Form 8949

Department of the Treasury 

Internal Revenue Service (99) 

Sales and Other Dispositions of Capital Assets

▶ See Instructions for Schedule D (Form 1040).

▶ For more information about Form 8949, see www.irs.gov/form8949

▶ Attach to Schedule D to list your transactions for lines 1, 2, 3, 8, 9, and 10.

OMB No. 1545-0074

2011

Attachment 

Sequence No. 12A

Name(s) shown on return Your social security number

Part I Short-Term Capital Gains and Losses—Assets Held One Year or Less

Note: You must check one of the boxes below. Complete a separate Form 8949, page 1, for each box that is checked.

*Caution. Do not complete column (b) or (g) until you have read the instructions for those columns (see the Instructions for Schedule 

D (Form 1040)). Columns (b) and (g) do not apply for most transactions and should generally be left blank.

(A) Short-term transactions reported on 

Form 1099-B with basis reported to the IRS

(B) Short-term transactions reported on Form 

1099-B but basis not reported to the IRS

(C) Short-term transactions for which 

you cannot check box A or B

1

(a) 

Description of property 

(Example: 100 sh. XYZ Co.)

(b) 

Code, if any, 

for column (g)*

(c) 

Date acquired 

(Mo., day, yr.)

(d) 

Date sold 

(Mo., day, yr.)

(e) 

Sales price 

(see instructions)

(f) 

Cost or other basis 

(see instructions)

(g) 

Adjustments to 

gain or loss, if any*

2 Totals. Add the amounts in columns (e) and (f). Also, combine the

amounts in column (g). Enter here and include on Schedule D, line 1 (if 

box A above is checked), line 2 (if box B above is checked), or line 3 (if 

box C above is checked) . . . . . . . . . . . . . . . ▶ 2

For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 37768Z Form 8949 (2011) 
Form 8949 (2011) Attachment Sequence No. 12A Page 2

Name(s) shown on return. Do not enter name and social security number if shown on other side. Your social security number

Part II Long-Term Capital Gains and Losses—Assets Held More Than One Year

Note: You must check one of the boxes below. Complete a separate Form 8949, page 2, for each box that is checked.

*Caution. Do not complete column (b) or (g) until you have read the instructions for those columns (see the Instructions for Schedule 

D (Form 1040)). Columns (b) and (g) do not apply for most transactions and should generally be left blank.

(A) Long-term transactions reported on 

Form 1099-B with basis reported to the IRS

(B) Long-term transactions reported on Form 

1099-B but basis not reported to the IRS

(C) Long-term transactions for which 

you cannot check box A or B

3

(a) 

Description of property 

(Example: 100 sh. XYZ Co.)

(b) 

Code, if any, 

for column (g)*

(c) 

Date acquired 

(Mo., day, yr.)

(d) 

Date sold 

(Mo., day, yr.)

(e) 

Sales price 

(see instructions)

(f) 

Cost or other basis 

(see instructions)

(g) 

Adjustments to 

gain or loss, if any*

4 Totals. Add the amounts in columns (e) and (f). Also, combine the

amounts in column (g). Enter here and include on Schedule D, line 8 (if 

box A above is checked), line 9 (if box B above is checked), or line 10

(if box C above is checked) . . . . . . . . . . . . . . ▶ 4

Form 8949 (2011)