Instructions For Form 8915 - Qualified Hurricane Retirement Plan Distributions And Repayments - 2009

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Department of the Treasury
Internal Revenue Service
Instructions for Form 8915
Qualified Hurricane Retirement Plan Distributions and Repayments
A qualified pension, profit-sharing, or
Section references are to the Internal
Qualified Hurricane
stock bonus plan (including a 401(k)
Revenue Code unless otherwise noted.
Distribution
plan).
General Instructions
A qualified annuity plan.
A qualified hurricane distribution is any
A tax-sheltered annuity contract.
distribution you received in 2005 or 2006
A governmental section 457 deferred
Purpose of Form
from an eligible retirement plan if both of
compensation plan.
the following conditions were met.
Use Form 8915 to report repayments of
A traditional, SEP, SIMPLE, or Roth
qualified hurricane distributions made in
1. Your main home was located in a
IRA.
2009 that were not included on your 2008
hurricane disaster area listed below on
Distribution of plan loan offsets. A
Form 8915.
the date shown for that area.
distribution of a plan loan offset is a
a. August 28, 2005, for the Hurricane
Parts I and II
distribution that occurs when, under the
Katrina disaster area. For this purpose,
terms of a plan, the participant’s accrued
Use Part I to report any repayments of
that area includes the states of Alabama,
benefit is reduced (offset) in order to
qualified hurricane distributions from
Florida, Louisiana, and Mississippi.
repay a loan. A distribution of a plan loan
retirement plans (other than IRAs).
b. September 23, 2005, for the
offset amount can occur for a variety of
Use Part II to report any repayments of
Hurricane Rita disaster area. For this
reasons, such as when a participant
qualified hurricane distributions from
purpose, that area includes the states of
terminates employment or does not
IRAs.
Louisiana and Texas.
comply with the terms of repayment. Plan
c. October 23, 2005, for the Hurricane
loan offsets are treated as actual
Additional Information
distributions and are reported on Form
Wilma disaster area. For this purpose,
See Pub. 4492, Information for Taxpayers
that area includes the state of Florida.
1099-R, box 1.
Affected by Hurricanes Katrina, Rita, and
2. You sustained an economic loss
Main home. Generally, your main home
Wilma, for more details.
because of Hurricane Katrina, Rita, or
is the home where you live most of the
Wilma, on the date in (1) above for that
time. A temporary absence due to special
Who Must File
hurricane. Examples of an economic loss
circumstances, such as illness, education,
include, but are not limited to (a) loss,
business, military service, evacuation, or
File Form 8915 if you made a repayment
damage to, or destruction of real or
of a qualified hurricane distribution in
vacation, will not change your main home.
personal property from fire, flooding,
2009 that was not included on your 2008
Additional tax. Qualified hurricane
looting, vandalism, theft, wind, or other
Form 8915.
distributions were not subject to the 10%
cause; (b) loss related to displacement
additional tax (or the 25% additional tax
If you were affected by the Kansas
from your home; or (c) loss of livelihood
for certain distributions from SIMPLE
TIP
storms and tornadoes that began
due to temporary or permanent layoffs.
IRAs) on early distributions and are not
on May 4, 2007, see Pub. 4492-A
required to be reported on Form 5329.
to determine what version of Form 8915
If (1) and (2) applied, you could have
However, any distributions you received
you must file.
generally designated any distribution in
in excess of the $100,000 qualified
2005 or 2006 (including periodic
hurricane distribution limit may have been
When and Where to File
payments and required minimum
subject to the additional tax.
distributions) from an eligible retirement
File Form 8915 with your 2009 Form
Note. If you chose to treat a distribution
plan as a qualified hurricane distribution,
1040, 1040A, or 1040NR. If you are not
as a qualified hurricane distribution, it is
regardless of whether the distribution was
required to file an income tax return but
not eligible for the 20% Capital Gain
made on account of Hurricane Katrina,
are required to file Form 8915, sign Form
Election or the 10-Year Tax Option. For
Rita, or Wilma. Qualified hurricane
8915 and send it to the Internal Revenue
information on those options, see the
distributions were permitted without
Service at the same time and place you
instructions for Form 4972.
regard to your need or the actual amount
would otherwise file Form 1040, 1040A,
of your economic loss.
or 1040NR.
Repayment of a Qualified
A reduction or offset in 2005 or 2006 of
How is a Qualified
Hurricane Distribution
your account balance in an eligible
Hurricane Distribution
If you choose, you can generally repay
retirement plan in order to repay a loan
any portion of a qualified hurricane
also could have been designated as a
Taxed?
distribution that is eligible for tax-free
qualified hurricane distribution. See
Generally, a qualified hurricane
rollover treatment to an eligible retirement
Distribution of plan loan offsets later.
plan. Also, you can repay a qualified
distribution is included in your income in
Limit. The total of your qualified
equal amounts over 3 years. However,
hurricane distribution made on account of
hurricane distributions for 2005 and 2006
hardship from a retirement plan.
you could have elected to include the
from all plans was limited to $100,000. If
entire distribution in your income in the
However, see Exceptions on page 2 for
you had distributions in excess of
qualified hurricane distributions you
year of the distribution.
$100,000 from more than one type of
cannot repay.
Also, qualified hurricane distributions
plan, such as a 401(k) plan and an IRA,
You have 3 years from the day after
are not subject to the 10% additional tax
you could have allocated the $100,000
the date you received the distribution to
on early distributions.
limit among the plans any way you chose.
make a repayment. The amount of your
You cannot repay a qualified
Eligible retirement plan. An eligible
repayment cannot be more than the
!
hurricane distribution after 2009.
retirement plan can be any of the
amount of the original distribution.
CAUTION
following.
Amounts that are repaid are treated as a
Cat. No. 48411X

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