8915-B

Qualified 2017 Disaster Retirement Plan Distributions and Repayments

Agency
IRS
Revision
2021
Fillable fields
30
Pages
1
Official source
IRS form page
Checked
October 21, 2026
Fill 8915-B online
Page 1 of form 8915-B

Form 8915-B: Qualified 2017 Disaster Retirement Plan Distributions and Repayments

Form 8915-B covers qualified 2017 disaster distributions from retirement plans and IRAs. The 2021 form is short: it reports repayments of those distributions made in 2021 that were not included on the 2020 Form 8915-B, plus any excess repayment carried over from 2020. The instructions say qualified 2017 disaster distributions can't be made in 2021, and that the 2021 revision is the last revision of Form 8915-B and its instructions.

The instructions list the covered 2017 disasters as Hurricane Harvey (including Tropical Storm Harvey), Hurricane Irma, Hurricane Maria and the California wildfires. Part I is for retirement plans other than IRAs, and Part II is for traditional, SEP, SIMPLE and Roth IRAs. The amounts on lines 5 and 10 can be carried back to reduce income reported on a 2018, 2019 or 2020 return.

The form points to Form 8915-F for coronavirus-related distributions. You can fill out the PDF free in your browser on this page and download it without an account.

What's on 2021 Form 8915-B

Name and address

Name and SSN for every filer. The home address lines are completed only when filing the form by itself, not with a tax return, with a box for an amended return.

Part I, lines 1a to 3

Amounts from the 2020 Form 8915-B, lines 6 and 1, the excess repayment from 2020, and the part of it already carried back to a prior year.

Part I, lines 4 and 5

Repayments made in 2021 to plans other than IRAs, and the total that can be carried back to reduce the amount subject to tax in a prior year.

Part II, lines 6a to 8

The same carryover steps for IRAs, using lines 13 and 8 of the 2020 Form 8915-B.

Part II, lines 9 and 10

Repayments made in 2021 to traditional, SEP, SIMPLE and Roth IRAs, and the total that can be carried back.

Signature and paid preparer

A signature section used only when filing the form by itself, and a Paid Preparer Use Only section with PTIN and firm details.

How to fill out 2021 Form 8915-B

  1. 1

    Name and SSN

    Enter the name and SSN of the person whose repayment is reported. Fill in the address only when filing the form without a tax return. For a foreign address, the instructions say not to abbreviate the country name.

  2. 2

    Lines 1a to 3 and 6a to 8

    Copy the listed amounts from the 2020 Form 8915-B, subtract as the lines say, and enter on line 2b or 7b any excess already carried back to a prior year.

  3. 3

    Lines 4 and 9

    Enter repayments made during 2021 that were not on the 2020 form. The instructions say not to include repayments of nontaxable amounts or repayments made after the 3-year cutoff date.

  4. 4

    Lines 5 and 10

    Add the lines as shown. The instructions say an amount here may be carried back to a 2018, 2019 or 2020 return, and if both lines 5 and 10 are zero, not to file the 2021 form.

  5. 5

    Sign if filing alone

    Sign and date only when filing the form by itself and not with a tax return. A paid preparer completes the preparer section.

Why fill Form 8915-B on indox

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Where it goes and timing

With the tax return

The form says to attach it to a 2021 Form 1040, 1040-SR or 1040-NR.

Filed by itself

Without a return, sign it and send it at the same time and place a 2021 Form 1040, 1040-SR or 1040-NR would otherwise be filed.

Repayment window

The instructions say the repayment period ends 3 years and 1 day after the distribution was received, and a repayment cannot be more than the original distribution.

Carrying back

To use a line 5 or line 10 amount on a 2018, 2019 or 2020 return already filed, the instructions point to Form 1040-X, generally filed within 3 years after the original return or 2 years after the tax was paid, whichever is later.

Distributions that cannot be repaid

The instructions list distributions received as a beneficiary (other than a surviving spouse), required minimum distributions, and certain series of substantially equal periodic payments.

Related forms

Who files 2021 Form 8915-B?

  • People who repaid in 2021

    The instructions say to file 2021 Form 8915-B if a repayment of a qualified 2017 disaster distribution was made in 2021 and was not included on the 2020 Form 8915-B.

  • Married filers

    If both spouses are required to file it, each files a separate Form 8915-B. On a joint return, enter only the name and SSN of the spouse whose information is reported.

  • People who do not file a return

    The instructions say someone not required to file an income tax return but required to file 2021 Form 8915-B signs it and sends it at the time and place a 2021 Form 1040, 1040-SR or 1040-NR would be filed.

  • Not for other disaster years

    The instructions point to Form 8915-C for 2018 disasters, Form 8915-D for 2019 disasters and Form 8915-F for 2020 disasters and coronavirus-related distributions.

The About page says the form is for someone adversely affected by a 2017 disaster who received a distribution that qualifies for favorable tax treatment. The instructions say to file the 2021 form for a 2021 repayment that was not included on the 2020 Form 8915-B.

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Questions about Form 8915-B

Can a 2017 disaster distribution be reported as received in 2021?

No. The instructions say qualified 2017 disaster distributions can't be made in 2021. The 2021 form only reports repayments and carryovers.

Which disasters does Form 8915-B cover?

The instructions list Hurricane Harvey (including Tropical Storm Harvey), Hurricane Irma, Hurricane Maria and the California wildfires.

Is there a newer Form 8915-B?

The instructions say the 2021 revision is the last revision of Form 8915-B and its instructions.

Where are coronavirus-related repayments reported?

The instructions say not to use 2021 Form 8915-B for them and to use Form 8915-F, Qualified Disaster Retirement Plan Distributions and Repayments, instead.

Does each spouse file a separate form?

Yes, if both spouses are required to file 2021 Form 8915-B, the instructions say to file a separate form for each.

What if lines 5 and 10 are both zero?

The instructions say not to file a 2021 Form 8915-B in that case.