Information Collection

Casualties and Thefts

IC 39670 under ICR 200908-1545-058 · OMB 1545-0177.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-0177 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form 4684 Casualties and Thefts	Form
I4684.pdf	Instruction
Form 4684 Casualties and Thefts df4684_2009.pdf	Form
F4684_brdn_indiv.PDF Burden for Form 4684	IC Document

IC Title:

Casualties and Thefts

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Form 4684	Casualties and Thefts	df4684_2009.pdf		Yes	Yes	Fillable Fileable
Instruction			I4684.pdf		No		Printable Only

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 268,350

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 35 %

table that charts list of burden
	Approved	Program Change Due to New Statute	Previously Approved
Annual Number of Responses for this IC	268,350	155,017	113,333
Annual IC Time Burden (Hours)	1,486,659	832,727	653,932
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Burden for Form 4684	F4684_brdn_indiv.PDF	01/05/2009

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.