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Publication 584-B (12-2011) BUSINESS CASUALTY, DISASTER, AND THEFT LOSS WORKBOOK


Publication 584-B (12-2011)

DATED
DOCUMENT ATTRIBUTES
  • Institutional Authors
    Internal Revenue Service
  • Jurisdictions
  • Language
    English
Citations: Publication 584-B (12-2011)

What's New

 

Introduction

 

How To Use This Workbook

 

Comments and Suggestions

 

How To Get Tax Help

 

Schedule 1. Office Furniture and Fixtures

 

Schedule 2. Information Systems

 

Schedule 3. Motor Vehicles

 

Schedule 4. Office Supplies

 

Schedule 5. Building, Building Components, and Land

 

Schedule 6. Equipment

What's New

The IRS has created a page on IRS.gov for information about Publication 584-B, at http://www.irs.gov/pub584b. Information about any future developments affecting Publication 584-B (such as legislation enacted after we released it) will be posted on that page.

Introduction

This workbook is designed to help you figure your loss on business and income-producing property in the event of a disaster, casualty, or theft. It contains schedules to help you figure the loss to your office furniture and fixtures, information systems, motor vehicles, office supplies, buildings, and equipment. These schedules, however, are for your information only. You must complete Form 4684, Casualties and Thefts, to report your loss.

How To Use This Workbook

You can use this workbook by following these five steps.

 

1. Read

Publication 547

to learn about the tax rules for casualties, disasters, and thefts.

2. Know the definitions of adjusted basis and fair market value, discussed below.

3. Fill out Schedules 1 through 6.

4. Read the Instructions for Form 4684.

5. Fill out Form 4684 using the information you entered in Schedules 1 through 6.

 

Use the chart below to find out how to use Schedules 1 through 6 to fill out Form 4684.

 Take what's in each row    And enter it on

 

 

of...

                         

Form 4684...

 

 Column 1                            Line 19

 

 Column 2                            Line 20

 

 Column 3                            Line 21

 

 Column 4                            Line 22

 

 Column 5                            Line 23

 

 Column 6                            Line 24

 

 Column 7                            Line 25

 

 Column 8                            Line 26

 

 Column 9                            Line 27

 

 

Adjusted basis.

Adjusted basis usually means original cost plus improvements, minus depreciation allowed or allowable (including any section

179

expense deduction), amortization, depletion, etc. If you did not acquire the property by purchasing it, your basis is determined as discussed in

Publication 551

, Basis of Assets. If you inherited the property from someone who died in 2010 and the executor of the decedent's estate made the election to file Form 8939, Allocation of Increase in Basis for Property Received From a Decedent, refer to the information provided by the executor or see

Publication 4895

, Tax Treatment of Property Acquired From a Decedent Dying in 2010.

Fair market value. Fair market value is the price for which you could sell your property to a willing buyer, when neither of you has to sell or buy and both of you know all the relevant facts. When filling out Schedules 1 through 6, you need to know the fair market value of the property immediately before and immediately after the disaster or casualty.

Deduction limits. If your casualty or theft loss involved a home you used for business or rented out, your deductible loss may be limited. See the Instructions for Form 4684, Section B. If the casualty or theft loss involved property used in a passive activity, see Form 8582, Passive Activity Loss Limitations, and its instructions.

The casualty and theft loss deduction for employee property, when added to your job expenses and most other miscellaneous itemized deductions on Schedule A (Form 1040), must be reduced by 2% of your adjusted gross income. Employee property is property used in performing services as an employee.

Comments and Suggestions

We welcome your comments about this publication and your suggestions for future editions.

You can write to us at the following address:

Internal Revenue Service Individual Forms and Publications Branch SE:W:CAR:MP:T:I 1111 Constitution Ave. NW, IR-6526 Washington, DC 20224

We respond to many letters by telephone. Therefore, it would be helpful if you would include your daytime phone number, including the area code, in your correspondence.

You can email us at taxforms@irs.gov. Please put "Publications Comment" on the subject line. You can also send us comments from http://www.irs.gov/formspubs/. Select "Comment on Tax Forms and Publications" under "Information about."

Although we cannot respond individually to each comment received, we do appreciate your feedback and will consider your comments as we revise our tax products.

Ordering forms and publications. Visit http://www.irs.gov/formspubs/ to download forms and publications, call 1-800-829-3676, or write to the address below and receive a response within 10 days after your request is received.

Internal Revenue Service 1201 N. Mitsubishi Motorway Bloomington, IL 61705-6613

Tax questions. If you have a tax question, check the information available on IRS.gov or call 1-800-829-1040. We cannot answer tax questions sent to either of the above addresses.

How To Get Tax Help

You can get help with unresolved tax issues, order free publications and forms, ask tax questions, and get information from the IRS in several ways. By selecting the method that is best for you, you will have quick and easy access to tax help.

Free help with your return. Free help in preparing your return is available nationwide from IRS-certified volunteers. The Volunteer Income Tax Assistance (VITA) program is designed to help low-moderate income taxpayers and the Tax Counseling for the Elderly (TCE) program is designed to assist taxpayers age 60 and older with their tax returns. Most VITA and TCE sites offer free electronic filing and all volunteers will let you know about credits and deductions you may be entitled to claim. To find the nearest VITA or TCE site, visit IRS.gov or call 1-800-906-9887 or 1-800-829-1040.

As part of the TCE program, AARP offers the Tax-Aide counseling program. To find the nearest AARP Tax-Aide site, call 1-888-227-7669 or visit AARP's website at http://www.aarp.org/money/taxaide.

For more information on these programs, go to IRS.gov and enter keyword "VITA" in the upper right-hand corner.

Internet. You can access the IRS website at IRS.gov 24 hours a day, 7 days a week to:

 

• Check the status of your 2011 refund. Go to IRS.gov and click on

Where's My Refund

. Wait at least 72 hours after the IRS acknowledges receipt of your e-filed return, or 3 to 4 weeks after mailing a paper return. If you filed Form 8379 with your return, wait 14 weeks (11 weeks if you filed electronically). Have your 2011 tax return available so you can provide your social security number, your filing status, and the exact whole dollar amount of your refund.

E-file your return. Find out about commercial tax preparation and e-file services available free to eligible taxpayers.

• Download forms, including talking tax forms, instructions, and publications.

• Order IRS products online.

• Research your tax questions online.

• Search publications online by topic or keyword.

• Use the online Internal Revenue Code, regulations, or other official guidance.

• View Internal Revenue Bulletins (IRBs) published in the last few years.

• Figure your withholding allowances using the withholding calculator online at http://www.irs.gov/individuals.

• Determine if Form 6251 must be filed by using our Alternative Minimum Tax (AMT) Assistant available online at http://www.irs.gov/individuals.

• Sign up to receive local and national tax news by email.

• Get information on starting and operating a small business.

 

Phone.

Many services are available by phone.

 

Ordering forms, instructions, and publications.

Call 1-800-TAX-FORM (1-800-829-3676) to order current-year forms, instructions, and publications, and prior-year forms and instructions. You should receive your order within 10 days.

Asking tax questions. Call the IRS with your tax questions at 1-800-829-1040.

Solving problems. You can get face-to-face help solving tax problems every business day in IRS Taxpayer Assistance Centers. An employee can explain IRS letters, request adjustments to your account, or help you set up a payment plan. Call your local Taxpayer Assistance Center for an appointment. To find the number, go to http://www.irs.gov/localcontacts or look in the phone book under United States Government, Internal Revenue Service.

TTY/TDD equipment. If you have access to TTY/TDD equipment, call 1-800-829-4059 to ask tax questions or to order forms and publications.

TeleTax topics. Call 1-800-829-4477 to listen to pre-recorded messages covering various tax topics.

Refund information. You can check the status of your refund on the new IRS phone app. Download the free IRS2Go app by visiting the iTunes app store or the Android Marketplace. IRS2Go is a new way to provide you with information and tools. To check the status of your refund by phone, call 1-800-829-4477 (automated refund information 24 hours a day, 7 days a week). Wait at least 72 hours after the IRS acknowledges receipt of your e-filed return, or 3 to 4 weeks after mailing a paper return. If you filed Form 8379 with your return, wait 14 weeks (11 weeks if you filed electronically). Have your 2011 tax return available so you can provide your social security number, your filing status, and the exact whole dollar amount of your refund. If you check the status of your refund and are not given the date it will be issued, please wait until the next week before checking back.

Other refund information. To check the status of a prior-year refund or amended return refund, call 1-800-829-1040.

 

Evaluating the quality of our telephone services.

To ensure IRS representatives give accurate, courteous, and professional answers, we use several methods to evaluate the quality of our telephone services. One method is for a second IRS representative to listen in on or record random telephone calls. Another is to ask some callers to complete a short survey at the end of the call.

Walk-in. Many products and services are available on a walk-in basis.

 

Products.

You can walk in to many post offices, libraries, and IRS offices to pick up certain forms, instructions, and publications. Some IRS offices, libraries, grocery stores, copy centers, city and county government offices, credit unions, and office supply stores have a collection of products available to print from a CD or photocopy from reproducible proofs. Also, some IRS offices and libraries have the Internal Revenue Code, regulations, Internal Revenue Bulletins, and Cumulative Bulletins available for research purposes.

Services. You can walk in to your local Taxpayer Assistance Center every business day for personal, face-to-face tax help. An employee can explain IRS letters, request adjustments to your tax account, or help you set up a payment plan. If you need to resolve a tax problem, have questions about how the tax law applies to your individual tax return, or you are more comfortable talking with someone in person, visit your local Taxpayer Assistance Center where you can spread out your records and talk with an IRS representative face-to-face. No appointment is necessary--just walk in. If you prefer, you can call your local Center and leave a message requesting an appointment to resolve a tax account issue. A representative will call you back within 2 business days to schedule an in-person appointment at your convenience. If you have an ongoing, complex tax account problem or a special need, such as a disability, an appointment can be requested. All other issues will be handled without an appointment. To find the number of your local office, go to http://www.irs.gov/localcontacts or look in the phone book under United States Government, Internal Revenue Service.

 

Mail.

You can send your order for forms, instructions, and publications to the address below. You should receive a response within 10 days after your request is received.

Internal Revenue Service 1201 N. Mitsubishi Motorway Bloomington, IL 61705-6613

Taxpayer Advocate Service. The Taxpayer Advocate Service (TAS) is your voice at the IRS. Our job is to ensure that every taxpayer is treated fairly, and that you know and understand your rights. We offer free help to guide you through the often-confusing process of resolving tax problems that you haven't been able to solve on your own. Remember, the worst thing you can do is nothing at all.

TAS can help if you can't resolve your problem with the IRS and:

 

• Your problem is causing financial difficulties for you, your family, or your business.

• You face (or your business is facing) an immediate threat of adverse action.

• You have tried repeatedly to contact the IRS but no one has responded, or the IRS has not responded to you by the date promised.

 

If you qualify for our help, we'll do everything we can to get your problem resolved. You will be assigned to one advocate who will be with you at every turn. We have offices in every state, the District of Columbia, and Puerto Rico. Although TAS is independent within the IRS, our advocates know how to work with the IRS to get your problems resolved. And our services are always free.

As a taxpayer, you have rights that the IRS must abide by in its dealings with you. Our tax toolkit at http://www.TaxpayerAdvocate.irs.gov can help you understand these rights.

If you think TAS might be able to help you, call your local advocate, whose number is in your phone book and on our website at http://www.irs.gov/advocate. You can also call our toll-free number at 1-877-777-4778.

TAS also handles large-scale or systemic problems that affect many taxpayers. If you know of one of these broad issues, please report it to us through our Systemic Advocacy Management System at http://www.irs.gov/advocate.

Low Income Taxpayer Clinics (LITCs). Low Income Taxpayer Clinics (LITCs) are independent from the IRS. Some clinics serve individuals whose income is below a certain level and who need to resolve a tax problem. These clinics provide professional representation before the IRS or in court on audits, appeals, tax collection disputes, and other issues for free or for a small fee. Some clinics can provide information about taxpayer rights and responsibilities in many different languages for individuals who speak English as a second language. For more information and to find a clinic near you, see the LITC page at http://www.irs.gov/advocate or IRS Publication 4134, Low Income Taxpayer Clinic List. This publication is also available by calling 1-800-829-3676 or at your local IRS office.

Free tax services. Publication 910, IRS Guide to Free Tax Services, is your guide to IRS services and resources. Learn about free tax information from the IRS, including publications, services, and education and assistance programs. The publication also has an index of over 100 TeleTax topics (recorded tax information) you can listen to on the telephone. The majority of the information and services listed in this publication are available to you free of charge. If there is a fee associated with a resource or service, it is listed in the publication.

Accessible versions of IRS published products are available on request in a variety of alternative formats for people with disabilities.

DVD for tax products. You can order Publication 1796, IRS Tax Products DVD, and obtain:

 

• Current-year forms, instructions, and publications.

• Prior-year forms, instructions, and publications.

• Tax Map: an electronic research tool and finding aid.

• Tax law frequently asked questions.

• Tax Topics from the IRS telephone response system.

• Internal Revenue Code--Title 26 of the U.S. Code.

• Links to other Internet based Tax Research Materials.

• Fill-in, print, and save features for most tax forms.

• Internal Revenue Bulletins.

• Toll-free and email technical support.

• Two releases during the year.

 

• The first release will ship the beginning of January 2012.

• The final release will ship the beginning of March 2012.

Purchase the DVD from National Technical Information Service (NTIS) at

http://www.irs.gov/cdorders

for $30 (no handling fee) or call 1-877-233-6767 toll free to buy the DVD for $30 (plus a $6 handling fee).

Schedule 1. Office Furniture and Fixtures

 --------------------------------------------------------------------

 

   

(1)          (2)         (3)          (4)        (5)       (6)

 

                                                     

Fair      Fair

 

                Cost                      Gain      market    market

 

                 or       Insurance       from      value     value

 

                other     or other      casualty    before    after

 

   Item         basis   reimbursement   or theft

1

  casualty  casualty

 

 --------------------------------------------------------------------

 

 

Example

 

 --------------------------------------------------------------------

 

 

Bookcase      250.00      50.00           .00     150.00       .00

 

 --------------------------------------------------------------------

 

 

Chair         695.00     375.00           .00     500.00    200.00

 

 --------------------------------------------------------------------

 

 

Desk          425.00     480.00         55.00

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

  Bookcase

 

 --------------------------------------------------------------------

 

  Book

 

 --------------------------------------------------------------------

 

  Chair

 

 --------------------------------------------------------------------

 

  Desk

 

 --------------------------------------------------------------------

 

  File cabinet

 

 --------------------------------------------------------------------

 

  Lamp

 

 --------------------------------------------------------------------

 

  Partition

 

 --------------------------------------------------------------------

 

  Sofa

 

 --------------------------------------------------------------------

 

  Table

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 

[Table Continued]

 

 -------------------------------------------------

 

   

(1)            (7)       (8)         (9)

 

                           Smaller

 

                             of

 

                 Column    column   Casualty/Theft

 

                (5) minus  (2) or    Loss (column

 

                 column    column     (8) minus

 

 Item              (6)      (7)

2    

column (3))

3

 

 -------------------------------------------------

 

 

Example

 

 -------------------------------------------------

 

 

Bookcase       150.00    250.00       200.00

 

 -------------------------------------------------

 

 

Chair          300.00    300.00          -0-

 

 -------------------------------------------------

 

 

Desk

 

 -------------------------------------------------

 

 -------------------------------------------------

 

  Bookcase

 

 -------------------------------------------------

 

  Book

 

 -------------------------------------------------

 

  Chair

 

 -------------------------------------------------

 

  Desk

 

 -------------------------------------------------

 

  File cabinet

 

 -------------------------------------------------

 

  Lamp

 

 -------------------------------------------------

 

  Partition

 

 -------------------------------------------------

 

  Sofa

 

 -------------------------------------------------

 

  Table

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 

1

 If column (3) is greater than column (2), enter

 

 the difference here and skip columns (5) through

 

 (9) for that item.

 

 

2

 If the property was completely destroyed or

 

 stolen, enter in column (8) the amount from

 

 column (2).

 

 

3

 If zero or less, enter -0-.

 

 =================================================

 

 

Schedule 2. Information Systems

 --------------------------------------------------------------------

 

   

(1)          (2)         (3)          (4)        (5)       (6)

 

                                                     

Fair      Fair

 

                Cost                      Gain      market    market

 

                 or       Insurance       from      value     value

 

                other     or other      casualty    before    after

 

   Item         basis   reimbursement   or theft

1

  casualty  casualty

 

 --------------------------------------------------------------------

 

  Computer

 

 --------------------------------------------------------------------

 

  Disc drive

 

 --------------------------------------------------------------------

 

  Disc file

 

 --------------------------------------------------------------------

 

  Fax machine

 

 --------------------------------------------------------------------

 

  Hub

 

 --------------------------------------------------------------------

 

  Keyboard

 

 --------------------------------------------------------------------

 

  Modem

 

 --------------------------------------------------------------------

 

  Monitor

 

 --------------------------------------------------------------------

 

  Mouse

 

 --------------------------------------------------------------------

 

  Optical

 

  character

 

  reader

 

 --------------------------------------------------------------------

 

  Printer

 

 --------------------------------------------------------------------

 

  Router

 

 --------------------------------------------------------------------

 

  Scanner

 

 --------------------------------------------------------------------

 

  Server

 

 --------------------------------------------------------------------

 

  Software

 

 --------------------------------------------------------------------

 

  Surge

 

  protector

 

 --------------------------------------------------------------------

 

  Tape drive

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 

[Table Continued]

 

 -------------------------------------------------

 

   

(1)            (7)       (8)         (9)

 

                           Smaller

 

                             of

 

                 Column    column   Casualty/Theft

 

                (5) minus  (2) or    Loss (column

 

                 column    column     (8) minus

 

 Item              (6)      (7)

2    

column (3))

3

 

 -------------------------------------------------

 

  Computer

 

 -------------------------------------------------

 

  Disc drive

 

 -------------------------------------------------

 

  Disc file

 

 -------------------------------------------------

 

  Fax machine

 

 -------------------------------------------------

 

  Hub

 

 -------------------------------------------------

 

  Keyboard

 

 -------------------------------------------------

 

  Modem

 

 -------------------------------------------------

 

  Monitor

 

 -------------------------------------------------

 

  Mouse

 

 -------------------------------------------------

 

  Optical

 

  character

 

  reader

 

 -------------------------------------------------

 

  Printer

 

 -------------------------------------------------

 

  Router

 

 -------------------------------------------------

 

  Scanner

 

 -------------------------------------------------

 

  Server

 

 -------------------------------------------------

 

  Software

 

 -------------------------------------------------

 

  Surge

 

  protector

 

 -------------------------------------------------

 

  Tape drive

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 

1

 If column (3) is greater than column (2), enter

 

 the difference here and skip columns (5) through

 

 (9) for that item.

 

 

2

 If the property was completely destroyed or

 

 stolen, enter in column (8) the amount from

 

 column (2).

 

 

3

 If zero or less, enter -0-.

 

 =================================================

 

 

Schedule 3. Motor Vehicles

 --------------------------------------------------------------------

 

   

(1)          (2)         (3)          (4)        (5)       (6)

 

 

Vehicle                                            Fair      Fair

 

   (year,       Cost                      Gain      market    market

 

   make,         or       Insurance       from      value     value

 

    and         other     or other      casualty    before    after

 

   model)       basis   reimbursement   or theft

1

  casualty  casualty

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 

[Table Continued]

 

 -------------------------------------------------

 

   

(1)            (7)       (8)         (9)

 

                           Smaller

 

  Vehicle                    of

 

   (year,        Column    column   Casualty/Theft

 

   make,        (5) minus  (2) or    Loss (column

 

    and          column    column     (8) minus

 

   model)          (6)      (7)

2    

column (3))

3

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 

1

 If column (3) is greater than column (2), enter

 

 the difference here and skip columns (5) through

 

 (9) for that item.

 

 

2

 If the property was completely destroyed or

 

 stolen, enter in column (8) the amount from

 

 column (2).

 

 

3

 If zero or less, enter -0-.

 

 =================================================

 

 

Schedule 4. Office Supplies

 --------------------------------------------------------------------

 

   

(1)          (2)         (3)          (4)        (5)       (6)

 

                                                     

Fair      Fair

 

                Cost                      Gain      market    market

 

                 or       Insurance       from      value     value

 

                other     or other      casualty    before    after

 

   Item         basis   reimbursement   or theft

1

  casualty  casualty

 

 --------------------------------------------------------------------

 

  Calendar

 

 --------------------------------------------------------------------

 

  Correction

 

  fluid

 

 --------------------------------------------------------------------

 

  Envelopes

 

 --------------------------------------------------------------------

 

  File folders

 

 --------------------------------------------------------------------

 

  Glue

 

 --------------------------------------------------------------------

 

  Hole puncher

 

 --------------------------------------------------------------------

 

  Paper

 

 --------------------------------------------------------------------

 

  Paperclips

 

 --------------------------------------------------------------------

 

  Pencils

 

 --------------------------------------------------------------------

 

  Pens

 

 --------------------------------------------------------------------

 

  Ruler

 

 --------------------------------------------------------------------

 

  Scissors

 

 --------------------------------------------------------------------

 

  Stamp pad

 

 --------------------------------------------------------------------

 

  Stapler

 

 --------------------------------------------------------------------

 

  Staples

 

 --------------------------------------------------------------------

 

  Tape

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 

[Table Continued]

 

 -------------------------------------------------

 

   

(1)            (7)       (8)         (9)

 

                           Smaller

 

                             of

 

                 Column    column   Casualty/Theft

 

                (5) minus  (2) or    Loss (column

 

                 column    column     (8) minus

 

 Item              (6)      (7)

2    

column (3))

3

 

 -------------------------------------------------

 

  Calendar

 

 -------------------------------------------------

 

  Correction

 

  fluid

 

 -------------------------------------------------

 

  Envelopes

 

 -------------------------------------------------

 

  File folders

 

 -------------------------------------------------

 

  Glue

 

 -------------------------------------------------

 

  Hole puncher

 

 -------------------------------------------------

 

  Paper

 

 -------------------------------------------------

 

  Paperclips

 

 -------------------------------------------------

 

  Pencils

 

 -------------------------------------------------

 

  Pens

 

 -------------------------------------------------

 

  Ruler

 

 -------------------------------------------------

 

  Scissors

 

 -------------------------------------------------

 

  Stamp pad

 

 -------------------------------------------------

 

  Stapler

 

 -------------------------------------------------

 

  Staples

 

 -------------------------------------------------

 

  Tape

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 

1

 If column (3) is greater than column (2), enter

 

 the difference here and skip columns skip columns

 

 (5) through (9) for that item.

 

 

2

 If the property was completely destroyed or

 

 stolen, enter in column (8) the amount from

 

 column (2).

 

 

3

 If zero or less, enter -0-.

 

 =================================================

 

 

Schedule 5. Building, Building Components, and Land

 --------------------------------------------------------------------

 

   

(1)          (2)         (3)          (4)        (5)       (6)

 

                                                     

Fair      Fair

 

                Cost                      Gain      market    market

 

                 or       Insurance       from      value     value

 

                other     or other      casualty    before    after

 

   Item         basis   reimbursement   or theft

1

  casualty  casualty

 

 --------------------------------------------------------------------

 

  Air

 

  conditioning

 

  unit

 

 --------------------------------------------------------------------

 

  Building

 

 --------------------------------------------------------------------

 

  Central air

 

  conditioning

 

 --------------------------------------------------------------------

 

  Fan

 

 --------------------------------------------------------------------

 

  Fence

 

 --------------------------------------------------------------------

 

  Generator

 

 --------------------------------------------------------------------

 

  Heating

 

  system

 

 --------------------------------------------------------------------

 

  Heating unit

 

 --------------------------------------------------------------------

 

  Landscaping

 

 --------------------------------------------------------------------

 

  Lighting

 

  system

 

 --------------------------------------------------------------------

 

  Plumbing

 

  system

 

 --------------------------------------------------------------------

 

  Roof

 

 --------------------------------------------------------------------

 

  Security

 

  System

 

 --------------------------------------------------------------------

 

  Wall-to-wall

 

  carpet

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 

[Table Continued]

 

 -------------------------------------------------

 

   

(1)            (7)       (8)         (9)

 

                           Smaller

 

                             of

 

                 Column    column   Casualty/Theft

 

                (5) minus  (2) or    Loss (column

 

                 column    column     (8) minus

 

 Item              (6)      (7)

2    

column (3))

3

 

 -------------------------------------------------

 

  Air

 

  conditioning

 

  unit

 

 -------------------------------------------------

 

  Building

 

 -------------------------------------------------

 

  Central air

 

  conditioning

 

 -------------------------------------------------

 

  Fan

 

 -------------------------------------------------

 

  Fence

 

 -------------------------------------------------

 

  Generator

 

 -------------------------------------------------

 

  Heating

 

  system

 

 -------------------------------------------------

 

  Heating unit

 

 -------------------------------------------------

 

  Landscaping

 

 -------------------------------------------------

 

  Lighting

 

  system

 

 -------------------------------------------------

 

  Plumbing

 

  system

 

 -------------------------------------------------

 

  Roof

 

 -------------------------------------------------

 

  Security

 

  System

 

 -------------------------------------------------

 

  Wall-to-wall

 

  carpet

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 

1

 If column (3) is greater than column (2), enter

 

 the difference here and skip columns (5) through

 

 (9) for that item.

 

 

2

 If the property was completely destroyed or

 

 stolen, enter in column (8) the amount from

 

 column (2).

 

 

3

 If zero or less, enter -0-.

 

 =================================================

 

 

Schedule 6. Equipment

 --------------------------------------------------------------------

 

   

(1)          (2)         (3)          (4)        (5)       (6)

 

                                                     

Fair      Fair

 

                Cost                      Gain      market    market

 

                 or       Insurance       from      value     value

 

                other     or other      casualty    before    after

 

   Item         basis   reimbursement   or theft

1

  casualty  casualty

 

 --------------------------------------------------------------------

 

  Accounting

 

  machine

 

 --------------------------------------------------------------------

 

  Calculator

 

 --------------------------------------------------------------------

 

  Clock

 

 --------------------------------------------------------------------

 

  Copier

 

 --------------------------------------------------------------------

 

  Duplicating

 

  equipment

 

 --------------------------------------------------------------------

 

  DVD

 

 --------------------------------------------------------------------

 

  Microwave

 

  oven

 

 --------------------------------------------------------------------

 

  Paper

 

  shredder

 

 --------------------------------------------------------------------

 

  Radio

 

 --------------------------------------------------------------------

 

  Safe

 

 --------------------------------------------------------------------

 

  Telephone

 

 --------------------------------------------------------------------

 

  Television

 

 --------------------------------------------------------------------

 

  Typewriter

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 --------------------------------------------------------------------

 

 

[Table Continued]

 

 -------------------------------------------------

 

   

(1)            (7)       (8)         (9)

 

                           Smaller

 

                             of

 

                 Column    column   Casualty/Theft

 

                (5) minus  (2) or    Loss (column

 

                 column    column     (8) minus

 

 Item              (6)      (7)

2    

column (3))

3

 

 -------------------------------------------------

 

  Accounting

 

  machine

 

 -------------------------------------------------

 

  Calculator

 

 -------------------------------------------------

 

  Clock

 

 -------------------------------------------------

 

  Copier

 

 -------------------------------------------------

 

  Duplicating

 

  equipment

 

 -------------------------------------------------

 

  DVD

 

 -------------------------------------------------

 

  Microwave

 

  oven

 

 -------------------------------------------------

 

  Paper

 

  shredder

 

 -------------------------------------------------

 

  Radio

 

 -------------------------------------------------

 

  Safe

 

 -------------------------------------------------

 

  Telephone

 

 -------------------------------------------------

 

  Television

 

 -------------------------------------------------

 

  Typewriter

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 -------------------------------------------------

 

 

1

 If column (3) is greater than column (2), enter

 

 the difference here and skip columns (5) through

 

 (9) for that item.

 

 

2

 If the property was completely destroyed or

 

 stolen, enter in column (8) the amount from

 

 column (2).

 

 

3

 If zero or less, enter -0-.

 

 =================================================

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