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Identification number Short-Term Capital Gains and Losses Assets Held One Year or Less (a) Description of property (Example: 100 shares of Z Co.) OMB No. 1545-0130 (b) Date acquired (mo., day, yr.) (c) Date sold (mo., day, yr.) (d) Sales price (e) Cost or other basis (see instructions) (f) Gain or (loss) (Subtract (e) from (d)) 1 2 3 4 5 6 Short-term capital gain from installment sales from Form 6252, line 26 or 37 . Short-term capital gain or (loss) from like-kind exchanges from For.

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