Form Il-4644 - Gains From Sales Of Employer'S Securities Received From A Qualified Employee Benefit Plan

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Illinois Department of Revenue
Gains from Sales of Employer’s Securities
IL-4644
Received from a Qualified Employee Benefit Plan
IL Attachment No. 20
Attach this form and a copy of your federal Schedule D to your Form IL-1040 or Form IL-1041.
Step 1: Provide the following information
1
This form is for calendar year
or other taxable year beginning
and ending
.
Year
Month
Year
Month
Year
2
Write your name as shown on your Form IL-1040 or Form IL-1041.
3
Write your Social Security number or federal employer identification number.
4
Check one
Individual
Estate or trust
Step 2: Provide general security information
Column A
Column B
Column C
Column D
Description of security
Date distributed
Date sold
Federal gain
(List each sale separately)
(month, year)
(month, year)
on disposition
5
00
6
00
7
00
8
00
Step 3: Calculate net unrealized appreciation
Column E
Column F
Column G
Column H
Market value of stock
Federal tax basis of stock
Column E minus Column F
Lesser of Columns G or D
on date of distribution
on date of distribution
(If Column F is greater than
(See instructions.)
(See instructions.)
Column E, write zero.)
9
00
00
00
00
10
00
00
00
00
11
00
00
00
00
12
00
00
00
00
13
13
Write the total here and on Form IL-1040, Line 5 or Form IL-1041, Line 14.
00
If you must file a Schedule F (because Line 18 below is a gain), also write this amount on Form IL-1040, Schedule F, Line 13, or
Form IL-1041, Schedule F, Line 14.
Step 4: Identify securities received in a distribution prior to August 1, 1969
Column I
Column J
Column K
Column L
Column M
August 1, 1969, value
Federal tax basis
Column I minus Column J
The greater of Columns H or K
Subtract Column H
or applicable fraction
August 1, 1969
or fraction in Column I times
but not greater than Column D
from Column L
(See instructions.)
(See instructions.)
Column D (See instructions.)
14
_________________
00
00
00
00
15
_________________
00
00
00
00
16
_________________
00
00
00
00
17
_________________
00
00
00
00
18 Total
18
00
If this amount is a gain, you must complete Schedule F. Write this amount on Form IL-1040, Schedule F, Line 3 or Form IL-1041, Schedule F, Line 3.
*361801110*
This form is authorized as outlined under the Illinois Income Tax Act. Disclosure of
IL-4644 front (R-12/13)
this information is required. Failure to provide information could result in a penalty.

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