Form 4684 - Casualties and Thefts

Forms and Documents

Document Name	Status
Form 4684 Form 4684 - Casualties and Thefts Form	Modified
Rev Proc 2011-58.pdf Supplementary Document	2014-11-26
Rev Proc 2009-20.pdf Supplementary Document	2014-11-26
Supporting Statement 2014.doc Supporting Statement A	2014-12-16

IC Document Collections

IC ID	Document Title	Status
39670	Form 4684 - Casualties and Thefts Form	Modified

ICR Details

OMB Control No: 1545-0177	ICR Reference No: 201305-1545-012
Status: Historical Active	Previous ICR Reference No: 201108-1545-040
Agency/Subagency: TREAS/IRS	Agency Tracking No:
Title: Form 4684 - Casualties and Thefts
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/20/2015
	Date Received in OIRA: 12/29/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2018	36 Months From Approved	11/30/2015
Responses	320,000	0	268,350
Time Burden (Hours)	1,830,400	0	1,486,659
Cost Burden (Dollars)	0	0	0

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Abstract: Form 4684 is used by taxpayers to compute their gain or loss from casualties or thefts, and to summarize such gains and losses. The data is used to verify that the correct gain or loss has been computed.

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Authorizing Statute(s): US Code: 26 USC 1231 Name of Law: Property used in the trade or business and involuntary conversions
   US Code: 26 USC 6103 Name of Law: Confidentiality and disclosure of returns and return information
   US Code: 26 USC 165 Name of Law: Losses
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 29504	05/22/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 77084	12/23/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Form 4684 - Casualties and Thefts	4684	Casualties and Thefts

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	320,000	268,350	0	0	51,650	0
Annual Time Burden (Hours)	1,830,400	1,486,659	0	57,600	286,141	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The agency added a new section (C), requiring taxpayers to include specific information supporting key eligibility requirements, such as identifying the criminal act and individual or entity that committed the criminal act, which could be used to verify that requirements were met. This new section incorporates Appendix A from Revenue Procedure 2009-20. It will require taxpayers, claiming a theft loss deduction due to a Ponzi-type investment scheme and using the procedures in Rev. Proc. 2009-20, to include specific information supporting key eligibility requirements. The Department has updated the hour and cost burden associated with the ICR to reflect its most recent data on Form 4684 filings. We estimate 51,650 additional filings which will increase our estimates from 268,350 to 320,000. The addition to Schedule C and changes in instructions will increase the estimated burden hours from 1,772,800 to 1,830,400.

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Annual Cost to Federal Government: $12,739

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/29/2014

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