2006 Form 8915 Qualified Hurricane Retirement Plan Distributions and Repayments modified to report recovery assistance distributions and repayments (page 2). Summary: This is a sample of page 2 of the 2006 Form 8915, it has been modified to report qualified recovery assistance distributions and repayments and it illustrates Example 2. The modifications to the form are described in the text of the publication. Additionally, these line items are completed:

“20. Did you enter an amount on line 3, column (b), or line 4, column (b) ? Yes. (checkbox) Go to line 21. No (checkbox) Skip line 21 through 26, and go to line 27.” field contains a check in No checkbox

“27. Enter the amount, if any, from your 2007 Form 8915, line 17. If you checked the box on that line, enter -0-” field contains 4,375

“28. Add line 26 and 27” field contains 4,375

“29. Enter the amount, if any, from your 2007 Form 8915, line 18”

“30. Enter the amount, if any, from your 2007 Form 8915, line 17”

“31. Subtract line 30 from line 29. If zero or less, enter -0-” field contains -0-

“32. Enter the total amount of any repayments you made before filing your 2008 tax return. But do not include repayments made later than the due date (including extensions) for that return. See instructions” field contains -0-

“33. Add lines 31 and 32” field contains -0-

“34. Amount subject to tax in 2008. Subtract line 33 from line 28. 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” field contains 4,375