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
2021_SS_1545-0177.docx Supporting Statement A	2021-11-27

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: 202109-1545-001
Status: Received in OIRA	Previous ICR Reference No: 201808-1545-016
Agency/Subagency: TREAS/IRS	Agency Tracking No:
Title: Casualties and Thefts
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 12/31/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved	12/31/2021
Responses	213,867	213,867
Time Burden (Hours)	1,293,895	1,293,895
Cost Burden (Dollars)	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): PL: Pub.L. 115 - 97 11045(a) Name of Law: Tax Cuts and Jobs Act of 2017
   US Code: 26 USC 1231 Name of Law: Property used in the trade or business and involuntary conversions
   US Code: 26 USC 165 Name of Law: Losses
   PL: Pub.L. 115 - 97 11044(a) Name of Law: Tax Cuts and Jobs Act of 2017
  

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:
	86 FR 51450	09/15/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 73851	12/28/2021
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 Request	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	213,867	213,867	0	0	0	0
Annual Time Burden (Hours)	1,293,895	1,293,895	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $80,920

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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? No

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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: 12/31/2021

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