i8915-a--2020-00-00

2020

Department of the Treasury
Internal Revenue Service

Instructions for Form 8915-A

Qualified 2016 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-A and
its instructions, such as legislation
enacted after they were published, go to
IRS.gov/Form8915A.

What’s New
Coronavirus-related distributions. Do
not report coronavirus-related
distributions on Form 8915-A.
Coronavirus-related distributions are
reported on Form 8915-E, Qualified 2020
Disaster Retirement Plan Distributions and
Repayments. If you were impacted by the
coronavirus and you made withdrawals
from your retirement plan in 2020 before
December 31, you may have
coronavirus-related distributions eligible
for special tax benefits on Form 8915-E.
Repayments. The repayment period for
a qualified 2016 disaster distribution ends
3 years and 1 day after the distribution
was received. Repayments reported on
2020 Form 8915-A can only be used to
reduce the income from qualified 2016
disaster distributions made in 2017 and
reportable on your 2017, 2018, or 2019
tax return. The amounts from lines 5 and
10 of 2020 Form 8915-A can only be
carried back to reduce that income. If you
have already filed your tax return for the
year in question, you will need to amend
that return.
Last revision. This 2020 revision is the
last revision of Form 8915-A.

Purpose of Form

Use 2020 Form 8915-A if you were
adversely affected by a 2016 disaster
listed in Table 1. Qualified 2016 Disaster
Areas for Form 8915-A (and Form 8915A)
at the end of these instructions and you
received a distribution that qualifies for
favorable tax treatment. For distributions
for qualified 2017, 2018, 2019, and 2020
disasters, see Form 8915-B, Qualified
2017 Disaster Retirement Plan
Distributions and Repayments; Form
8915-C, Qualified 2018 Disaster
Retirement Plan Distributions and
Repayments; Form 8915-D, Qualified
2019 Disaster Retirement Plan

Mar 05, 2021

Distributions and Repayments; and Form
8915-E, Qualified 2020 Disaster
Retirement Plan Distributions and
Repayments, respectively, and their
instructions.
Use Form 8915-A only to report
repayments of qualified 2016 disaster
distributions made in 2020 that were not
included on your 2019 Form 8915-A.
Qualified 2016 disaster distributions can't
be made in 2020.
For details on qualified 2016

TIP disaster distributions, see the

2017 Instructions for Form 8915A.

Note. Repayments of distributions from
retirement plans (other than IRAs) are
reported in Part I, and repayments of
distributions from IRAs are reported in Part
II.

Who Must File

File 2020 Form 8915-A if you made a
repayment of a qualified 2016 disaster
distribution in 2020 that was not included
on your 2019 Form 8915-A.

When and Where To File

File 2020 Form 8915-A with your 2020
Form 1040, 1040-SR, or 1040-NR. If you
are not required to file an income tax
return but are required to file 2020 Form
8915-A, sign Form 8915-A and send it to
the IRS at the same time and place you
would otherwise file 2020 Form 1040,
1040-SR, or 1040-NR.

Qualified 2016 Disaster
Distribution
What 2016 Disasters Are
Covered?

In order to have had a qualified 2016
disaster distribution, you must have been
adversely affected by a disaster listed in
Table 1.

How Is a Qualified 2016
Disaster Distribution Taxed?

Generally, a qualified 2016 disaster
distribution is included in your income in
equal amounts over 3 years. However, if
you elected, you could have included the
entire distribution in your income in the
year of the distribution. If you received
more than one distribution during 2017,
you must have treated all the distributions
for that year the same way. Qualified 2016
Cat. No. 71195C

disaster distributions aren't subject to the
additional 10% tax (or the 25% additional
tax for certain distributions from SIMPLE
IRAs) on early distributions.

Repayment of a Qualified 2016
Disaster Distribution
An amount paid more than 3 years
and 1 day after the distribution
CAUTION was received cannot be treated as
a repayment on your 2020 Form 8915-A.
For example, if your qualified 2016
disaster distribution was received on
October 4, 2017, and you choose to repay
the distribution, the repayment must be
made before October 5, 2020.

!

If you choose, you can generally repay to
an eligible retirement plan any portion of a
qualified 2016 disaster distribution that is
eligible for tax-free rollover treatment.
Also, you can repay a qualified 2016
disaster distribution from a retirement plan
made on account of hardship. However,
see Exceptions below for qualified 2016
disaster distributions you can’t repay.
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 2020 Form 8915-A any
repayments you make during 2020 that
were not included on your 2019 Form
8915-A. Any repayments may be carried
back to your 2017, 2018, or 2019 return.
See Amending Form 8915-A, later.
Exceptions. You cannot repay the
following types of distributions.
1. Qualified 2016 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
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.

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.

information is being reported on the 2020
Form 8915-A.

Amending Form 8915-A

Part I—Qualified 2016
Disaster Distributions
From Retirement Plans
(Other Than IRAs)

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.
If, after filing a 2017, 2018, or 2019
Form 1040 with a Form 8915A or 8915-A,
you make a repayment, the repayment
may reduce the amount of your qualified
2016 disaster distributions reported on the
earlier return.
If you make any repayments during
2020, include the repayments on your
2020 Form 8915-A if they were not
included on your 2019 Form 8915-A. If
you make a repayment reported on your
2020 Form 8915-A, you must file an
amended 2017 or 2018 Form 8915A, an
amended 2019 Form 8915-A, or a
combination of these forms to reduce the
qualified 2016 disaster distributions
reported on them. (But see the examples
below. Also, see the caution under
Repayment of a Qualified 2016 Disaster
Distribution, earlier, for limitations.)
Example 1. You received a qualified
2016 disaster distribution in the amount of
$90,000 on November 15, 2017. You
choose to spread the $90,000 over 3
years ($30,000 in income for 2017, 2018,
and 2019). On November 10, 2020, you
make a repayment of $40,000, which you
report on line 9 of your 2020 Form 8915-A.
The repayment of $40,000 can be carried
back to 2017, 2018, or 2019.
Example 2. The same facts as in
Example 1, except the repayment was
made on December 20, 2020. The
$40,000 can't be treated as a repayment
because it was made after the 3-year
period for making a repayment had
passed.

Specific Instructions
Married filers. If both you and your
spouse are required to file 2020 Form
8915-A, file a separate Form 8915-A for
each of you.
Name and social security number
(SSN). If you file a joint return, enter only
the name and SSN of the spouse whose

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.

Complete Part I if you made a repayment
in 2020 of qualified 2016 disaster
distribution amounts from line 10 of 2017
Form 8915A. See the examples under
Amending Form 8915-A, earlier, and
under Line 4 below. Also, see the caution
under Repayment of a Qualified 2016
Disaster Distribution, earlier, for
limitations.

Line 4. At any time during the 3-year
period beginning 1 day after the date you
received a qualified 2016 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 2016 Disaster
Distribution, earlier, for details.
Enter on line 4 the amount of any
repayments you made during 2020. Don't
include any repayments you included on
your 2019 Form 8915-A. Do not include
any repayments of nontaxable amounts.
Repayments made after the due date of
your 2019 return (including extensions)
but before 2021 will generally be reported
on your 2020 Form 8915-A. See
Amending Form 8915-A, earlier. For a
discussion of repayments made more than
3 years and 1 day after the qualified 2016
disaster distribution to which the
repayment relates was received, see the
caution under Repayment of a Qualified
2016 Disaster Distribution, earlier.
Example. You received a $90,000
qualified 2016 disaster distribution on May
7, 2017, from your 401(k) plan. You had
an economic loss due to the Kansas
Severe Storms and Flooding. On April 1,
2020, you repay $30,000 to your 401(k)
plan. You file your return on April 10, 2020.
Since the repayment was made within the
3-year period beginning 1 day after the
distribution was received, you would enter
the $30,000 repayment on line 4.
Line 5. If you have an amount on line 5,
you may be able to carry this amount back
to your 2017, 2018, or 2019 return and
reduce the amount of tax. For more
-2-

information, see Amending Form 8915-A,
earlier.

!

CAUTION

year.

On line 5, you can't carry back an
amount from line 3 that you have
already carried back to a prior

Example. You received a qualified
2016 disaster distribution from a
retirement plan other than an IRA in the
amount of $90,000 on January 15, 2017.
You choose to spread the $90,000 over 3
years ($30,000 in income for 2017, 2018,
and 2019). On January 10, 2019, you
make a repayment of $40,000. For 2019,
none of the qualified 2016 disaster
distribution is included in income. On your
2019 Form 8915-A, you enter $40,000 on
line 6 and $30,000 on line 1. You transfer
these amounts to your 2020 Form 8915-A,
entering $40,000 on line 1 and $30,000 on
line 2 of that form. Your excess repayment
from 2019 of $10,000 ($40,000 - $30,000)
is entered on line 3 of your 2020 Form
8915-A. If you have already carried back
the full $10,000 or any part of the $10,000,
you should not include on line 5 the
amount you have already carried back.

Part II—Qualified 2016
Disaster Distributions
From Traditional, SEP,
SIMPLE, and Roth IRAs

Complete Part II if you made a repayment
in 2020 of qualified 2016 disaster
distribution amounts from line 25 of 2017
Form 8915A. See the examples under
Amending Form 8915-A, earlier, and
under Line 9 below. Also, see the caution
under Repayment of a Qualified 2016
Disaster Distribution, earlier, for
limitations.

Line 9. At any time during the 3-year
period beginning 1 day after the date you
received a qualified 2016 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 2016 Disaster
Distribution, earlier, for details.
Enter on line 9 the amount of any
repayments you made during 2020. Don't
include any repayments you included on
your 2019 Form 8915-A. Do not include
any repayments of nontaxable amounts.
Repayments made after the due date of
your 2019 return (including extensions)
but before 2021 will generally be reported
on your 2020 Form 8915-A. See
Amending Form 8915-A, earlier. For a
discussion of repayments made more than
3 years and 1 day after the qualified 2016
disaster distribution to which the
repayment relates was received, see the

Instructions for Form 8915-A (2020)

caution under Repayment of a Qualified
2016 Disaster Distribution, earlier.
Example. You received a $60,000
qualified 2016 disaster distribution on May
1, 2017, from your traditional IRA. You had
an economic loss due to the Tennessee
Wildfires. On April 1, 2020, you repay
$30,000 to your traditional IRA. You file
your return on April 10, 2020. Since the
repayment was made within the 3-year
period beginning 1 day after the
distribution was received, you would enter
the $30,000 repayment on line 9.
If, in 2020, you made a repayment
of a qualified 2017 disaster
CAUTION distribution that you opted to claim
on Part III of 2017 Form 8915A, any
repayments of that distribution in 2020
must be claimed on 2020 Form 8915-A,
Part II. They can't be claimed on 2020
Form 8915-B, Qualified 2017 Disaster
Retirement Plan Distributions and
Repayments.

!

Example. In 2017, you reported
qualified 2016 disaster distributions on
2017 Form 8915A and qualified 2017
disaster distributions on 2017 Form
8915B. You elected to spread the
repayments over 3 years on both forms.
You had to complete 2017 Form 8606;
you chose to enter the amounts from 2017
Form 8606, lines 15b and 25b, on 2017
Form 8915A, lines 22 and 23; and you
entered -0- on 2017 Form 8915B, lines 13
and 14. You make a repayment of those
qualified 2017 disaster distributions in
November 2020, a date that is not later
than 3 years and 1 day after the last
qualified 2017 disaster distribution was
received in 2017. That repayment should
be entered on your 2020 Form 8915-A,
line 9, and not on 2020 Form 8915-B.

Instructions for Form 8915-A (2020)

Line 10. If you have an amount on
line 10, you may be able to carry this
amount back to your 2017, 2018, or 2019
return and reduce the amount of tax. For
more information, see Amending Form
8915-A, earlier.

!

CAUTION

year.

On line 10, you can't carry back an
amount from line 8 that you have
already carried back to a prior

Example. You received a qualified
2016 disaster distribution from an IRA in
the amount of $90,000 on January 15,
2017. You choose to spread the $90,000
over 3 years ($30,000 in income for 2017,
2018, and 2019). On January 10, 2019,
you make a repayment of $40,000. For
2019, none of the qualified 2016 disaster
distribution is included in income. On your
2019 Form 8915-A, you enter $40,000 on
line 13 and $30,000 on line 8. You transfer
these amounts to your 2020 Form 8915-A,
entering $40,000 on line 6 and $30,000 on
line 7 of that form. Your excess repayment
from 2019 of $10,000 ($40,000 - $30,000)
is entered on line 8 of your 2020 Form
8915-A. If you have already carried back
the full $10,000 or any part of the $10,000,
you should not include on line 10 the
amount you have already carried back.
Privacy Act and Paperwork Reduction
Act Notice. We ask for the information on
this form to carry out the Internal Revenue
laws of the United States. We need this
information to ensure that you are
complying with these laws and to allow us
to figure and collect the right amount of
tax. You are required to give us this
information if you made certain
contributions or received certain
distributions from qualified plans, including

-3-

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.

Table 1. Qualified 2016 Disaster Areas for Form 8915-A (and Form 8915A)
By State

Type

Date of Declaration

Incident Period

Alabama

Severe Storms, Tornadoes, Straight-line Winds, and Flooding (DR-4251)

1/21/2016

December 23, 2015 – December 31, 2015

Alaska

Severe Storm (DR-4257)

2/17/2016

December 12, 2015 – December 15, 2015

Arkansas

Severe Storms, Tornadoes, Straight-line Winds, and Flooding (DR-4254)

2/5/2016

December 26, 2015 – January 22, 2016

Arkansas

Severe Storms, Tornadoes, Straight-line Winds, and Flooding (DR-4270)

5/6/2016

March 08, 2016 – March 13, 2016

Delaware

Severe Winter Storm and Flooding (DR-4265)

3/16/2016

January 22, 2016 – January 23, 2016

District of Columbia (DC)

Snowstorm (DR-4260)

3/4/2016

January 22, 2016 – January 23, 2016

Florida

Hurricane Matthew (DR-4283)

10/8/2016

October 03, 2016 – October 19, 2016

Florida

Hurricane Hermine (DR-4280)

9/28/2016

August 31, 2016 – September 11, 2016

Georgia

Severe Storms and Flooding (DR-4259)

2/26/2016

December 22, 2015 – January 13, 2016

Georgia

Hurricane Matthew (DR-4284)

10/8/2016

October 04, 2016 – October 15, 2016

Hawaii

Severe Storms, Flooding, Landslides, and Mudslides (DR-4282)

10/6/2016

September 11, 2016 – September 14, 2016

Idaho

Severe Winter Storms (DR-4252)

2/1/2016

December 16, 2015 – December 27, 2015

Iowa

Severe Storms, Straight-line Winds, and Flooding (DR-4281)

9/29/2016

August 23, 2016 – August 27, 2016

Iowa

Severe Storms and Flooding (DR-4289)

10/31/2016

September 21, 2016 – October 03, 2016

Kansas

Severe Storms and Flooding (DR-4287)

10/20/2016

September 02, 2016 – September 12, 2016

Kentucky

Severe Storms, Tornadoes, Flooding, Landslides, and Mudslides (DR-4278)

8/26/2016

July 02, 2016 – July 09, 2016

Louisiana

Severe Storms and Flooding (DR-4263)

3/13/2016

March 08, 2016 – April 08, 2016

Louisiana

Severe Storms and Flooding (DR-4277)

8/14/2016

August 11, 2016 – October 02, 2016

Maryland

Severe Winter Storm and Snowstorm (DR-4261)

3/4/2016

January 22, 2016 – January 23, 2016

Maryland

Severe Storm and Flooding (DR-4279)

9/16/2016

July 30, 2016 – July 31, 2016

Mississippi

Severe Storms and Flooding (DR-4268)

3/25/2016

March 09, 2016 – March 29, 2016

Mississippi

Severe Storms, Tornadoes, Straight-line Winds, and Flooding (DR-4248)

1/4/2016

December 23, 2015 – December 28, 2015

Missouri

Severe Storms, Tornadoes, Straight-line Winds, and Flooding (DR-4250)

1/21/2016

December 23, 2015 – January 09, 2016

Montana

Severe Winter Storm and Straight-line Winds (DR- 4271)

5/24/2016

April 15, 2016 – April 16, 2016

Montana

Tornado (DR-4275)

8/3/2016

June 11, 2016

New Jersey

Severe Winter Storm and Snowstorm (DR-4264)

3/14/2016

January 22, 2016 – January 24, 2016

North Carolina

Hurricane Matthew (DR-4285)

10/9/2016

October 04, 2016 – October 25, 2016

Oklahoma

Severe Storms and Flooding (DR-4274)

7/15/2016

June 11, 2016 – June 13, 2016

Oklahoma

Severe Winter Storms and Flooding (DR-4256)

2/10/2016

December 26, 2015 – January 05, 2016

Oregon

Severe Winter Storms, Straight-line Winds, Flooding, Landslides, and Mudslides (DR-4258)

2/17/2016

December 06, 2015 – December 23, 2015

Pennsylvania

Severe Winter Storm and Snowstorm (DR-4267)

3/23/2016

January 22, 2016 – January 23, 2016

Pennsylvania

Severe Storms and Flooding (DR-4292)

12/2/2016

October 20, 2016 – October 21, 2016

South Carolina

Hurricane Matthew (DR-4286)

10/11/2016

October 04, 2016 – October 30, 2016

Tennessee

Wildfires (DR-4293)

12/15/2016

November 28, 2016 – December 09, 2016

Texas

Severe Storms and Flooding (DR-4269)

4/25/2016

April 17, 2016 – April 30, 2016

Texas

Severe Storms and Flooding (DR-4272)

6/11/2016

May 22, 2016 – June 24, 2016

Texas

Severe Storms, Tornadoes, and Flooding (DR-4266)

3/19/2016

March 07, 2016 – March 29, 2016

Texas

Severe Winter Storms, Tornadoes, Straight-line Winds, and Flooding (DR-4255)

2/9/2016

December 26, 2015 – January 22, 2016

Virginia

Severe Winter Storm and Snowstorm (DR-4262)

3/7/2016

January 22, 2016 – January 23, 2016

Virginia

Hurricane Matthew (DR-4291)

11/2/2016

October 07, 2016 – October 15, 2016

Washington

Severe Storms, Straight-line Winds, Flooding, Landslides, and Mudslides (DR-4249)

1/15/2016

November 12, 2015 – November 21, 2015

Washington

Severe Winter Storm, Straight-line Winds, Flooding, Landslides, Mudslides, and a Tornado
(DR-4253)

2/2/2016

December 01, 2015 – December 14, 2015

West Virginia

Severe Storms, Flooding, Landslides, and Mudslides (DR-4273)

6/25/2016

June 22, 2016 – June 29, 2016

Wisconsin

Severe Storms and Flooding (DR-4276)

8/9/2016

July 11, 2016 – July 12, 2016

Wisconsin

Severe Storms, Flooding, and Mudslides (DR-4288)

10/20/2016

September 21, 2016 – September 22, 2016

-4-

Instructions for Form 8915-A (2020)