Instructions For Form 4684 - Casualties And Thefts

partnerships), enter on Form 1065,

Line 40

Line 46

Schedule K, line 13d. Electing large

Enter the initial amount of cash or basis of

Potential third-party recovery. This is the

partnerships, enter on Form 1065-B, Part II,

property that you invested in the investment

line 11. S corporations, enter on Form

amount of all actual or potential claims for

arrangement. Don't include any of the

recovery, as of the last day of the discovery

1120S, Schedule K, line 12d. Next to that

following on this line, line 41, or line 42.

year (defined earlier), that are not from

line, enter “Form 4684.”

Amounts borrowed from the responsible

potential insurance or Securities Investor

group and invested in the specified

Protection Corporation (SIPC) recovery, or a

Line 33

fraudulent arrangement, to the extent the

potential direct recovery.

borrowed amounts weren't repaid at the time

If you had a casualty or theft gain from

Potential insurance/SIPC recovery. This

the theft was discovered.

certain trade, business, or income-producing

is the total of all actual or potential claims for

Amounts such as fees that were paid to

property held more than 1 year, you may

reimbursement that, as of the last day of the

the responsible group and deducted for

have to recapture part or all of the gain as

discovery year, are attributable to:

federal income tax purposes.

ordinary income. See the instructions for

Insurance policies in your name that

Amounts reported to you (the qualified

Form 4797, Part III, for more information on

protect you from this type of loss;

investor) as taxable income that weren't

the types of property subject to recapture. If

Contractual arrangements, other than

included in gross income on the investor's

recapture applies, complete Form 4797, Part

insurance, that guaranteed or otherwise

federal income tax returns.

III, and this line, instead of Form 4684,

protected against this type of loss; or

Cash or property that you (the qualified

line 34.

Amounts payable from SIPC, as

investor) invested in a fund or other entity

advances for customer claims under the

(separate from you (the qualified investor) for

Line 35

Securities Investor Protection Act of 1970, or

federal income tax purposes) that invested in

by a similar entity under a similar provision.

a specified fraudulent arrangement.

Include in the total any amounts from the

additional sheet you attached because you

Potential direct recovery. This is the

For definitions of responsible group,

had more than two casualties or thefts.

amount of all actual or potential claims for

specified fraudulent arrangement, and

recovery, as of the last day of the discovery

qualified investor, see Section 4 of Revenue

Line 38a

year (defined earlier), against the

Procedure 2009-20.

responsible individual or group.

Taxpayers, other than partnerships and S

corporations, if Form 4797 isn't otherwise

Line 41

Line 48

required, enter the amount from this line on

Enter the amounts of cash or the basis of

page 1 of your tax return, on the line

Enter the amounts you actually received as a

property that you invested after you made

identified as from Form 4797. Next to that

reimbursement or recovery from any source.

the initial investment (including amounts

line, enter “Form 4684.”

Don't include amounts that are potential

reinvested).

direct recoveries (defined earlier) or potential

Section C—Theft Loss

third-party recoveries (defined earlier).

Deduction for Ponzi-Type

Line 42

Investment Scheme Using the

Line 49

Enter the total amounts of net income (for

Procedures in Revenue

example, interest and dividends minus

Enter the amount of potential insurance/

expenses) from the specified fraudulent

Procedure 2009-20

SIPC recovery (defined earlier).

arrangement that, consistent with information

Fill out Section C if you claim a theft loss

received from that arrangement, you

deduction for a Ponzi-type investment

Line 51

included in income for federal tax purposes

scheme and you meet both of the following

for all tax years before the discovery year,

Enter the amount from line 51 on line 28 of

conditions.

including tax years for which a refund is

Section B. Don't complete lines 19 to 27 for

You qualify to use Revenue Procedure

barred by the statute of limitations.

this loss. Then complete Section B, Part II.

2009-20, as modified by Revenue Procedure

Discovery year. The discovery year is the

2011-58.

If you had other casualties or thefts,

tax year when one of the following occurs.

You choose to follow the procedures in

fill out a separate Section B, Part I,

TIP

The indictment, information, or complaint

the guidance.

for them.

described in section 4.02(1) or (2) of

If you meet both conditions, fill out

Revenue Procedure 2009-20 (as modified by

Section C in lieu of Appendix A in Revenue

Revenue Procedure 2011-58) is filed.

Part II

Procedure 2009-20.

The complaint or similar document

Read the statements and declarations in this

For more information about claiming a

described in section 4.02(3) of Revenue

part carefully. Enter the required information

theft loss deduction from a Ponzi-type

Procedure 2009-20 (as modified by Revenue

in the spaces provided. You are agreeing to

investment scheme, see the following

Procedure 2011-58) is filed, or the death of

these statements and declarations when you

guidance.

the lead figure occurs, whichever is later.

sign your tax return. The information you

Revenue Ruling 2009-9, 2009-14 I.R.B.

enter in this part will be used to verify the

735 (available at

IRS.gov/irb/2009-14_IRB/

Line 44

fraudulent investment arrangement.

ar07.html).

Revenue Procedure 2009-20, 2009-14

Enter the total amount of cash or property

Section D—Election To Deduct

I.R.B. 749 (available at

IRS.gov/irb/

that you withdrew from the investment

Federally Declared Disaster

2009-14_IRB/ar11.html).

arrangement in all years (whether

Loss in Preceding Tax Year

Revenue Procedure 2011-58, 2011-50

designated as income or principal).

I.R.B. 849 (available at

IRS.gov/irb/

Read the discussion under

Disaster

Losses,

2011-50_IRB/ar11.html).

Line 45

earlier. Then fill out Section D if you want to

elect to deduct a disaster loss on your tax

Don't fill out Section C if you don't

This is the amount of your investment that is

return for the preceding year as long as the

qualify to use the procedures in

eligible for a deduction before any actual or

loss was attributable to a federally declared

Revenue Procedure 2009-20, as

potential recoveries are taken into account.

CAUTION

disaster, occurred in a federally declared

modified by Revenue Procedure 2011-58, or

disaster area, and was sustained in the

you don't choose to follow them. Instead, go

disaster year. You may also fill out Section D

to the instructions for Section B.

-7-

Instructions For Form 4684 - Casualties And Thefts - 2017 Page 7

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