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Tax Loss Harvesting Form

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TAX LOSS HARVESTING AUTHORIZATION

Taxpayer Identification

Taxpayer Name:

Entity Type (select applicable):

Taxpayer Identification Number

Provide either Social Security Number or Employer Identification Number (do not enter both).

Account and Contact Information

Harvest Instructions

Effective Harvest Date:

Lot Selection Preference:

Assets to be Sold (List specific lots where applicable)

Provide up to six (6) securities. For specific lot sales, specify lot ID and acquisition date. Use additional pages if necessary.

1. Security: Ticker: CUSIP: Shares / Units:

Acquisition Date: Cost Basis: Lot ID: Action: Desired Sale Date:

2. Security: Ticker: CUSIP: Shares / Units:

Acquisition Date: Cost Basis: Lot ID: Action: Desired Sale Date:

3. Security: Ticker: CUSIP: Shares / Units:

Acquisition Date: Cost Basis: Lot ID: Action: Desired Sale Date:

4. Security: Ticker: CUSIP: Shares / Units:

Acquisition Date: Cost Basis: Lot ID: Action: Desired Sale Date:

5. Security: Ticker: CUSIP: Shares / Units:

Acquisition Date: Cost Basis: Lot ID: Action: Desired Sale Date:

6. Security: Ticker: CUSIP: Shares / Units:

Acquisition Date: Cost Basis: Lot ID: Action: Desired Sale Date:

Replacement Strategy and Notes

Wash Sale Acknowledgement and Tax Consequences

I acknowledge that sales executed pursuant to this authorization may be subject to the wash sale rules under applicable tax law. I understand that acquiring substantially identical securities within the wash sale window may disallow or defer the recognition of losses for tax reporting purposes, and that adjustments to cost basis and holding periods may be required.

I understand that neither the advisor nor the custodian guarantees any particular tax result and that final tax treatment depends on the facts and circumstances of each sale and the application of governing tax rules. I accept sole responsibility for the preparation and accuracy of tax returns and will consult a qualified tax professional regarding the tax consequences of these transactions.

Certifications and Authorization (Numbered)

1. I certify that the information provided on this form is true, correct and complete to the best of my knowledge and that I am authorized to provide instructions for the account identified above.

2. I authorize the advisor and custodian named on this form to identify, prepare and execute the sale of the securities listed above consistent with my instructions, and to purchase replacement securities as described. I understand that execution is subject to market conditions and custodian/broker processes.

3. I acknowledge that cost basis reporting may be performed by the custodian and that adjustments may be required for disallowed losses resulting from wash sales. I authorize the custodian to report cost basis and sales proceeds to taxing authorities as required by law.

4. I agree to indemnify and hold harmless the advisor, its affiliates and the custodian from any claims, losses, damages or liabilities arising from the implementation of these instructions, except for losses resulting from the gross negligence or willful misconduct of the party sought to be indemnified.

5. I acknowledge that the advisor and custodian are not providing tax advice by executing transactions under this authorization. I will seek independent tax advice concerning any tax consequences of these transactions.

6. Under penalties of perjury, I certify that the taxpayer identification number provided on this form is correct and that I am not subject to backup withholding (unless I have been notified otherwise).

Taxpayer Printed Name:

Signature:

Date:

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What the Tax Loss Harvesting Form Is and when it’s used

The Tax Loss Harvesting Form is a record used by investors, advisors, and broker-dealers to document realized capital losses from specific dispositions of securities and other assets. It captures trade-level details — trade date, settlement date, security description, lot quantity, cost basis, proceeds, and wash-sale indicators — so losses can be matched to gains on Schedule D and Form 8949 for federal tax reporting. Firms often use an internal or broker-provided harvesting worksheet; the form is not a standalone IRS filing but supports accurate tax returns and audit documentation.

Why keeping a clear Tax Loss Harvesting Form matters

A complete form preserves tax savings by documenting deductible losses, supports correct Schedule D and Form 8949 reporting, reduces audit risk, and helps apply wash-sale rules correctly. Accurate records also make year-end accounting and advisor review more efficient.

Why keeping a clear Tax Loss Harvesting Form matters

Who typically completes and receives this form

Maintain a copy with your tax records and provide a signed or electronically authenticated version to the preparer, advisor, or custodian as required.

  • Individual investors and households who realize capital losses and prepare their own returns or provide records to a tax preparer.
  • Registered investment advisors and portfolio managers who harvest losses on client accounts and need a standardized client record.
  • Broker-dealers and custodial firms that generate lot-level statements and share harvesting worksheets with clients or their tax professionals.

Step-by-step: completing the Tax Loss Harvesting Form

Follow these steps to produce a reliable, auditable harvesting record before you attach results to tax returns or share with an advisor.

  • 01
    Collect records: Gather trade confirmations and brokerage cost-basis reports for the tax year.
  • 02
    Identify loss lots: Select specific lots sold and confirm acquisition dates to detect short‑term vs long‑term status.
  • 03
    Apply wash sale rules: Flag any repurchases within 30 days and adjust basis or disallow loss as required.
  • 04
    Finalize and share: Sign, date, and deliver the form to your preparer or upload to custodian records.

Typical eSignature vendor pricing and capabilities for signing harvesting forms

Comparing basic plan price, trial availability, bulk-send support, audit trails, HIPAA compliance, and envelope limits can help choose an eSignature provider for high-volume tax record workflows.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Varies by vendor Varies by vendor Varies by vendor Varies by vendor
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
Envelope Cap No cap 100 envelopes/user/yr Varies Varies Varies

Security and compliance controls to protect harvesting records

Transport Encryption: TLS 1.2/1.3
Data at Rest: AES-256 encryption
Certifications: SOC 2 Type II, ISO 27001
Regulatory Compliance: ESIGN, UETA, HIPAA (BAA available)
Audit Trail: Timestamped actions and IP log
Accessibility: WCAG 2.0 Level AA

Key penalties and tax risks to avoid

Incorrect TIN: Backup withholding 24%
Late reporting: IRC §6721 penalties apply
Intentional disregard: $660+ per misfiled form
Wash-sale errors: Loss disallowed; basis adjustments required
Mismatched names: Processing delays and verification
Insufficient records: Increased audit exposure

Common preparation mistakes to watch for

  • Not flagging wash-sale repurchases across taxable and tax-advantaged accounts, which can lead to disallowed losses and incorrect basis adjustments.
  • Relying on aggregated reports without lot-level reconciliation, causing short-term and long-term holding period misclassification on Form 8949.
  • Entering truncated security identifiers (missing CUSIP) that result in misapplied cost basis between similar tickers or corporate actions.
  • Failing to capture trade settlement versus trade date differences when brokers report on different bases, producing inconsistent reported results.

Typical eSubmission workflow for a completed harvesting form

A standard digital workflow speeds review, retains an audit trail, and ensures signed records are reproducible for tax or audit purposes.

  • Upload form: Attach PDF or DOCX of the completed worksheet
  • Place fields: Add signature, date, and initial fields where needed
  • Authenticate signer: Use email link, SMS code, or stronger methods
  • Store & share: Save encrypted copy and send signer receipt

Recommended eSignature settings for harvesting forms

Configure the following settings to balance legal validity and signer convenience for tax record workflows.

Field Configuration
Signature Type Electronic signature with timestamp and audit trail
Authentication Email + optional SMS code for additional verification
Storage Encrypted cloud storage with access controls
Notifications Email confirmation to all parties upon completion

Technical considerations for choosing an eSignature platform

Confirm BAA availability for healthcare-related accounts and 21 CFR Part 11 support for FDA-regulated workflows where applicable.

  • Integrations: Salesforce, NetSuite, Microsoft 365, Google Workspace
  • Formats: PDF, DOCX, HTML and Excel support
  • Authentication: Email, SMS, KBA, and SSO options

Practical examples of how the form is used

Two concise scenarios show typical uses of a Tax Loss Harvesting Form and the outcomes for recordkeeping and tax reporting.

Advisory Firm Scenario

An advisor documents realized losses across ten client accounts to offset capital gains

  • The firm flags wash sales and updates lot bases across taxable and IRA accounts
  • The consolidated harvesting form reduced manual reconciliation time and provided clear backup for Schedule D adjustments.

Individual Investor

A retail investor records three sale lots with differing acquisition dates

  • The form identifies one short-term and two long-term losses and notes a 30-day repurchase
  • The investor provided the form to their CPA, who used it to prepare Form 8949 and confirm allowable deductions.

Best practices for accurate, audit-ready harvesting records

Adopt these practices to reduce errors and preserve the tax benefits of realized losses.

Record lot-level details consistently
Capture acquisition date, lot identifier, purchase price, and quantity for every lot to ensure correct short-term/long-term classification and avoid basis misallocation.
Document wash-sale chains
When repurchases occur within 30 days, document replacement lots, disallowed loss amounts, and basis adjustments to maintain a defensible tax position.
Reconcile with broker statements
Match your harvesting form to broker-provided cost-basis reports and trade confirmations before finalizing numbers for tax returns.
Retain supporting evidence
Keep electronic copies of confirmations, statements, and the signed form for at least three years, longer if large understatements or state rules apply.

Timing considerations and common deadline touchpoints

While the harvesting form itself is an internal record, timing affects reporting and withholding obligations tied to tax deadlines.

Provide to preparer:

As soon as possible before Form 1040 filing (April 15 typical)

File Form 1040:

April 15 (extension to Oct 15 with Form 4868)

1099/1099-NEC deadlines:

Recipient and IRS deadlines (e.g., Jan 31 for many 1099s) affect withholding references

Broker statements:

Year-end cost-basis statements available early January; reconcile promptly

Record retention:

Keep records for at least 3 years from filing per IRS guidance

Frequently asked questions about the Tax Loss Harvesting Form

Answers to common questions about form purpose, wash-sale handling, signing authority, and record retention for tax reporting and audits.


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