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4 NEAR FINAL DRAFT 8/1/24 4
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6 *241451* 6
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2024 Schedule M1CAT, Casualty and Theft
8 Do not complete Schedule M1CAT if you completed federal Form 4684 to report a net gain from a casualty or theft on your federal income tax return. 8
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10 FIRST NAME, INITXXXXX YOUR LAST NAMEXXXXXXXXXXXXXXXXXXXX 112233333 10
11 Your First Name and Initial Last Name Social Security Number 11
12 1 Description of properties, including the type, location, and date acquired for each property. Use a separate line for each property lost or damaged 12
13 from the same casualty or theft event. You must file a separate Schedule M1CAT for each casualty or theft event involving personal property. 13
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15 Property A PROPERTY A DESCRIPTIONXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 15
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17 Property B PROPERTY B DESCRIPTIONXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 17
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19 Property C PROPERTY C DESCRIPTIONXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 19
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21 Property D PROPERTY D DESCRIPTIONXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 21
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23 Property A Property B Property C Property D 23
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25 2 Cost or other basis (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . 2 123456789123456789123456789 12345678 25
26 3 Insurance or other reimbursement, whether or not you filed a claim 26
27 (see instructions) Note: If line 2 is more than line 3, skip line 4 . . . . . 3 12345678 12345678 12345678 12345678 27
28 4 Gain from casualty or theft. Subtract line 2 from 28
29 line 3 and skip lines 5 through 9 for that column . . . . . . . . . . . . . . . . . 4 12345678 12345678 12345678 12345678 29
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31 5 Fair market value before casualty or theft . . . . . . . . . . . . . . . . . . . . . . . 5 12345678 12345678 12345678 12345678 31
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33 6 Fair market value after casualty or theft . . . . . . . . . . . . . . . . . . . . . . . . 6 12345678 12345678 12345678 12345678 33
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35 7 Subtract line 6 from line 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 12345678 12345678 12345678 12345678 35
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37 8 Enter the smaller of line 2 or line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 1234678 1234678 1234678 12345678 37
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39 9 Subtract line 3 from line 8. If zero or less, enter 0 . . . . . . . . . . . . . . . . . 9 12345678 12345678 12345678 12345678 39
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41 10 Casualty or theft loss. Add the amounts on line 9 for Properties A through D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 12345678 41
42 (see instructions if you are filing multiple schedules for the same event) 42
43 11 Enter $100 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 $100 43
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45 12 See instructions before completing line 12. Subtract line 11 from line 10. If zero or less, enter 0. . . . . . . . . . . . . . . . . 12 12345678 45
46 13 If you had one casualty or theft event, enter the amount from line 12 46
47 If you had more than one event, see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 12345678 47
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49 14 Add the amounts on line 4 of all Schedules M1CAT you are filing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 12345678 49
50 15 If line 14 is greater than or equal to line 13, enter the difference here. STOP HERE and see instructions. 50
51 If line 14 is less than line 13, enter 0 here and continue to line 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 12345678 51
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53 16 Add lines 14 and 15. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 12345678 53
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55 17 Subtract line 16 from line 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 12345678 55
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57 18 Enter the amount from line 1 of Form M1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 12345678 57
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59 19 Multiply line 18 by 10% (.10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 12345678 59
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61 20 Subtract line 19 from line 17. If the result is zero or less, enter 0. Enter the result on line 19 of Schedule M1SA . . . . 20 12345678 61
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