Schedule
Income Tax Deferral of
CG
2012
Long-Term Capital Gain
Wisconsin
Department of Revenue
Enclose with Wisconsin Form 1 or 1NPR
Your name
Your social security number
Spouse’s name if filing a joint return
Spouse’s social security number
1 Date asset sold that generated the long-term capital gain . . . . . . . . . . . . . . . . . . . . .
2 Description of asset sold
.00
3 Amount of long-term capital gain on sale of the asset . . . . . . . . . . . . . . . . . . . . . .
3
4 Amount of gain deposited in a segregated account in a financial institution
(do not fill in more than $10,000,000 if investing in a “qualified new business venture”)
.00
. . . . . .
4
5 Name of financial institution
6 Date gain deposited in the financial institution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7 Date of investment in a “qualified new business venture” or in a “qualified
Wisconsin business” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8 If investment is in a “qualified new business venture,” fill in name of “qualified new
business venture”
9 If investment is in a “qualified Wisconsin business,” fill in name of the “qualified
Wisconsin business”
10 Amount invested in the “qualified new business venture” or “qualified Wisconsin
business.” (Line 10 must equal or exceed line 4.) . . . . . . . . . . . . . . . . . . . . . . . . . 10
.00
11 Basis of investment in the “qualified new business venture” or “qualified
Wisconsin business” (line 10 less the amount on line 4) . . . . . . . . . . . . . . . . . . . . 11
.00
INSTRUCTIONS FOR SCHEDULE CG
Purpose of Schedule CG
Who may claim the deferral of gain
Schedule CG must be completed by individuals who are not
The deferral of gain may be claimed by an individual,
declaring income from a long-term capital gain on their 2012
including an individual partner of a partnership, member of a
Wisconsin income tax return (Schedule WD) because they
limited liability company, or shareholder of a tax-option (S)
have reinvested the capital gain.
corporation.
Wisconsin law provides that the long-term capital gain may
Definitions
be deferred when certain conditions are met and the gain is
reinvested in either (1) a “qualified new business venture” or
“Financial institution” means any bank, savings bank,
(2) a “qualified Wisconsin business.”
savings and loan association or credit union that is authorized
to do business under state or federal laws relating to financial
institutions.
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