8915 Qualified Hurricane Retirement Plan Distributions and Re

2007 Form 8915,
Qualified Hurricane Retirement Plan Distributions and Repayments
Purpose: This is the first circulated draft of the 2007 Form 8915 for your review
and comments. See below for a discussion of the major changes.
TPCC Meeting: None, but one may be arranged if requested.
Instructions: The 2007 Instructions for Form 8915 will be circulated at a later
date. The 2006 instructions are available at:
http://www.irs.gov/pub/irs-pdf/i8915.pdf
Prior Version: The 2006 Form 8915 is available at:
http://www.irs.gov/pub/irs-pdf/f8915.pdf
Other Products: Circulations of draft tax forms, instructions, notices, and
publications are posted at:
http://taxforms.web.irs.gov/draft_products.html
Comments: Please email, fax, call, or mail any comments by August 17, 2007.
Gregg M. Lynam
Tax Forms and Publications
SE:W:CAR:MP:T:I:S

Email: Gregg.M.Lynam@irs.gov
Phone: 202- 622- 4056
Fax: 202- 622- 5022
Major Changes to the 2007 Form 8915
•
•

•

•

Part I was deleted. Qualified hurricane distributions cannot be made after
12/31/2006. (IRC 1400Q) (I-Plan 65.00051)
Subsequent parts and lines were renumbered.
In Part II (new Part I):
o Lines 8 through 11, used to report current year distributions, were
deleted.
o New line 2 was added to be used to bring forward the amount from
line 11 of the 2006 Form 8915.
In Part III (new Part II):
o Lines 20 through 26, used to report current year distributions, were
deleted.
o New line 11 was added to be used to bring forward the amount
from line 26 of the 2006 Form 8915.
Year and line references were updated as appropriate throughout the
form.

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FORM 8915, PAGE 1 OF 2 (PAGE 2 IS BLANK)
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8915

Action

Date

O.K. to print
Revised proofs
requested

OMB No. 1545-0074

Qualified Hurricane Retirement
Plan Distributions and Repayments

Department of the Treasury
Internal Revenue Service

©

2007

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Attachment
Sequence No.

Attach to Form 1040, Form 1040A, or Form 1040NR.

Name. If married, file a separate form for each spouse required to file Form 8915. See instructions.

Fill in Your Address Only
If You are Filing This
Form by Itself and Not
With Your Tax Return

©

Signature

156

Your social security number

Home address (number and street, or P.O. box if mail is not delivered to your home)

Apt. no.

City, town or post office, state, and ZIP code

Part I Qualified Hurricane Distributions From Retirement Plans (other than IRAs)
1
2
3
4
5
6
7

8
9

Enter the amount, if any, from your 2005 Form 8915, line 9, only if you did not check the box
on that line

1

Enter the amount, if any, from your 2006 Form 8915, line 11, only if you did not check the box
on that line
Add lines 1 and 2

2
3

4
Enter the amount, if any, from your 2006 Form 8915, line 18
5
Enter the amount, if any, from your 2006 Form 8915, line 13
Subtract line 5 from line 4. If zero or less, enter -0Enter the total amount of any repayments you made before filing your 2007 tax return. But do
not include repayments made later than the due date (including extensions) for that return. See
instructions
Add lines 6 and 7
Amount subject to tax in 2007. Subtract line 8 from line 3. If zero or less, enter -0-. Include
this amount in the total on Form 1040, line 16b; Form 1040A, line 12b; or Form 1040NR,
line 17b

6

7
8

9

Part II Qualified Hurricane Distributions From Traditional, SEP, SIMPLE, and Roth IRAs
10

12

Enter the amount, if any, from your 2005 Form 8915, line 17, only if you did not check the box
on that line
Enter the amount, if any, from your 2006 Form 8915, line 26, only if you did not check the box
on that line
Add lines 10 and 11

13

Enter the amount, if any, from your 2006 Form 8915, line 33

14
15
16

14
Enter the amount, if any, from your 2006 Form 8915, line 28
Subtract line 14 from line 13. If zero or less, enter -0Enter the total amount of any repayments you made before filing your 2007 tax return. But do
not include repayments made later than the due date (including extensions) for that return.
See instructions

17
18

Add lines 15 and 16
Amount subject to tax in 2007. Subtract line 17 from line 12. If zero or less, enter -0-. Include
this amount in the total on Form 1040, line 15b; Form 1040A, line 11b; or Form 1040NR,
line 16b

11

10
11
12

13

15

16
17

18

Signature. Complete only if you are filing this form by itself and not with your tax return.

Please
Sign
Here

Under penalties of perjury, I declare that I have examined this form, including accompanying attachments, and to the best of my knowledge and
belief, it is true, correct, and complete.

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Date

©

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EIN

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©

Phone no.
Cat. No. 37726T

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Form

8915

(2007)