Information Collection

Form 4684 - Casualties and Thefts

IC 39670 under ICR 201808-1545-016 · 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⚠️ Notice: This information collection may be referencing outdated material.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 4684 Form 4684 - Casualties and Thefts	Form
Instructions for Form 4684 (TY 2017).pdf	Instruction
i4684_draft_2018.pdf	Instruction
4684 Casualties and Thefts Form 4684 (TY 2017).pdf	Form
4684 Casualties and Thefts Form 4684 (Draft TY 2018).pdf	Form
Pub 547- 2013-.pdf Pub 547	IC Document
2018-4684-Burden-2018-07-20 12-25-12.pdf 2018 Burden	IC Document

IC Title:

Form 4684 - 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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	4684	Casualties and Thefts	Form 4684 (TY 2017).pdf	Yes	Yes	Fillable Fileable
Form	4684	Casualties and Thefts	Form 4684 (Draft TY 2018).pdf	Yes	No	Fillable Printable
Instruction			Instructions for Form 4684 (TY 2017).pdf	Yes	No	Printable Only
Instruction			i4684_draft_2018.pdf	No		Printable Only

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 213,867

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Approved	Program Change Due to New Statute	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	213,867	0	-106,133	320,000
Annual IC Time Burden (Hours)	1,293,895	70,576	-607,081	1,830,400
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Pub 547	Pub 547- 2013-.pdf	11/26/2014
2018 Burden	2018-4684-Burden-2018-07-20 12-25-12.pdf	08/21/2018

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