HOME Tax Notes Research Federal IRS Guidance publications

Publication 584 (6-2012) CASUALTY, DISASTER, AND THEFT LOSS WORKBOOK

Publication 584 (6-2012)

DATED

DOCUMENT ATTRIBUTES

Institutional Authors
Internal Revenue Service
Jurisdictions
United States
Language
English

Citations: Publication 584 (6-2012)

What's New

Introduction
How To Use This Workbook
Losses
Comments and Suggestions
How To Get Tax Help

What's New

Future developments. The IRS has created a page on IRS.gov for information about Publication 584, at http://www.irs.gov/pub584. Information about any future developments affecting Publication 584 (such as legislation enacted after we release it) will be posted on that page.

Introduction

This workbook is designed to help you figure your loss on personal-use property in the event of a disaster, casualty, or theft. It contains schedules to help you figure the loss to your main home, its contents, and your motor vehicles. However, these schedules 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 cost or other basis and fair market value, discussed later.

3. Fill out Schedules 1 through 20.

4. Read the instructions for Form 4684.

5. Fill out Form 4684 using the information you entered in Schedules 1 through 20.

Use the chart below to find out how to use Schedules 1 through 19 to fill out Form 4684.

And enter it on

Take what's in each row of . . .

Form 4684 . . .

Column 1 Line 1

Column 2 Line 2

Column 3 Line 3

Column 4 Line 4

Column 5 Line 5

Column 6 Line 6

Column 7 Line 7

Column 8 Line 8

Column 9 Line 9

Losses

Generally, you may deduct losses to your home, household goods, and motor vehicles on your federal income tax return. However, you may not deduct a casualty or theft loss that is covered by insurance unless you filed a timely insurance claim for reimbursement. Any reimbursement you receive will reduce the loss. If you did not file an insurance claim, you may deduct only the part of the loss that was not covered by insurance.

Amount of loss. You figure the amount of your loss using the following steps.

1. Determine your cost or other basis in the property before the casualty or theft.

2. Determine the decrease in fair market value (FMV) of the property as a result of the casualty or theft. (The decrease in FMV is the difference between the property's value immediately before and immediately after the casualty or theft.)

3. From the smaller of the amounts you determined in (1) and (2), subtract any insurance or other reimbursement you received or expect to receive.

Apply the deduction limits, discussed later, to determine the amount of your deductible loss.

Cost or other basis. Cost or other basis usually means original cost plus improvements. 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, 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. FMV 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 20, you need to know the FMV of the property immediately before and immediately after the disaster, casualty, or theft.

Separate computations. Generally, if a single casualty or theft involves more than one item of property, you must figure the loss on each item separately. Then combine the losses to determine the total loss from that casualty or theft.

Exception for personal-use real property. In figuring a casualty loss on personal-use real property, the entire property (including any improvements, such as buildings, trees, and shrubs) is treated as one item. Figure the loss using the smaller of the following.

• The decrease in FMV of the entire property.

• The adjusted basis of the entire property.

Deduction limits.

After you have figured the amount of your loss, as discussed earlier, you must figure how much of the loss you can deduct. You do this on Form 4684, section A. If the loss was to property for your personal use or your family's, there are two limits on the amount you can deduct for your casualty or theft loss.

1. You must reduce each casualty or theft loss by $100 ($100 rule).

2. You must further reduce the total of all your losses by 10% of your adjusted gross income (10% rule).

More information.

For more information about the deduction limits, see

Publication 547

When your loss is deductible. You can generally deduct a casualty or disaster area loss only in the tax year in which the casualty or disaster occurred. You can generally deduct a theft loss only in the year you discovered your property was stolen. However, you can choose to deduct disaster area losses on your return for the year immediately before the year of the disaster if the President has declared your area a federal disaster area. For details, see Disaster Area Losses in Publication 547.

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:

•

E-file

your return. Find out about commercial tax preparation and

e-file

services available free to eligible taxpayers.

• 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.

• 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. To check the status of your 2011 refund, call 1-800-829-1954 or 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 or TTY/TDD 1-800-829-4059.

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 on 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. Entrance Hall

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

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

Cost Insurance Gain from Fair market

or or casualty value

other other or before

Item basis reimbursement theft

casualty

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

Example:

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

Chair 350.00 200.00 .00 275.00

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

Clock 90.00 .00 .00 60.00

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

Chair

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

Clock

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

Curtains

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

Draperies

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

Lamp

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

Mirror

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

Picture

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

Rug

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

Table

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

Umbrella stand

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

Wall fixture

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

[Table Continued]

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

(1) (6) (7) (8) (9)

Fair market Smaller of Casualty/Theft

value Column column (2) loss (column

after (5) minus or column (8) minus

Item casualty column (6) (7) column (3))

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

Example:

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

Chair .00 275.00 275.00 75.00

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

Clock .00 60.00 60.00 60.00

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

Chair

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

Clock

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

Curtains

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

Draperies

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

Lamp

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

Mirror

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

Picture

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

Rug

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

Table

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

Umbrella stand

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

Wall fixture

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

If column (3) is greater than column (2), enter the difference here

and skip columns (5) through (9) for that item.

If zero or less, enter -0-.

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

Schedule 2. Living Room

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

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

Cost Insurance Gain from Fair market

or or casualty value

other other or before

Item basis reimbursement theft

casualty

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

Accessories

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

Blinds

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

Bookcase

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

Book

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

Chair

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

Chest

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

Clock

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

Coffee table

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

Curtains

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

Desk

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

Draperies

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

Fireplace

hardware

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

Lamp

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

Magazine rack

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

Mirror

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

Piano

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

Picture

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

Pillow

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

Radio

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

Rug & pad

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

Shades

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

Shutters

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

Sofa

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

Stereo

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

Television

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

Wall fixture

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

[Table Continued]

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

(1) (6) (7) (8) (9)

Fair market Smaller of Casualty/Theft

value Column column (2) loss (column

after (5) minus or column (8) minus

Item casualty column (6) (7) column (3))

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

Accessories

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

Blinds

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

Bookcase

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

Book

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

Chair

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

Chest

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

Clock

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

Coffee table

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

Curtains

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

Desk

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

Draperies

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

Fireplace

hardware

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

Lamp

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

Magazine rack

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

Mirror

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

Piano

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

Picture

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

Pillow

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

Radio

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

Rug & pad

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

Shades

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

Shutters

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

Sofa

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

Stereo

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

Television

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

Wall fixture

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

If column (3) is greater than column (2), enter the difference here

and skip columns (5) through (9) for that item.

If zero or less, enter -0-.

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

Schedule 3. Dining Room

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

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

Cost Insurance Gain from Fair market

or or casualty value

other other or before

Item basis reimbursement theft

casualty

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

Buffet

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

Chair

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

China cabinet

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

Chinaware

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

Crystal

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

Curtains

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

Draperies

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

Glassware

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

Mirror

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

Picture

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

Rug & pad

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

Silver flatware

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

Silver tea set

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

Silver items

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

Table

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

Tea cart

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

Wall fixture

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

[Table Continued]

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

(1) (6) (7) (8) (9)

Fair market Smaller of Casualty/Theft

value Column column (2) loss (column

after (5) minus or column (8) minus

Item casualty column (6) (7) column (3))

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

Buffet

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

Chair

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

China cabinet

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

Chinaware

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

Crystal

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

Curtains

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

Draperies

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

Glassware

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

Mirror

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

Picture

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

Rug & pad

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

Silver flatware

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

Silver tea set

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

Silver items

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

Table

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

Tea cart

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

Wall fixture

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

If column (3) is greater than column (2), enter the difference here

and skip columns (5) through (9) for that item.

If zero or less, enter -0-.

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

Schedule 4. Kitchen

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

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

Cost Insurance Gain from Fair market

or or casualty value

other other or before

Item basis reimbursement theft

casualty

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

Blender

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

Broiler

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

Canned goods

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

Can opener

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

Clock

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

Coffee maker

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

Curtains

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

Cutlery

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

Dishes

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

Dishwasher

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

Food processor

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

Freezer

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

Frozen food

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

Glassware

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

Ice crusher

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

Microwave oven

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

Mixer

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

Pots and pans

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

Radio

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

Refrigerator

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

Stove

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

Table and chairs

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

Telephone

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

Toaster

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

Trash compactor

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

Utensils

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

Wall accessory

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

[Table Continued]

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

(1) (6) (7) (8) (9)

Fair market Smaller of Casualty/Theft

value Column column (2) loss (column

after (5) minus or column (8) minus

Item casualty column (6) (7) column (3))

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

Blender

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

Broiler

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

Canned goods

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

Can opener

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

Clock

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

Coffee maker

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

Curtains

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

Cutlery

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

Dishes

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

Dishwasher

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

Food processor

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

Freezer

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

Frozen food

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

Glassware

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

Ice crusher

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

Microwave oven

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

Mixer

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

Pots and pans

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

Radio

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

Refrigerator

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

Stove

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

Table and chairs

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

Telephone

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

Toaster

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

Trash compactor

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

Utensils

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

Wall accessory

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

If column (3) is greater than column (2), enter the difference here

and skip columns (5) through (9) for that item.

If zero or less, enter -0-.

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

Schedule 5. Den

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

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

Cost Insurance Gain from Fair market

or or casualty value

other other or before

Item basis reimbursement theft

casualty

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

Bookcase

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

Book

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

CD player

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

Chair

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

Computer

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

Clock

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

Curtains

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

Desk

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

Draperies

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

DVD player

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

Lamp

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

Mirror

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

Picture

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

Pillow

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

Radio

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

CDs/Records

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

Rug & pad

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

Telephone

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

Sofa

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

Stereo

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

Table

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

Television

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

VCR

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

[Table Continued]

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

(1) (6) (7) (8) (9)

Fair market Smaller of Casualty/Theft

value Column column (2) loss (column

after (5) minus or column (8) minus

Item casualty column (6) (7) column (3))

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

Bookcase

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

Book

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

CD player

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

Chair

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

Computer

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

Clock

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

Curtains

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

Desk

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

Draperies

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

DVD player

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

Lamp

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

Mirror

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

Picture

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

Pillow

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

Radio

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

CDs/Records

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

Rug & pad

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

Telephone

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

Sofa

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

Stereo

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

Table

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

Television

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

VCR

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

If column (3) is greater than column (2), enter the difference here

and skip columns (5) through (9) for that item.

If zero or less, enter -0-.

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

Schedule 6. Bedrooms

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

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

Cost Insurance Gain from Fair market

or or casualty value

other other or before

Item basis reimbursement theft

casualty

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

Bed cover

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

Bed

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

Bedside table

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

Bureau

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

Chair

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

Chest

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

Clock

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

Clothes hamper

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

Desk

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

Dresser

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

Jewelry box

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

Lamp

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

Linens

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

Mirror

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

Picture

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

Radio

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

Rug & pad

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

Telephone

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

Television

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

[Table Continued]

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

(1) (6) (7) (8) (9)

Fair market Smaller of Casualty/Theft

value Column column (2) loss (column

after (5) minus or column (8) minus

Item casualty column (6) (7) column (3))

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

Bed cover

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

Bed

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

Bedside table

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

Bureau

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

Chair

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

Chest

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

Clock

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

Clothes hamper

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

Desk

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

Dresser

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

Jewelry box

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

Lamp

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

Linens

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

Mirror

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

Picture

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

Radio

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

Rug & pad

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

Telephone

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

Television

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

If column (3) is greater than column (2), enter the difference here

and skip columns (5) through (9) for that item.

If zero or less, enter -0-.

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

Schedule 7. Bathrooms

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

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

Cost Insurance Gain from Fair market

or or casualty value

other other or before

Item basis reimbursement theft

casualty

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

Bath mat

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

Clothes hamper

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

Curtains

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

Hair dryer

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

Linens

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

Mirror

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

Picture

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

Razor

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

Scale

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

Towel rack

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

Wall fixture

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

[Table Continued]

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

(1) (6) (7) (8) (9)

Fair market Smaller of Casualty/Theft

value Column column (2) loss (column

after (5) minus or column (8) minus

Item casualty column (6) (7) column (3))

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

Bath mat

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

Clothes hamper

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

Curtains

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

Hair dryer

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

Linens

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

Mirror

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

Picture

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

Razor

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

Scale

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

Towel rack

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

Wall fixture

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

If column (3) is greater than column (2), enter the difference here

and skip columns (5) through (9) for that item.

If zero or less, enter -0-.

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

Schedule 8. Recreation Room

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

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

Cost Insurance Gain from Fair market

or or casualty value

other other or before

Item basis reimbursement theft

casualty

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

Billiard table

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

Book

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

Card table

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

CD player

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

Chair

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

Clock

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

Curtains

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

DVD player

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

Game

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

Lamp

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

Picture

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

Ping Pong table

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

Pool table

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

Radio

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

CDs/Records

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

Rug & pad

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

Sofa

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

Stereo

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

Table

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

Television

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

VCR

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

[Table Continued]

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

(1) (6) (7) (8) (9)

Fair market Smaller of Casualty/Theft

value Column column (2) loss (column

after (5) minus or column (8) minus

Item casualty column (6) (7) column (3))

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

Billiard table

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

Book

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

Card table

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

CD player

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

Chair

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

Clock

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

Curtains

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

DVD player

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

Game

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

Lamp

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

Picture

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

Ping Pong table

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

Pool table

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

Radio

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

CDs/Records

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

Rug & pad

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

Sofa

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

Stereo

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

Table

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

Television

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

VCR

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

If column (3) is greater than column (2), enter the difference here

and skip columns (5) through (9) for that item.

If zero or less, enter -0-.

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

Schedule 9. Laundry and Basement

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

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

Cost Insurance Gain from Fair market

or or casualty value

other other or before

Item basis reimbursement theft

casualty

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

Chair

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

Dryer

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

Electric iron

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

Food freezer

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

Ironing board

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

Ladder

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

Luggage

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

Table

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

Tool

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

Tub

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

Washing machine

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

Work bench

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

[Table Continued]

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

(1) (6) (7) (8) (9)

Fair market Smaller of Casualty/Theft

value Column column (2) loss (column

after (5) minus or column (8) minus

Item casualty column (6) (7) column (3))

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

Chair

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

Dryer

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

Electric iron

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

Food freezer

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

Ironing board

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

Ladder

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

Luggage

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

Table

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

Tool

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

Tub

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

Washing machine

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

Work bench

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

If column (3) is greater than column (2), enter the difference here

and skip columns (5) through (9) for that item.

If zero or less, enter -0-.

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

Schedule 10. Garage

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

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

Cost Insurance Gain from Fair market

or or casualty value

other other or before

Item basis reimbursement theft

casualty

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

Bicycle

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

Garden hose

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

Garden tool

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

Hedger

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

Ladder

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

Lawn mower

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

Snow blower

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

Sprayer

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

Spreader

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

Tiller

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

Tool

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

Wheelbarrow

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

[Table Continued]

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

(1) (6) (7) (8) (9)

Fair market Smaller of Casualty/Theft

value Column column (2) loss (column

after (5) minus or column (8) minus

Item casualty column (6) (7) column (3))

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

Bicycle

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

Garden hose

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

Garden tool

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

Hedger

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

Ladder

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

Lawn mower

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

Snow blower

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

Sprayer

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

Spreader

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

Tiller

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

Tool

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

Wheelbarrow

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

If column (3) is greater than column (2), enter the difference here

and skip columns (5) through (9) for that item.

If zero or less, enter -0-.

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

Schedule 11. Sporting Equipment

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

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

Cost Insurance Gain from Fair market

or or casualty value

other other or before

Item basis reimbursement theft

casualty

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

Boat & motor

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

Camera

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

Camping

equipment

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

Field glasses

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

Fishing tackle

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

Golf clubs

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

Gun

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

Lawn game

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

Projector

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

Tennis racket

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

[Table Continued]

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

(1) (6) (7) (8) (9)

Fair market Smaller of Casualty/Theft

value Column column (2) loss (column

after (5) minus or column (8) minus

Item casualty column (6) (7) column (3))

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

Boat & motor

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

Camera

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

Camping

equipment

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

Field glasses

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

Fishing tackle

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

Golf clubs

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

Gun

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

Lawn game

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

Projector

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

Tennis racket

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

If column (3) is greater than column (2), enter the difference here

and skip columns (5) through (9) for that item.

If zero or less, enter -0-.

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

Schedule 12. Men's Clothing

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

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

Cost Insurance Gain from Fair market

or or casualty value

other other or before

Item basis reimbursement theft

casualty

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

Belt

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

Boots

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

Gloves

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

Handkerchief

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

Hat

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

Overcoat

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

Raincoat

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

Shirt

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

Shoes

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

Shorts

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

Slacks

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

Socks

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

Sport jacket

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

Suit

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

Sweater

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

Tie

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

Underwear

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

[Table Continued]

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

(1) (6) (7) (8) (9)

Fair market Smaller of Casualty/Theft

value Column column (2) loss (column

after (5) minus or column (8) minus

Item casualty column (6) (7) column (3))

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

Belt

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

Boots

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

Gloves

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

Handkerchief

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

Hat

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

Overcoat

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

Raincoat

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

Shirt

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

Shoes

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

Shorts

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

Slacks

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

Socks

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

Sport jacket

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

Suit

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

Sweater

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

Tie

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

Underwear

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

If column (3) is greater than column (2), enter the difference here

and skip columns (5) through (9) for that item.

If zero or less, enter -0-.

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

Schedule 13. Women's Clothing

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

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

Cost Insurance Gain from Fair market

or or casualty value

other other or before

Item basis reimbursement theft

casualty

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

Belt

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

Blouse

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

Boots

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

Coat

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

Dress

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

Fur

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

Gloves

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

Hat

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

Hosiery

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

Jacket

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

Lingerie

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

Scarf

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

Shirt

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

Shoes

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

Skirt

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

Slacks

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

Suit

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

Sweater

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

[Table Continued]

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

(1) (6) (7) (8) (9)

Fair market Smaller of Casualty/Theft

value Column column (2) loss (column

after (5) minus or column (8) minus

Item casualty column (6) (7) column (3))

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

Belt

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

Blouse

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

Boots

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

Coat

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

Dress

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

Fur

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

Gloves

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

Hat

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

Hosiery

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

Jacket

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

Lingerie

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

Scarf

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

Shirt

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

Shoes

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

Skirt

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

Slacks

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

Suit

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

Sweater

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

If column (3) is greater than column (2), enter the difference here

and skip columns (5) through (9) for that item.

If zero or less, enter -0-.

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

Schedule 14. Children's Clothing

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

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

Cost Insurance Gain from Fair market

or or casualty value

other other or before

Item basis reimbursement theft

casualty

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

Blouse

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

Boots

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

Coat

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

Dress

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

Gloves

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

Hat

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

Shirt

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

Shoes

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

Skirt

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

Slacks

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

Socks

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

Sport jacket

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

Stockings

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

Suit

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

Sweater

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

Underwear

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

[Table Continued]

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

(1) (6) (7) (8) (9)

Fair market Smaller of Casualty/Theft

value Column column (2) loss (column

after (5) minus or column (8) minus

Item casualty column (6) (7) column (3))

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

Blouse

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

Boots

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

Coat

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

Dress

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

Gloves

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

Hat

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

Shirt

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

Shoes

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

Skirt

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

Slacks

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

Socks

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

Sport jacket

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

Stockings

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

Suit

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

Sweater

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

Underwear

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

If column (3) is greater than column (2), enter the difference here

and skip columns (5) through (9) for that item.

If zero or less, enter -0-.

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

Schedule 15. Jewelry

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

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

Cost Insurance Gain from Fair market

or or casualty value

other other or before

Item basis reimbursement theft

casualty

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

Bracelet

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

Brooch

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

Earrings

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

Engagement ring

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

Necklace

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

Ring

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

Watch

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

Wedding ring

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

[Table Continued]

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

(1) (6) (7) (8) (9)

Fair market Smaller of Casualty/Theft

value Column column (2) loss (column

after (5) minus or column (8) minus

Item casualty column (6) (7) column (3))

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

Bracelet

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

Brooch

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

Earrings

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

Engagement ring

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

Necklace

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

Ring

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

Watch

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

Wedding ring

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

If column (3) is greater than column (2), enter the difference here

and skip columns (5) through (9) for that item.

If zero or less, enter -0-.

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

Schedule 16. Electrical Appliances

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

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

Cost Insurance Gain from Fair market

or or casualty value

other other or before

Item basis reimbursement theft

casualty

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

Air conditioner

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

Blanket

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

Dehumidifier

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

Fan

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

Floor polisher

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

Grill

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

Heating pad

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

Humidifier

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

Sewing machine

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

Sun lamp

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

Vacuum cleaner

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

[Table Continued]

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

(1) (6) (7) (8) (9)

Fair market Smaller of Casualty/Theft

value Column column (2) loss (column

after (5) minus or column (8) minus

Item casualty column (6) (7) column (3))

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

Air conditioner

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

Blanket

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

Dehumidifier

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

Fan

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

Floor polisher

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

Grill

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

Heating pad

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

Humidifier

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

Sewing machine

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

Sun lamp

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

Vacuum cleaner

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

If column (3) is greater than column (2), enter the difference here

and skip columns (5) through (9) for that item.

If zero or less, enter -0-.

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

Schedule 17. Linens

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

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

Cost Insurance Gain from Fair market

or or casualty value

other other or before

Item basis reimbursement theft

casualty

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

Bath mat

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

Bedsheet

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

Bedspread

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

Blanket

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

Comforter

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

Mattress pad

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

Napkins

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

Pillow

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

Pillowcase

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

Placemat

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

Quilt

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

Tablecloth

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

Towel

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

Washcloth

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

[Table Continued]

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

(1) (6) (7) (8) (9)

Fair market Smaller of Casualty/Theft

value Column column (2) loss (column

after (5) minus or column (8) minus

Item casualty column (6) (7) column (3))

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

Bath mat

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

Bedsheet

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

Bedspread

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

Blanket

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

Comforter

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

Mattress pad

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

Napkins

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

Pillow

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

Pillowcase

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

Placemat

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

Quilt

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

Tablecloth

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

Towel

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

Washcloth

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

If column (3) is greater than column (2), enter the difference here

and skip columns (5) through (9) for that item.

If zero or less, enter -0-.

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

Schedule 18. Miscellaneous

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

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

Cost Insurance Gain from Fair market

or or casualty value

other other or before

Item basis reimbursement theft

casualty

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

Barbeque

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

Lawn furniture

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

Musical

instrument

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

Outdoor shed

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

Picnic set

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

Porch furniture

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

Sport equipment

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

Swing set

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

Toy

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

[Table Continued]

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

(1) (6) (7) (8) (9)

Fair market Smaller of Casualty/Theft

value Column column (2) loss (column

after (5) minus or column (8) minus

Item casualty column (6) (7) column (3))

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

Barbeque

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

Lawn furniture

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

Musical

instrument

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

Outdoor shed

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

Picnic set

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

Porch furniture

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

Sport equipment

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

Swing set

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

Toy

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

If column (3) is greater than column (2), enter the difference here

and skip columns (5) through (9) for that item.

If zero or less, enter -0-.

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

Schedule 19. Motor Vehicles

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

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

Cost Insurance Gain from Fair market

Vehicle or or casualty value

(year, make other other or before

and model) basis reimbursement theft

casualty

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

[Table Continued]

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

(1) (6) (7) (8) (9)

Fair market Smaller of Casualty/Theft

Vehicle value Column column (2) loss (column

(year, make after (5) minus or column (8) minus

and model) casualty column (6) (7) column (3))

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

If column (3) is greater than column (2), enter the difference here

and skip columns (5) through (9) for that item.

If zero or less, enter -0-.

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

Schedule 20. Home (Excluding Contents)

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

Note.

If you used the entire property as your home, fill out only

column (a). If you used part of the property as your home and part

of it for business or to produce rental income, you must allocate

the entries on lines 2-9 between the personal part (column (a)) and

the business/rental part (column (b)).

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

1. Description of property (Show

(a) (b)

location and date acquired.)

______________________________________ Personal Business/

______________________________________ Part Rental Part

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

2. Cost or other (adjusted) basis of

property (from Worksheet A)

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

3. Insurance or other reimbursement

Note.

If line 2 is more than line 3,

skip line 4. If line 3 is more than

line 2, you exclude gain, and the gain

is more than you can exclude, see the

instructions for line 3 in the

Instructions for Form 4684 for the

amount to enter.

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

4. Gain from casualty. If line 3 is more

than line 2, enter the difference here

and skip lines 5 through 9. But see

Next

below line 9.

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

5. Fair market value before casualty

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

6. Fair market value after casualty

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

7. Decrease in fair market value. Subtract

line 6 from line 5.

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

8. Enter the smaller of line 2 or line 7

Note for business/rental part.

If the

property was totally destroyed by

casualty, enter on line 8, column (b)

the amount from line 2, column (b).

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

9. Subtract line 3 from line 8. If zero

or less, enter -0-.

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

Next:

Transfer the entries from line 1 and lines 2-9, column (a),

above to the corresponding lines on Form 4684, Section A. Transfer the

entries from line 1 and lines 2-9, column (b), to the corresponding

lines on Form 4684, Section B.

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

Worksheet A. Cost or Other (Adjusted) Basis

Keep for Your Records

Caution.

See the

Worksheet A Instructions

before you use this

worksheet.

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

(a) (b)

Personal Business/

Part Rental Part

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

Enter the purchase price of the home

damaged or destroyed. (If you filed

Form 2119 when you originally

acquired that home to postpone gain

on the sale of a previous home

before May 7, 1997, enter the

adjusted basis of the new home from

that Form 2119.)

_________ _________

Seller paid points for home bought

after 1990. Do not include any

seller-paid points you already

subtracted to arrive at the amount

entered on line 1

_________ _________

Subtract line 2 from line 1

_________ _________

Settlement fees or closing costs.

(See

Settlement costs

Publication 551

.) If line 1

includes the adjusted basis of

the new home from Form 2119, skip

lines 4a-4g and 5; go to line 6.

Abstract and recording fees

4a.

_________ _________

Legal fees (including fees for title

search and preparing documents)

4b.

_________ _________

Survey fees

4c.

_________ _________

Title insurance

4d.

_________ _________

Transfer or stamp taxes

4e.

_________ _________

Amounts that the seller owed that

you agreed to pay (back taxes or

interest, recording or mortgage

fees, and sales commissions)

4f.

_________ _________

Other

4g.

_________ _________

Add lines 4a through 4g

_________ _________

Cost of additions and improvements.

(See

Increases to Basis

Publication 551

.) Do not include

any additions and improvements

included on line 1

_________ _________

Special tax assessments paid for

local improvements, such as streets

and sidewalks

_________ _________

Other increases to basis

_________ _________

Add lines 3, 5, 6, 7, and 8

_________ _________

10.

Depreciation allowed or allowable,

related to the business use or

rental of the home

10.

_________

11.

Other decreases to basis (See

Decreases to Basis

Publication 551

11.

_________ _________

12.

Add lines 10 and 11

12.

_________ _________

13. Cost or other (adjusted) basis of

home damaged or destroyed.

Subtract

line 12 from line 9. Enter here and

on Schedule 20, line 2

13.

_________ _________

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

Worksheet A Instructions.

Keep for Your Records

If you use

Worksheet A

to figure the cost or other (adjusted) basis

of your home, follow these instructions. DO NOT use this worksheet to

determine your basis if you acquired an interest in your home from a

decedent who died in 2010 and whose executor filed Form 8939.

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

IF . . . THEN . . .

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

you inherited your home from 1 skip lines 1-4 of the worksheet.

a decedent who died either ----------------------------------------

before or after 2010 or from 2 find your basis using the rules under

a decedent who died in 2010

Inherited Property

Publication 551

and whose executor did not Enter this amount on line 5 of the

file Form 8939. worksheet.

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

3 fill out lines 6-13 of the worksheet.

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

you received your home as a 1 read

Property Received as a Gift

gift

Publication 551

and enter on lines 1

and 3 of the worksheet either the

donor's adjusted basis or the home's

fair market value at the time of the

gift, whichever is appropriate.

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

2 if you can add any federal gift tax

to your basis, enter that amount on

line 5 of the worksheet.

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

3 fill out the rest of the worksheet.

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

you received your home as a 1 enter on line 1 of the worksheet the

trade for other property fair market value of the other

property at the time of the trade.

(But if you received your home as a

trade for your previous home before

May 7, 1997, and had a gain on the

trade that you postponed using

Form 2119, enter on line 1 of the

worksheet the adjusted basis of the

new home from that Form 2119.)

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

2 fill out the rest of the worksheet.

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

you built your home 1 add the purchase price of the land and

the cost of building the home. Enter

that total on line 1 of the worksheet.

(However, if you filed a Form 2119 to

postpone gain on the sale of a

previous home before May 7, 1997,

enter on line 1 of the worksheet the

adjusted basis of the new home from

that Form 2119.)

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

2 fill out the rest of the worksheet.

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

you received your home from 1 skip lines 1-4 of the worksheet.

your spouse after July 18, ----------------------------------------

1984 2 enter on line 5 of the worksheet your

spouse's cost or other (adjusted)

basis in the home just before you

received it.

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

3 fill out lines 6-13 of the worksheet,

making adjustments to basis only for

events after the transfer.

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

you owned a home jointly fill out one worksheet, making

with your spouse, who adjustments to basis for events both

transferred his or her before and after the transfer.

interest in the home to you

after July 18, 1984

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

you received your home from 1 skip lines 1-4 of the worksheet.

your spouse before July 19, ----------------------------------------

1984 2 enter on line 5 of the worksheet the

home's fair market value at the time

you received it.

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

3 fill out lines 6-13 of the worksheet,

making adjustments to basis only for

events after the transfer.

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

you owned a home jointly 1 fill out a worksheet, lines 1-13,

with your spouse, and your making adjustments to basis only for

spouse transferred his or events before the transfer.

her interest in the home to ----------------------------------------

you before July 19, 1984 2 multiply the amount on line 13 of that

worksheet by 50% (0.50) to get the

adjusted basis of your half-interest

at the time of the transfer.

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

3 multiply the fair market value of the

home at the time of the transfer by

50% (0.50). Generally, this is the

basis of the half-interest that your

spouse owned.

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

4 add the amounts from steps 2 and 3

and enter the total on line 5 of a

second worksheet.

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

5 complete lines 6-13 of the second

worksheet, making adjustments to basis

only for events after the transfer.

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

you owned your home jointly 1 fill out lines 1-13 of the worksheet.

with a nonspouse ----------------------------------------

2 multiply the amount on line 13 by your

percentage of ownership to get the

adjusted basis of your part-interest.

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

you owned your home jointly 1 fill out a worksheet, lines 1-13,

with your spouse who died including adjustments to basis only

before 2010 and before the for events before your spouse's death.

casualty ----------------------------------------

2 multiply the amount on line 13 of that

worksheet by 50% (0.50) to get the

adjusted basis of your half-interest

on the date of death.

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

3 figure the basis for the half-interest

owned by your spouse. This is one-half

of the fair market value on the date

of death (or later alternate valuation

used for estate or inheritance tax).

(The basis in your half will remain

one-half of the adjusted basis

determined in step 2.)

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

4 add the amounts from steps 2 and 3 and

enter the total on line 5 of a second

worksheet.

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

5 complete lines 6-13 of the second

worksheet, making adjustments to basis

only for events after your spouse's

death.

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

you owned your home jointly 1 skip lines 1-4 of the worksheet.

with your spouse who died ----------------------------------------

before 2010 and before the 2 enter the amount of your basis on line

casualty, and your permanent 5 of the worksheet. Generally, this is

legal home is in a community the fair market value of the home at

property state the time of death. (But see

Community

Property

Publication 551

for

special rules.)

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

3 fill out lines 6-13 of the worksheet,

making adjustments to basis only for

events after your spouse's death.

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

you owned your home jointly 1 fill out lines 1-13 of the worksheet,

with a nonspouse who died including adjustments to basis only

before 2010 and before the for events before the co-owner's

casualty death.

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

2 multiply the amount on line 13 by your

percentage of ownership to get the

adjusted basis of your part-interest

on the date of death.

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

3 multiply the fair market value on the

date of death (or later alternate

valuation used for estate or

inheritance tax) by the co-owner's

percentage of ownership. This is the

basis for the co-owner's

part-interest.

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

4 add the amounts from steps 2 and 3 and

enter the total on line 5 of a second

worksheet.

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

5 complete lines 6-13 of the second

worksheet, including adjustments to

basis only for events after the

co-owner's death.

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

your home was ever 1 on line 8 of the worksheet, enter any

damaged as a result of a amounts you spent to restore the home

prior casualty to its condition before the prior

casualty.

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

2 on line 11 enter:

any insurance reimbursements

you received (or expect to

receive) for the prior loss,

and

any deductible casualty losses

from prior years not covered

by insurance.

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

the person who sold you your on line 2 enter the seller-paid points

home paid points on your only if you deducted them as home

loan and you bought your mortgage interest in the year paid

home after 1990 but before (unless you used the seller-paid

April 4, 1994. points to reduce the amount on line

1).

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

the person who sold you your on line 2 enter the seller-paid points

home paid points on your even if you did not deduct them

loan and you bought your (unless you used the seller-paid

home after April 3, 1994 points to reduce the amount on line

1).

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

you used part of the you must allocate the entries on

property as your home and Worksheet A between the personal part

part of it for business or (column (a)) and the business/rental

to produce rental income part (column (b)).

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

none of these items apply fill out the entire worksheet.

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

Copy RID