Form 3921 - Exercise Of An Incentive Stock Option Under Section 422(B)

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Attention:
This form is provided for informational purposes only. Copy A appears in red, similar to the
official IRS form. Do not file copy A downloaded from this website. The official printed
version of this IRS form is scannable, but the online version of it, printed from this website,
is not. A penalty may be imposed for filing forms that can’t be scanned. See part O in the
current General Instructions for Certain Information Returns for more information about
penalties.
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To order official IRS forms, call 1-800-TAX-FORM (1-800-829-3676) or
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See IRS Publications 1141, 1167, 1179 and other IRS resources for information about
printing these tax forms.

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