Form N-66 (REV. 2004)
Page 2
Capital Gains and Losses
Caution: Use Schedule D-1 instead of Schedule D if the startup day was
(
Schedule D
after November 11, 1991. See instructions.)
Part I — Short-Term Capital Gains and Losses — Assets Held One Year or Less
(a) Description of property
(b) Date acquired
(c) Date sold
(d) Sale price
(e) Cost or other basis
(f) Gain (or loss)
(Example: 100 shares 7% preferred of “Z” Co.)
(mo., day, yr.)
(mo., day, yr.)
(see Instructions)
(see Instructions)
(col. (d) less (e))
1
2
Short-term capital gain from installment sales from federal Form 6252 ...........................................................................
2
3
Short-term capital loss carryover......................................................................................................................................
3
(
)
4
Net short-term capital gain (or loss) (combine lines 1 through 3).....................................................................................
4
Part II — Long-Term Capital Gains and Losses — Assets Held More Than One Year
5
6
Long-term capital gain from installment sales from federal Form 6252............................................................................
6
7
Capital gain distributions ..................................................................................................................................................
7
8
Enter gain, if applicable, from Schedule D-1 ....................................................................................................................
8
9
Long-term capital loss carryover ......................................................................................................................................
9
(
)
10
Net long-term capital gain (or loss) (combine lines 5 through 9) ......................................................................................
10
Part III — Summary of Parts I and II
11
Combine lines 4 and 10, and enter the net gain (or loss) here.........................................................................................
11
12
If line 11 is a gain, enter here and also on line 3, Section I (page 1)................................................................................
12
13
If line 11 is a loss, enter here and as a loss on line 3, Section I (page 1), the smaller of:
a
The amount on line 11; or
b
$3,000 ......................................................................................................................................................................
13
(
)
Part IV —
Computation of Capital Loss Carryovers From 2004 to 2005
(Complete this part if the loss on line 11 is more than the loss on line 13.)
14
Enter loss shown on line 4; if none, enter zero and go to line 19 .....................................................................................
14
15
Enter gain shown on line 10. If line 10 is blank or shows a loss, enter zero ...................................................................
15
16
Combine lines 14 and 15..................................................................................................................................................
16
17
Enter the smaller of line 13 or 16......................................................................................................................................
17
18
Subtract line 17 from line 16. This is your short-term capital loss carryover from 2004 to 2005 ...............................
18
19
Enter loss from line 10; if none, enter zero and skip lines 20 through 23.........................................................................
19
20
Enter gain shown on line 4. If line 4 is blank or shows a loss, enter zero .......................................................................
20
21
Combine lines 19 and 20..................................................................................................................................................
21
22
Subtract line 17 from line 13. (Note: If lines 15 through 18 are blank, enter the amount from line 13. ).........................
22
23
Subtract line 22 from line 21. This is your long-term capital loss carryover from 2004 to 2005 ................................
23