Section A: Personal use property

(To report casualties and thefts of property not used in a trade or business or for income-producing purposes, complete this section.)

1 Description of properties (show type, location, and date acquired for each property). For each property lost or damaged from the same casualty or theft, complete a separate line. You must complete a separate worksheet (through line 12) for each casualty or theft event involving personal use property.

Property A

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Property B

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Property C

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Property D

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List List Properties List List A B C D 2 Cost or other basis of each property 2 3 Insurance or other reimbursement (whether or not you filed a claim) (see instructions) Note: If line 2 is more than line 3, skip line 4. 3 4 Gain from casualty or theft. If line 3 is more than line 2, enter the difference here and skip lines 5 through 9 for that column. If line 3 is less than line 2, enter 0 and continue with line 5. See instructions if line 3 includes insurance or other reimbursement you did not claim, or you received a payment for your loss in a later tax year 4 5 FMV before casualty or theft (see instructions) 5 6 FMV after casualty or theft (see instructions) 6 7 Subtract line 6 from line 5 7 8 Enter the smaller of line 2 or line 7 8 9 Subtract line 3 from line 8. If zero or less, enter 0 9 10 Casualty or theft loss. Add the amounts on line 9 in columns A through D 10 11 Limitation per casualty. (If you have a qualified disaster loss, see instructions) 11 100 12 Subtract line 11 from line 10. If zero or less, enter 0 Complete only one worksheet for lines 13 through 18. 12 13 Add the amounts on line 12 of all casualty and theft worksheets 13 14 Add the amounts on line 4 of all casualty and theft worksheets See the instructions before completing line 15. 14 15 If line 14 is more than line 13, enter the difference here. You have a net gain, see the instructions; do not complete lines 16 through 18 If line 14 is equal to line 13, enter 0 here. Do not complete the rest of this section. If line 14 is less than line 13, see instructions. 15 16 Add lines 14 and 15. Subtract the result from line 13 and enter the difference here 16 17 Enter 10% of your federal AGI from Form IT-201, line 19 or IT-203, line 19 ( Federal amount column; see instructions) 17 18 Subtract line 17 from line 16. Enter the result here and on Form IT-196, line 20. If the amount is zero or less, enter 0 . 18