You may omit
printing the expiration date on this form. Also, you may continue
to use previous versions of this form. Approved with the
understanding that the Department will submit an Inventory
Correction Worksheet with final revisions to the instructions for
review prior to printing the form.
Inventory as of this Action
Requested
Previously Approved
08/31/1993
08/31/1993
09/30/1990
300,000
0
300,000
924,000
0
888,000
0
0
0
FORM 4684 IS USED BY TAXPAYERS TO
COMPUTE THEIR GAIN OR LOSS FROM CASUALTY AND THEFTS, AND TO
SUMMARIZE SUCH GAINS AND LOSSES. THE DATA IS USED TO VERIFY THAT
THE CORRECT GAIN OR LOSS HAS BEEN COMPUTED.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.