Form 1099-Cap - Changes In Corporate Control And Capital Structure - 2017 Page 3

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Instructions for Shareholder
Account number. May show an account or other
A corporation in which you own stock that has had a
unique number the payer corporation assigned to
change in control or a substantial change in capital
structure must send you this statement by January 31 of
distinguish your account.
the year following the calendar year of the change. You
Box 1. Shows the date the stock was exchanged for
have received this statement because the corporation
cash, stock, or other property.
has reasonably determined that you may be required to
Box 2. Shows the aggregate amount of any cash and
recognize gain from the receipt of cash, stock, or other
the fair market value of any stock or other property
property that was exchanged for the corporation’s
received by you in the exchange for the stock you held.
stock. Report any gain from the exchange on Form
Box 3. Shows the number of shares of the corporation’s
8949. However, you cannot claim a (loss) on Form 8949
stock that you held which were exchanged in the
as a result of this exchange. See Pub. 550, chapter 4,
transaction.
for additional information.
Box 4. Shows the class or classes of stock that were
Shareholder's taxpayer identification number. For
exchanged.
your protection, this form may show only the last four
Future developments. For the latest information about
digits of your social security number (SSN), individual
developments related to Form 1099-CAP and its
taxpayer identification number (ITIN), adoption taxpayer
instructions, such as legislation enacted after they were
identification number (ATIN), or employer identification
published, go to
number (EIN). However, the issuer has reported your
complete identification number to the IRS.

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