4 797 Supplemental Schedule of Gains and Losses {OMB No, 1545-0184
Form (Includes Gains and Losses From Sales or Exchanges of Assets 1 984
Department of the Treasury Used in a Trade or Business and Involuntary Conversions)
Internal Revenue Service To be filed with Forms 1040, 1041, 1065, 1120S, 1120, etc.—See Separate Instructions
Name(s) as shown on return Identifying number

E2aea] Sales or Exchanges of Property Used in a Trade or Business, and Involuntary Conversions From Other Than
Casualty and Theft—Property Held More Than 1 Year (6 Months if Acquired After 6/22/84) (Except for
Certain Livestock)
Note: Use Form 4684 to report involuntary conversions from casualty and theft.
Caution: If you sold property on which you claimed the investment credit, you may be liable for recapture of that credit.
‘See Form 4255 for additional information.
Note: /f you report a loss below and have amounts invested in the activity for which you are not at risk, you will have to file Form 6198. (See
instructions under ‘‘Special Rules.”)

e.Depreciation | £. Costor other Loss
a. Description of | b, Date acquired . Date sold d. Gross sales allowed basis, plus Singsin h.GAIN
property (mo., day, yr.) (mo., day, yr.) price (or allowable) improvements and fd nde (dplus e minus f)
since acquisition expense of sale sum of dande)
1
2 Gain, if any, from Form 4684, Section B,line21. . . . .
3 Section 1231 gain from installment sales from Form 6252, line 22 or 30..
4 Gain, if any, on line 28 from other than casualty and theft. Lo
5 Add lines 1 through 4 incolumngandcolumnh. . . . Lo 2. )
6 Combine columns g and h of line 5. Enter gain or (loss) here, and rd on the appropriate ine as follows:
(@) For all except partnership returns:
(1) If line 6 is a gain, enter the gain as a long-term capital gain on Schedule D. See specific instructions for Part |.
(2) If line 6 is zero or a loss, enter that amount on line 7. (S corporations, enter on Schedule K (Form 1120S), line 6.)
(b) For partnership returns: Enter each partner's share of line 6 above, on Schedule K-1 (Form 1065), line 7.
ixagig Ordinary Gains and Losses
Depreciation |. Cost or other Loss
a.Descriptionof | b. Date acquired . Date sold . Gross sales allowed basis, plus Sines the GAIN
property (mo., day, yr.) (mo., day, yr.) price (or allowable) improvements and sum of dande) (d plus e minus f)
since acquisition expense of sale
7 Loss, ifany, fromline6(a2) 2. ee Mi

8 Gain, ifany, online27_.
9. Net gain or (loss) from Form 4684, Section B, lines 13 and 20(a) . La
10 Ordinary gain from installment sales from Form 6252, line 21 or 29 (Applies only to sales before 6/7/84) .

11 Recapture of section 179 deduction (see instructions)...
12. Other ordinary gains and losses (include property held 1 year or less, (6 months or less if acquired after 6/22/84): HM lj;
13 Addlines 7 through 12incolumngandcolumnh . ww. we ee ee ee ee ee Lb )

14 Combine columns g and h of line 13. Enter gain or (loss) here, and on the appropriate line as follows:
(a) For all except individual returns: Enter the gain or (loss) from line 14, on the return being filed. See instructions for Part Il for
specific line references. Uf
(b) For individual returns: h
(1) If the loss on line 7 includes a loss from Form 4684, Section B, Part Ii, column B(ii), enter that part of the loss here and on
line 19 of Schedule A (Form 1040). Identify as from “Form 4797, line 14(b)(1)". a
(2) Redetermine t the gain or (loss) on line 14, excluding the loss (if any) oF on line ue). Enter here and on Form "1040,
ine 1
For Paperwork Reduction Act Notice, see page Tof separate instructions. Form 4797 (1984)



Form 4797 (1984) Page 2

Gain From Disposition of Property Under Sections 1245, 1250, 1252, 1254, 1255
Skip section 1252 on line 23 and in the instructions, if you did not dispose of farmland, or if a partnership files this form.

15 Description of sections 1245, 1250, 1252, 1254, and 1255 property: Cate acauired nese)
@)
8)
©
(0)
Property Property Property Property
Relate lines 15(A) through 15(D) tothese columns > b> > > @) @®) «) @)

16 Gross sales price .
17 Cost or other basis plus expense eof sale .
18 Depreciation (or depletion) allowed (or allowable) .
19 Adjusted basis, subtract line 18 from line 17
20 _ Total gain, subtract line 19 from line 16.
21 If section 1245 property:
(a) Depreciation allowed (or allowable) (see instructions) ,

(b) Enter smaller of line 20 or 21(a) _

22 _ If section 1250 property: (If straight line depreciation used, enter zero
an tine 22() unless you ae a corporation subject to section 291.)
(a) Additional depreciation after 12/31/75. « :

(b) Applicable percentage times the smaller of line 20 or rine 2240)
(see instructions).
(c) Subtract line 22(a) from line 20. If ine 20 is not more than line
22(a), skip lines 22(d)and22(e) . . . . .
(a) Additional depreciation after 12/31/69 and before 1/1/76 .
(e) Applicable percentage times the smaller of line 22(c) or 22(d) (see
instructions) .
(f) Section 291 amount (For Corporations only.).
(g)_Add lines 22(b), 22(e), and 22(f)_
23 If section 1252 property:
(a) Soil, water, and landclearingexpenses . . . 1 1 1 we
(b) Line 23(a) times applicable percentage (see instructions) . . .
(c)_Enter smaller of line 20 or 23(b) a
24 If section 1254 property:
(a) Intangible drilling and development costs deducted after
12/31/75 (see instructions) . . . . 1 eee
(b) Enter smaller of line 20 or 24(a)
25 If section 1255 property:

(2) Applicable percentage of payments excluded from income under
section 126 (see instructions). . . . a

(b) Enter the smaller of line 20 or 25(a) .
Summary of Part Ill Gains (Complete Property columns A) through (D) through line 25(b) before going to line 26)

26 Total gains for all properties (add columns (A) through (D),line20). . . Soe
27 Add columns (A) through (0), lines 21(b), 22(@), 23(c), 24), and 25(b). Enter here and on Part line 8.

28 Subtract line 27 from line 26. Enter the portion from casualty and theft on Form 4684, Section B, line 15; enter the parton from
other than casualty and theft on Form 4797, Part, line 4.

Complete this Part Only if You Elect Out of the Installment Method And Report a Note or Other Obligation at
Less Than Full Face Value

1 Check here if you elect out of the installment method.

Enter the face amount of the note or other obligation >
Enter the percentage of valuation of the note or other obligation