Form 4684 Casualties and Theft

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Form

4684

Department of theTreasury
Internal Revenue Service

Version A, Cycle 5
OMB No. 1545-0177

Casualties and Thefts

2008



See separate instructions.
to your tax return.
 Use a separate Form 4684 for each casualty or theft.
 Attach

Attachment
Sequence No. 26
Identifying number

Name(s) shown on tax return

SECTION A—Personal Use Property (Use this section to report casualties and thefts of property not used in a trade
or business or for income-producing purposes.)
1 Description of properties (show type, location, and date acquired for each property). Use a separate line for each property lost or damaged from
the same casualty or theft.
Property A
Property B
Property C

DRAFT AS OF
November 25, 2008

Property D

Properties

A

2 Cost or other basis of each property .

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3 Insurance or other reimbursement (whether or not you
filed a claim) (see instructions) . . . . . . . .
Note: If line 2 is more than line 3, skip line 4.
4 Gain from casualty or theft. If line 3 is more than line 2,

B

C

D

2
3

enter the difference here and skip lines 5 through 9 for that
column. See instructions if line 3 includes insurance or other
reimbursement you did not claim, or you received payment
for your loss in a later tax year . . . . . . . .

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5 Fair market value before casualty or theft . . . .
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6 Fair market value after casualty or theft . . . . .
7 Subtract line 6 from line 5 . . . . . . . . .
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8 Enter the smaller of line 2 or line 7 . . . . . .
9
9 Subtract line 3 from line 8. If zero or less, enter -0- . .
10 Casualty or theft loss. Add the amounts on line 9 in columns A through D .

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11 Enter the smaller of line 10 or $100. But if the loss arose in a Midwestern disaster area because of a specified
major disaster, enter -0-. See the instructions for a list of specified major disasters . . . . . . . . .
12 Subtract line 11 from line 10 . . . . . . . . . . . . . . . . . . . . . . . . .
Caution: Use only one Form 4684 for lines 13 through 24.
13 Add the amounts on line 12 of all Forms 4684 . . . . . . . . . . . . . . . . . . . .
14 Add the amounts on line 4 of all Forms 4684. . . . . . . . . . . . . .
15 ● If line 14 is more than line 13, enter the difference here and on Schedule D. Do not
complete the rest of this section (see instructions).
● If line 14 is less than line 13, enter -0- here and go to line 16.
● If line 14 is equal to line 13, enter -0- here. Do not complete the rest of this section.

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16 If line 14 is less than line 13, enter the difference . . . . . . . . . . . . . . . . . . . .
17 Add the amounts on line 12 of all Forms 4684 on which you entered a loss attributable to a federally declared disaster .
18a Is line 17 more than line 14?
18a
Yes. Enter the difference. If you
y are filing
g Schedule A (Form
(
1040),
) go
g to line 19. Otherwise, enter this amount
on line 6 of the Standard Deduction Worksheet–Line 40 in the Form 1040 instructions. Also, check the box on
line 39c of Form 1040. If your
y
standard deduction also includes the deduction for state or local real estate
taxes, go to line 18b. Otherwise, do not complete the rest of Section A. Form 1040NR filers, see instructions.
No. Enter -0-. If you claim the standard deduction, do not complete the rest of Section A. . . . . . .

15

16
17

18a

b If your standard deduction includes the deduction for state or local real estate taxes, check this box and do not
complete the rest of Section A . . . . . . . . . . . . . . . . . . . . . . . . 
19 Subtract line 18a from line 16 . . . . . . . . . . . . . . . .
20 Add the amounts on line 12 of all Forms 4684 on which you entered -0- on line 11
21 Is line 20 less than line 19?

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No. Enter the amount from line 16 on Schedule A (Form 1040), line 20, or Form 1040NR, Schedule A, line 8. Estates and
trusts enter the amount from line 16 on the "Other deductions" line of your tax return. Do not complete the rest of Section A.
Yes. Subtract line 20 from line 19 . . . . . . . . . . . . . . . . . . . . . . .
22 Enter 10% of your adjusted gross income from Form 1040, line 38, or Form 1040NR, line 36. Estates and trusts, see instructions
23 Subtract line 22 from line 21. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . .
24 Add lines 18a, 20, and 23. Also enter the result on Schedule A (Form 1040), line 20, or Form 1040NR, Schedule A,
line 8. Estates and trusts, enter the result on the "Other deductions" line of your tax return . . . . . . . .
For Paperwork Reduction Act Notice, see page 5 of the instructions.
Cat. No. 12997O

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Form 4684 (2008)

Version A, Cycle 5
Page 2

Attachment Sequence No. 26

Form 4684 (2008)

Name(s) shown on tax return. Do not enter name and identifying number if shown on other side.

Identifying number

SECTION B—Business and Income-Producing Property
Casualty or Theft Gain or Loss (Use a separate Part l for each casualty or theft.)
Part I
25 Description of properties (show type, location, and date acquired for each property). Use a separate line for each property lost or damaged
from the same casualty or theft.
Property A
Property B
Property C
Property D

Properties

DRAFT AS OF
Nov
No
ovemb
vemb
emb 25, 2008
November
B

A

.

26

27 Insurance or other reimbursement (whether or not you
e the
th
t instructions
instru
truc
uctions for line 3 . . . .
filed a claim). See
Note: If line 26 is more
m
than
an line 27,
27 skip line 28.
28

27

26 Cost or adjusted basis of each property .

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C

D

28 Gain from
rom casualty
c
or theft. If line 27 is more than line 26, enter

feren here and on line 35 or line 40, column (c), except as
the difference
provided
ed in the instructions for line 39. Also, skip lines 29 through
33 for that
at column. See
Seee the instructions
insttru
ructions for line 4 if line 27 includes
includ
insurance or other reimbursement you did not claim, or you
received payment for your loss in a later tax year. . . . .

29 Fair market value before casualty or theft .

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30 Fair market value after casualty or theft .
31 Subtract line 30 from line 29 . . . .
32 Enter the smaller of line 26 or line 31 .

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29
30
31
32

Note: If the property was totally destroyed by casualty or lost
from theft, enter on line 32 the amount from line 26.
33 Subtract line 27 from line 32. If zero or less, enter -033
34 Casualty or theft loss. Add the amounts on line 33. Enter the total here and on line 35 or line 40 (see instructions) .

Part II

Summary of Gains and Losses (from separate Parts l)

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(b) Losses from casualties or thefts

(a) Identify casualty or theft

(c) Gains from
casualties or thefts
includible in income

(ii) Incomeproducing and
employee property

(i) Trade, business,
rental or royalty
property

Casualty or Theft of Property Held One Year or Less
35
36 Totals. Add the amounts on line 35

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(
(
36 (

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37 Combine line 36, columns (b)(i) and (c). Enter the net gain or (loss) here and on Form 4797, line 14. If Form 4797 is
not otherwise required, see instructions . . . . . . . . . . . . . . . . . . . . . . .

37

38 Enter the amount from linee 36, column (b)(ii) here. Individuals, enter the amount from income-producing property on Schedule A (Form
1040), line 28, or Form 1040NR, Schedule A, line 16, and enter the amount from property used as an employee on Schedule A (Form
1040), line 23, or Form 1040NR, Schedule A, line 11. Estates and trusts, partnerships, and S corporations, see instructions . . . .

38

Casualty or Theft of Property Held More Than One Year
39 Casualty or theft gains from Form 4797, line 32 . . . . . . . . . . . . . . . . . . . . . . . . .
(
)(
40

(
41 (

39

)
)
)

)(
)(

41 Total losses. Add amounts on line 40, columns (b)(i) and (b)(ii) . . . . .
42 Total gains. Add lines 39 and 40, column (c) . . . . . . . . . . . . . . . . . . . . . .
43 Add amounts on line 41, columns (b)(i) and (b)(ii) . . . . . . . . . . . . . . . . . . . .
44 If the loss on line 43 is more than the gain on line 42:
a Combine line 41, column (b)(i) and line 42, and enter the net gain or (loss) here. Partnerships (except electing large
partnerships) and S corporations, see the note below. All others, enter this amount on Form 4797, line 14. If Form
4797 is not otherwise required, see instructions . . . . . . . . . . . . . . . . . . . . .
b Enter the amount from line 41, column (b)(ii) here. Individuals, enter the amount from income-producing property on
Schedule A (Form 1040), line 28, or Form 1040NR, Schedule A, line 16, and enter the amount from property used as
an employee on Schedule A (Form 1040), line 23, or Form 1040NR, Schedule A, line 11. Estates and trusts, enter on
the “Other deductions” line of your tax return. Partnerships (except electing large partnerships) and
S corporations, see the note below. Electing large partnerships, enter on Form 1065-B, Part II, line 11 . . . . .

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43

44a

44b

45 If the loss on line 43 is less than or equal to the gain on line 42, combine lines 42 and 43 and enter here. Partnerships

(except electing large partnerships), see the note below. All others, enter this amount on Form 4797, line 3

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Note: Partnerships, enter the amount from line
e 44a, 44b, or line 45 on Form 1065, Schedule K, line 11.
S corporations, enter the amount from line 44a orr 44b on Form 1120S, Schedule K, line 10.
Form 4684 (2008)