roth IRA distribution of
$60,000 for a total of $300,000 in
distributions. The distributions were made on
May 15 and October 16, respectively. He
reported no qualified disaster distributions on
any other 8915 form. He completes the
Mosley's Filled-in Worksheet 2 for
Example 3. One by one, Mosley applies the
distributions up to the $100,000 limit against
each disaster, as possible. He applies
$100,000 of the May 15 distribution to
Disaster 1 and $100,000 of the May 15
distribution to Disaster 2. Mosley cannot
apply any part of the May 15 distribution to
Disaster 3 (even though $40,000 is not yet
used) as that disaster started after the May
15 distribution was made. He applies the full
$60,000 from the October distribution to
Disaster 3. He is only able to use $260,000
of the total $300,000 in 2019 distributions
even though he suffered economic losses
from three disasters. In column (b), lines 1
through 4, of his 2019 Form 8915-D, Mosley
enters the amounts from lines 1 through 4 of
his Filled-in Worksheet 2, column (b). He
leaves column (c) of his 2019 Form 8915-D
blank.
Example 4. The facts are the same as in
Example 3 except the traditional IRA

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distribution of $240,000 was made on
September 30, 2019, instead of May 15,
2019. He completes the Mosley's Filled-in
Worksheet 2 for Example 4. One by one,
Mosley applies the distributions up to the
$100,000 limit against each disaster, as
possible. He applies $100,000 of the
September 30 distribution to Disaster 1 and
$100,000 of the September 30 distribution to
Disaster 2. Mosley applies the remaining
$40,000 of the September 30 distribution to
Disaster 3. He applies, in addition, the full
$60,000 from the October distribution to
Disaster 3. He is able to use the total
$300,000 in 2019 distributions. In column
(b), lines 1 through 4, of his 2019 Form
8915-D, Mosley enters the amounts from
lines 1 through 4 of his Filled-in Worksheet 2,
column (b). He leaves column (c) of his 2019
Form 8915-D blank.

Line 5

See the caution below before you begin
line 5.
Before you begin line 5: If you are
using Worksheet 2, do not complete
CAUTION line 5 until you have completed
Worksheet 2.

If line 5 includes an amount distributed for
the purchase or construction of a main home
in a qualified 2019 disaster area, but you did
not purchase or construct that home
because of the qualified 2019 disaster,
report this amount on line 21. See Qualified
Distribution for the Purchase or Construction
of a Main Home in Qualified 2019 Disaster
Areas, earlier. Also, see the instructions for
your tax return for reporting all other
distributions included on line 5.

Instructions for Form 8915-D (2019)

Mosley's Filled-in Worksheets 2: Use if you have qualified 2019 disaster distributions for more than one
disaster and your total available distributions in 2019 exceed $100,000.
Mosley’s Filled-in Worksheet 2 for
Example 1

Distributions from retirement plans
(other than IRAs)

Distributions from traditional, SEP, and
SIMPLE IRAs

Distributions from Roth IRAs

Totals. Add lines 1 through 3.

Mosley’s Filled-in Worksheet 2 for
Example 2

Distributions from retirement plans
(other than IRAs)

Distributions from traditional, SEP, and
SIMPLE IRAs

Distributions from Roth IRAs

Totals. Add lines 1 through 3.

Mosley’s Filled-in Worksheet 2 for
Example 3

Distributions from retirement plans
(other than IRAs)

Distributions from traditional, SEP, and
SIMPLE IRAs

3
4

(a)

(X)

(b)

Total
available
distributions
in 2019

Qualified 2019 disaster distributions made in 2019

Qualified 2019 disaster distributions
made in 2019

Disaster 1

Disaster 2

Disaster 3

Disaster 4

(Total for all disasters)

-0-

$140,000

$100,000

-0-

$100,000

-0-

$140,000

$100,000

-0-

$100,000

(a)

(X)

(b)

Total
available
distributions
in 2019

Qualified 2019 disaster distributions made in 2019

Qualified 2019 disaster distributions
made in 2019

Disaster 1

Disaster 2

Disaster 3

Disaster 4

(Total for all disasters)

-0-

$140,000

$100,000

$40,000

$140,000

-0-

$140,000

$100,000

$40,000

$140,000

(a)

(X)

(b)

Total
available
distributions
in 2019

Qualified 2019 disaster distributions made in 2019

Qualified 2019 disaster distributions
made in 2019

Disaster 1

Disaster 2

Disaster 3

Disaster 4

(Total for all disasters)

-0-

$240,000

$100,000

-0-

$200,000

Distributions from Roth IRAs

$60,000

-0-

$60,000

Totals. Add lines 1 through 3.

$300,000

$100,000

$60,000

$260,000

Mosley’s Filled-in Worksheet 2 for
Example 4

Distributions from retirement plans
(other than IRAs)

Distributions from traditional, SEP, and
SIMPLE IRAs

3
4

(a)

(X)

(b)

Total
available
distributions
in 2019

Qualified 2019 disaster distributions made in 2019

Qualified 2019 disaster distributions
made in 2019

Disaster 1

Disaster 2

Disaster 3

Disaster 4

(Total for all disasters)

-0-

$240,000

$100,000

$40,000

$240,000

Distributions from Roth IRAs

$60,000

-0-

$60,000

Totals. Add lines 1 through 3.

$300,000

$100,000

$300,000

Part II—Qualified 2019
Disaster Distributions
From Retirement Plans
(Other Than IRAs)

Complete Part II if you have an amount
entered on line 1, column (b).

Instructions for Form 8915-D (2019)

Line 7. Enter on line 7 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 Form
1099-R, box 2a (taxable amount), the
difference between Form 1099-R, box 1 and
box 2a, is usually your cost. Enter the
difference on line 7.
-7-

If there is no amount in Form 1099-R,
box 2a, and the first box in box 2b is
checked, the issuer of Form 1099-R may not
have had all the facts needed to figure the
taxable amount. You may want to get Pub.
575, Pension and Annuity Income, to help
figure your taxable amount.

Also, see Pub. 575 if you use the
Simplified Method Worksheet to figure the
taxable amount of your periodic payments
and you designated some of these payments
as qualified 2019 disaster distributions.
If you have a Form 1099-R with both
qualified 2019 disaster distributions
CAUTION and nonqualified distributions, you
must separately figure the cost attributable to
each distribution.

Line 9. If you don’t check the box on line 9,
you must spread the amount on line 8 over 3
years. If you use this method to figure the
taxable amount of your distributions, you
cannot change it after the due date (including
extensions) for your tax return. If you
checked the box on line 17, you must check
the box on line 9.
If the taxpayer died during 2019 after
receiving a qualified 2019 disaster
distribution, the taxable amount of the
distribution may not be spread over 3 years.
The entire distribution must be reported on
the tax return of the deceased taxpayer.
Line 10. At any time during the 3-year
period that begins the day after the date you
received a qualified 2019 disaster
distribution, you can repay any portion of the
distribution to an eligible retirement plan that
accepts rollover contributions. You cannot,
however, repay more than the amount of the
original distribution. See Repayment of a
Qualified 2019 Disaster Distribution, earlier,
for details.
Enter on line 10 the amount of any
repayments you made before filing your
2019 return. Do not include any repayments
made later than the due date (including
extensions) for that return nor any
repayments of nontaxable amounts. If you
elected to repay the distribution over 3 years
and you repaid more than the amount on
line 9, the excess will be carried forward to
your 2020 tax return. Repayments made
after the due date of your 2019 return
(including extensions) but before the due
date of your 2020 return (including
extensions) generally will be reported on
your 2020 tax return if you elected to repay
the distribution over 3 years. However, you
may have to file an amended return in certain
situations. See Amending Form 8915-D,
earlier.
Example. You received a $90,000
qualified 2019 disaster distribution on
November 7, 2019, from your 401(k) plan.
You had an economic loss due to Hurricane
Barry. On April 2, 2020, you repay $30,000
to an IRA. You file your return on April 10,
2020. Since the repayment was made before
you filed your return, and not later than the
due date (including extensions), you would
enter the $30,000 repayment on line 10.

Part III—Qualified 2019
Disaster Distributions
From Traditional, SEP,
SIMPLE, and Roth IRAs

Complete Part III if you have an amount
entered on line 2, column (b), or line 3,
column (b).

Before completing this part, complete
2019 Form 8606 if either of the following
applies.
• You received a qualified 2019 disaster
distribution from a traditional, SEP, or
SIMPLE IRA, and you have a basis in the
IRA.
• You received a qualified 2019 disaster
distribution from a Roth IRA.
For more information, see 2019 Form
8606 and its instructions.
Lines 13 and 14. Enter the amounts from
Form 8606, lines 15b and 25b, as instructed.
If you have both 2019 Form 8915-C and
2019 Form 8915-D taxable amounts
computed on 2019 Form 8606, you may
need to prorate the Form 8606 amounts on
lines 15b and 25b to arrive at the amounts
you will enter on lines 13 and 14 of Form
8915-D. See the example below.
Example. You received a $30,000
distribution, that was not a qualified disaster
distribution, from your traditional IRA (that
you did not roll over). Later, you received a
qualified disaster distribution from your
traditional IRA in the amount of $10,000.
Both distributions were made in 2019. These
were your only distributions in 2019. You
reported $8,000 on 2019 Form 8915-C and
$2,000 on 2019 Form 8915-D. You will report
total distributions of $40,000 on 2019 Form
8606, line 7. You then will complete Form
8606, lines 8 through 14, as instructed. 2019
Form 8606, line 15a, shows an amount of
$36,000. You will enter $9,000 ($36,000 x
$10,000/$40,000) on Form 8606, line 15b.
You will place $7,200 ($36,000 x
$8,000/$40,000) on 2019 Form 8915-C,
line 22, and $1,800 ($36,000 x
$2,000/$40,000) on 2019 Form 8915-D,
line 13.
Line 17. If you do not check the box on
line 17, you must spread the amount on
line 16 over 3 years. If you use this method to
figure the taxable amount of your
distributions, you cannot change it after the
due date (including extensions) for your tax
return. If you checked the box on line 9, you
must check the box on line 17.
If the taxpayer died during 2019 after
receiving a qualified 2019 disaster
distribution, the taxable amount of the
distribution may not be spread over 3 years.
The entire distribution must be reported on
the tax return of the deceased taxpayer.
Line 18. At any time during the 3-year
period that begins the day after the date you
received a qualified 2019 disaster
distribution, you can repay any portion of the
distribution to an eligible retirement plan that
accepts rollover contributions. You cannot,
-8-

however, repay more than the amount of the
original distribution. See Repayment of a
Qualified 2019 Disaster Distribution, earlier,
for details.
Enter on line 18 the amount of any
repayments you made before filing your
2019 return. Do not include any repayments
made later than the due date (including
extensions) for that return nor any
repayments of nontaxable amounts. If you
elected to repay the distribution over 3 years
and you repaid more than the amount on
line 17, the excess will be carried forward to
your 2020 tax return. Repayments made
after the due date of your 2019 return
(including extensions) but before the due
date of your 2020 return (including
extensions) generally will be reported on
your 2020 tax return if you are spreading the
income over 3 years. However, you may
have to file an amended return in certain
situations. See Amending Form 8915-D,
earlier.
Example. You received a $90,000
qualified 2019 disaster distribution on
October 20, 2019, from your traditional IRA.
You had an economic loss due to Hurricane
Barry. On April 2, 2020, you repay $30,000
to your traditional IRA. You file your return on
April 10, 2020. Since the repayment was
made before you filed your return, and not
later than the due date (including
extensions), you would enter the $30,000
repayment on line 18.

Part IV—Qualified
Distributions for the
Purchase or Construction
of a Main Home in
Qualified 2019 Disaster
Areas

Complete Part IV if, in 2019, you received a
qualified distribution for the purchase or
construction of a main home in a qualified
2019 disaster area that you repaid, in whole
or in part, no earlier than the first day of the
disaster and no later than June 17, 2020. But
see also Line 20, later.
For qualified distributions received in

TIP 2018 for a qualified 2019 disaster,

see Qualified distributions under
Amending Form 8915-D, earlier.

If you are required to file 2019 Form 8606,
complete that form before you complete this
part.
Note. A distribution for the purchase or
construction of a main home made no earlier
than the first day of the disaster and no later
than June 17, 2020, may be treated as a
qualified 2019 disaster distribution in certain
circumstances. See Repayment of a
Qualified Distribution for the Purchase or
Construction of a Main Home, earlier.
Line 20. If you check the “Yes” box, but are
not required to complete lines 21 through 25,
you still must file Form 8915-D to show that
you received a qualified distribution.

Instructions for Form 8915-D (2019)

Line 21. Enter on line 21 your qualified
distributions (see Qualified Distribution for
the Purchase or Construction of a Main
Home in Qualified 2019 Disaster Areas,
earlier).
Don’t include any distributions you
designated as qualified 2019 disaster
distributions reported on line 6 or line 15.
Also, don’t include any amounts reported on
2019 Form 8606.

can’t, however, repay more than the amount
of the original distribution.
Enter on line 24 the amount of any
repayments you make on or after the first
day of the disaster and no later than June 17,
2020. Don’t include any repayments treated
as rollovers on 2019 Form 8606 nor any
repayments of nontaxable amounts.

Line 22. Enter on line 22 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 Form
1099-R, box 2a (taxable amount), the
difference between Form 1099-R, box 1 and
box 2a, is usually your cost. See Pub. 575 for
more information about figuring your cost in
the plan.
In many cases, a hardship distribution
from a 401(k) plan or a tax-sheltered annuity
contract will not have any cost.
If you received a first-time homebuyer
distribution from an IRA, don’t enter any
amount on line 22. Any cost or basis in an
IRA is figured on 2019 Form 8606 if you
made nondeductible contributions.

Line 25. Most distributions from qualified
retirement plans (including IRAs) made to
you before you reach age 591/2 are subject to
an additional tax on early distributions and
are reported on Form 5329. Qualified
distributions for the purchase or construction
of a main home in a qualified 2019 disaster
area that were not repaid to an eligible
retirement plan on or after the first day of the
disaster and no later than June 17, 2020,
may be subject to this additional tax unless
you qualify for an exception. See the
Instructions for Form 5329 for information on
exceptions to this tax. If you have not repaid
the distribution before June 18, 2020, you
may be able to designate the qualified
distribution as a qualified 2019 disaster
distribution. See Repayment of a Qualified
Distribution for the Purchase or Construction
of a Main Home, earlier.

If you have a Form 1099-R with both
qualified distributions and
CAUTION nonqualified distributions, you must
separately figure the cost attributable to each
distribution.

Privacy Act and
Paperwork Reduction Act
Notice

Line 24. At any time on or after the first day
of the disaster and no later than June 17,
2020, you can repay any portion of a
qualified distribution to an eligible retirement
plan that accepts rollovers (see Repayment
of a Qualified Distribution for the Purchase or
Construction of a Main Home, earlier). You

Instructions for Form 8915-D (2019)

We ask for the information on this form to
carry out the Internal Revenue laws of the
United States. We need this information to
ensure that you are complying with these
laws and to allow us to figure and collect the
right amount of tax. You are required to give
us this information if you made certain
contributions or received certain distributions

-9-

from qualified plans, including IRAs, and
other tax-favored accounts. Our legal right to
ask for the information requested on this
form is sections 6001, 6011, 6012(a), and
6109 and their regulations. If you don’t
provide this information, or you provide
incomplete or false information, you may be
subject to penalties. You are not required to
provide the information requested on a form
that is subject to the Paperwork Reduction
Act unless the form displays a valid OMB
control number. Books or records relating to
a form or its instructions must be retained as
long as their contents may become material
in the administration of any Internal Revenue
law. Generally, tax returns and return
information are confidential, as required by
section 6103. However, we may give this
information to the Department of Justice for
civil and criminal litigation, and to cities,
states, the District of Columbia, and U.S.
commonwealths and possessions to carry
out their tax laws. We may also disclose this
information to other countries under a tax
treaty, to federal and state agencies to
enforce federal nontax criminal laws, or to
federal law enforcement and intelligence
agencies to combat terrorism.
The average time and expenses required
to complete and file this form will vary
depending on individual circumstances. For
the estimated averages, see the instructions
for your income tax return.
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.

Worksheets

Blank Worksheets 1 and 2 follow.

Worksheet 1: Use if you complete Part I of 2019 Form 8915-C.
Form 8915-C
1

Enter in columns (b) and (c) the amount, if any,
from your 2018 Form 8915-C, line 4, column (b).
If this amount is $100,000 or more, do not
complete this worksheet, you have no qualified
2018 disaster distributions in 2019. If you used
Worksheet 2 in the 2018 Instructions for Form
8915-C, substitute the product of $100,000 times
the number of disasters for $100,000 in the prior
sentence.

Distributions from retirement plans (other than
IRAs) made in 2019

Distributions from traditional, SEP, and SIMPLE
IRAs made in 2019

Distributions from Roth IRAs made in 2019

column (a)

column (b)

column (c)

Total available distributions in
2019

Qualified 2018 disaster
distributions

Allocation of column (b)

column (a)
Total available distributions in 2019
(Form 8915-C, column (a) minus Form 8915-C, column (c), if completed
(otherwise minus Form 8915-C, column (b))
You can only use a distribution if the date of the distribution is on or after the first day of the qualified
2019 disaster with which you are matching it.

Form 8915-D

Distributions from retirement plans (other than IRAs)

Distributions from traditional, SEP, and SIMPLE IRAs

Distributions from Roth IRAs

Worksheet 2: Use if you have qualified 2019 disaster distributions for more than one disaster and your total available distributions in 2019 exceed $100,000.
Worksheet 2 for Form 8915-D

Distributions from retirement plans
(other than IRAs)

Distributions from traditional, SEP, and
SIMPLE IRAs

Distributions from Roth IRAs

Totals. Add lines 1 through 3.

(a)

(X)

(b)

Total
available
distributions
in 2019

Qualified 2019 disaster distributions made in 2019

Qualified 2019 disaster distributions
made in 2019

Disaster 1

Disaster 2

-10-

Disaster 3

Disaster 4

(Total for all disasters)

Instructions for Form 8915-D (2019)

Table 1. Qualified 2019 Disaster Areas for Form 8915-D
Disaster Area

Qualified 2019 Disaster

Date of Declaration

Disaster Period aka Incident Period

Alabama

Severe Storms, Straight-line Winds, Tornadoes, And Flooding (DR-4426)

April 17, 2019

February 19, 2019 - March 20, 2019

Alabama

Severe Storms, Straight-line Winds, And Tornadoes (DR-4419)

March 05, 2019

March 03, 2019

Arkansas

Severe Storms And Flooding (DR-4441)

June 08, 2019

May 21, 2019 - June 14, 2019

Arkansas

Severe Storms, Straight-line Winds, Tornadoes, And Flooding (DR-4460)

September 13, 2019

June 23, 2019 - June 24, 2019

Cahuilla Band of Indians

Severe Storms And Flooding (DR-4423)

March 28, 2019

February 14, 2019

California

Severe Winter Storms, Flooding, Landslides, And Mudslides (DR-4434)

May 17, 2019

February 24, 2019 - March 01, 2019

California

Severe Winter Storms, Flooding, Landslides, And Mudslides (DR-4431)

May 01, 2019

February 13, 2019 - February 15, 2019

Florida

Hurricane Dorian (DR-4468)

October 21, 2019

August 28, 2019 - September 09, 2019

Guam

Typhoon Wutip (DR-4433)

May 07, 2019

February 23, 2019 - February 25, 2019

Idaho

Severe Storms, Flooding, Landslides, And Mudslides (DR-4443)

June 12, 2019

April 07, 2019 - April 13, 2019

Illinois

Severe Storms And Flooding (DR-4461)

September 19, 2019

February 24, 2019 - July 03, 2019

Iowa

Severe Storms And Flooding (DR-4421)

March 23, 2019

March 12, 2019 - June 15, 2019

Kansas

Severe Storms, Straight-line Winds, Tornadoes, Flooding, landslides, and Mudslides (DR-4449) June 20, 2019

April 28, 2019 - July 12, 2019

Kentucky

Severe Storms, Straight-line Winds, Flooding, Landslides, And Mudslides (DR-4428)

April 17, 2019

February 06, 2019 - March 10, 2019

La Jolla Band of Luiseño Indians

Severe Storms, Flooding, Landslides, And Mudslides (DR-4422)

March 26, 2019

February 14, 2019 - February 15, 2019

Louisiana

Severe Storms And Tornadoes (DR-4439)

June 03, 2019

April 24, 2019 - April 25, 2019

Louisiana

Hurricane Barry (DR-4458)

August 27, 2019

July 10, 2019 - July 15, 2019

Louisiana

Flooding (DR-4462)

September 19, 2019

May 10, 2019 - July 24, 2019

Minnesota

Severe Winter Storm, Straight-line Winds, And Flooding (DR-4442)

June 12, 2019

March 12, 2019 - April 28, 2019

Mississippi

Severe Storms, Straight-line Winds, Tornadoes, And Flooding (DR-4429)

April 23, 2019

February 22, 2019 - August 23, 2019

Mississippi

Severe Storms, Tornadoes, Straight-line Winds, And Flooding (DR-4450)

June 20, 2019

April 13, 2019 - April 14, 2019

Mississippi

Severe Storm, Straight-line Winds, And Flooding (DR-4470)

December 06, 2019

October 26, 2019

Missouri

Severe Storms, Straight-line Winds, And Flooding (DR-4435)

May 20, 2019

March 11, 2019 - April 16, 2019

Missouri

Severe Storms, Tornadoes, And Flooding (DR-4451)

July 09, 2019

April 29, 2019 - July 05, 2019

Montana

Flooding (DR-4437)

May 24, 2019

March 20, 2019 - April 10, 2019

Muscogee (Creek) Nation

Severe Storms, Straight-line Winds, Tornadoes, And Flooding (DR-4456)

August 07, 2019

May 07, 2019 - June 09, 2019

Navajo Nation

Snowstorm And Flooding (DR-4436)

May 21, 2019

February 21, 2019 - February 24, 2019

Nebraska

Severe Winter Storm, Straight-line Winds, And Flooding (DR-4420)

March 21, 2019

March 09, 2019 - July 14, 2019

New Hampshire

Severe Storm And Flooding (DR-4457)

August 15, 2019

July 11, 2019 - July 12, 2019

New York

Severe Storms, Straight-line Winds, And Flooding (DR-4472)

December 19, 2019

October 31, 2019 - November 01, 2019

North Carolina

Hurricane Dorian (DR-4465)

October 04, 2019

September 01, 2019 - September 09, 2019

North Dakota

Flooding (DR-4444)

June 12, 2019

March 21, 2019 - April 28, 2019

North Dakota

Flooding (DR-4475)

January 21, 2020

October 09, 2019 - October 26, 2019

Oglala Sioux Tribe

Severe Winter Storm, Snowstorm, And Flooding (DR-4448)

June 20, 2019

March 13, 2019 - March 26, 2019

Ohio

Severe Storms, Flooding, And Landslides (DR-4424)

April 08, 2019

February 05, 2019 - February 13, 2019

Ohio

Severe Storms, Straight-line Winds, Tornadoes, Flooding, Landslides, And Mudslide (DR-4447) June 18, 2019

May 27, 2019 - May 29, 2019

Oklahoma

Severe Storms, Straight-line Winds, Tornadoes, And Flooding (DR-4438)

June 01, 2019

May 07, 2019 - June 09, 2019

Oklahoma

Severe Storms, Tornadoes, Straight-line Winds, And Flooding (DR-4453)

July 12, 2019

April 30, 2019 - May 01, 2019

Oregon

Severe Storms, Flooding, Landslides, And Mudslides (DR-4452)

July 09, 2019

April 06, 2019 - April 21, 2019

Oregon

Severe Winter Storms, Flooding, Landslides, And Mudslides (DR-4432)

May 02, 2019

February 23, 2019 - February 26, 2019

Ponca Tribe of Nebraska

Severe Storms And Flooding (DR-4446)

June 17, 2019

March 13, 2019 - April 01, 2019

Sac and Fox Tribe of the Mississippi in
Iowa

Severe Storms And Flooding (DR-4430)

April 29, 2019

March 13, 2019 - April 01, 2019

Soboba Band Luiseno Indians

Severe Storms And Flooding (DR-4425)

April 08, 2019

February 14, 2019 - February 15, 2019

South Carolina

Hurricane Dorian (DR-4464)

September 30, 2019

August 31, 2019 - September 06, 2019

South Dakota

Severe Winter Storm, Snowstorm, And Flooding (DR-4440)

June 07, 2019

March 13, 2019 - April 26, 2019

South Dakota

Severe Storms And Flooding (DR-4463)

September 23, 2019

May 21, 2019 - June 07, 2019

South Dakota

Dakota Severe Storms, Tornadoes, And Flooding (DR-4467)

October 07, 2019

June 30, 2019 - July 21, 2019

South Dakota

Severe Storms, Tornadoes, And Flooding (DR-4469)

November 18, 2019

September 09, 2019 - September 26, 2019

Tennessee

Severe Storms, Flooding, Landslides, And Mudslides (DR-4427)

April 17, 2019

February 19, 2019 - March 30, 2019

Tennessee

Severe Storm And Straight-line Winds (DR-4471)

December 06, 2019

October 26, 2019

Texas

Severe Storms And Flooding (DR-4454)

July 17, 2019

June 24, 2019 - June 25, 2019

Texas

Tropical Storm Imelda (DR-4466)

October 04, 2019

September 17, 2019 - September 23, 2019

Vermont

Severe Storms And Flooding (DR-4445)

June 14, 2019

April 15, 2019

Vermont

Severe Storm And Flooding (DR-4474)

January 17, 2020

October 31, 2019 - November 01, 2019

West Virginia

Severe Storms, Flooding, Landslides, And Mudslides (DR-4455)

August 02, 2019

June 29, 2019 - June 30, 2019

Wisconsin

Severe Storms, Tornadoes, Straight-line Winds, And Flooding (DR-4459)

August 27, 2019

July 18, 2019 - July 20, 2019

Instructions for Form 8915-D (2019)

-11-

File Type	application/pdf
File Title	2019 Instructions for Form 8915-D
Subject	Instructions for Form 8915-D, Qualified 2019 Disaster Retirement Plan Distributions and Repayments
Author	W:CAR:MP:FP
File Modified	2020-07-01
File Created	2020-07-01