1206710053
PA SCHEDULE D-IV
Sale, Exchange or Disposition of Property
Outside Pennsylvania
2012
PA-20S/PA-65 D
(05-12) (FI)
OFFICIAL USE ONLY
Name as shown on the PA-20S/PA-65 Information Return
FEIN
9 DIGIT - NO DASH
START
C
Part IV.
Sale, Exchange or Disposition of Property outside Pennsylvania.
If any of the federal gain (loss) transactions require adjustment, list
each transaction and show the differences in federal gain (loss). The difference in PA/federal gain (loss) equals PA gain (loss) minus federal gain (loss). If the difference is
negative, fill in the loss oval. Copy PA-20S/PA-65 Schedule D-IV to list additional properties. Enter whole dollars only.
Type of Property: R=Real P=Personal S=Security O=Other Intangible (not security)
Amended Schedule
If Part IV is blank, fill in the oval
1 Type of Property
Description of Property:
(MMDDYYYY)
Date acquired
MM/DD/YYYY
PA allowed or allowable depreciation
Cost or other PA basis
If a loss, enter "0"
If a loss, enter "0"
DOLLARS ONLY. NO CENTS.
Gross sales price
Difference in PA/Fed Gain (Loss)
Date sold
MM/DD/YYYY
(MMDDYYYY)
LOSS
If a loss, enter "0"
2 Type of Property
Description of Property:
(MMDDYYYY)
MM/DD/YYYY
PA allowed or allowable depreciation
Cost or other PA basis
Date acquired
If a loss, enter "0"
If a loss, enter "0"
DOLLARS ONLY. NO CENTS.
(MMDDYYYY)
MM/DD/YYYY
Gross sales price
Difference in PA/Fed Gain (Loss)
Date sold
LOSS
If a loss, enter "0"
3 Type of Property
Description of Property:
MM/DD/YYYY
Date acquired
(MMDDYYYY)
PA allowed or allowable depreciation
Cost or other PA basis
If a loss, enter "0"
If a loss, enter "0"
DOLLARS ONLY. NO CENTS.
Date sold
(MMDDYYYY)
MM/DD/YYYY
Gross sales price
Difference in PA/Fed Gain (Loss)
LOSS
If a loss, enter "0"
4 Type of Property
Description of Property:
Date acquired
(MMDDYYYY)
MM/DD/YYYY
PA allowed or allowable depreciation
Cost or other PA basis
If a loss, enter "0"
If a loss, enter "0"
DOLLARS ONLY. NO CENTS.
Gross sales price
Difference in PA/Fed Gain (Loss)
Date sold
(MMDDYYYY)
MM/DD/YYYY
LOSS
If a loss, enter "0"
5 Type of Property
Description of Property:
(MMDDYYYY)
Date acquired
MM/DD/YYYY
PA allowed or allowable depreciation
Cost or other PA basis
If a loss, enter "0"
If a loss, enter "0"
DOLLARS ONLY. NO CENTS.
MM/DD/YYYY
Gross sales price
Difference in PA/Fed Gain (Loss)
Date sold
(MMDDYYYY)
LOSS
If a loss, enter "0"
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