Form 3921 - Exercise Of An Incentive Stock Option Under Section 422(B) Page 4
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7Instructions for Employee
Box 1. Shows the date the option to purchase the stock was
granted to you.
You have received this form because your employer (or transfer
Box 2. Shows the date you exercised the option to purchase the
agent) transferred your employer’s stock to you pursuant to your
stock.
exercise of an incentive stock option (ISO). You must recognize
(report) gain or loss on your tax return for the year in which you
Box 3. Shows the exercise price per share of stock.
sell or otherwise dispose of the stock. Keep this form and use it to
Box 4. Shows the fair market value (FMV) of a share of stock on
figure the gain or loss. For more information, see Pub. 525,
the date the option was exercised.
Taxable and Nontaxable Income.
Box 5. Shows the number of shares of stock transferred to you
When you exercise an ISO, you may have to include in
pursuant to the exercise of the option.
alternative minimum taxable income a portion of the fair market
Box 6. Shows the name, address, and TIN of the corporation
value of the stock acquired through the exercise of the option. For
whose stock is being transferred (if other than the corporation
more information, see Form 6251, Alternative Minimum
shown in TRANSFEROR boxes in the upper left corner of the
Tax—Individuals, and its instructions.
form).
Employee’s taxpayer identification number (TIN). For your
Future developments. For the latest information about
protection, this form may show only the last four digits of your
developments related to Form 3921 and its instructions, such as
social security number (SSN), individual taxpayer identification
legislation enacted after they were published, go to
number (ITIN), or adoption taxpayer identification number (ATIN).
However, the employer has reported your complete TIN to the
IRS.
Account number. May show an account or other unique number
your employer or transfer agent assigned to distinguish your
account.
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