Form 3921 - Exercise Of An Incentive Stock Option Under Section 422(B) (Page 4 of 7) in pdf

Form 3921 - Exercise Of An Incentive Stock Option Under Section 422(B) Page 4

Instructions 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

Box 2. Shows the date you exercised the option to

transfer agent) transferred your employer’s stock to you

purchase the stock.

pursuant to your exercise of an incentive stock option

(ISO). You must recognize (report) gain or loss on your

Box 3. Shows the exercise price per share of stock.

tax return for the year in which you sell or otherwise

Box 4. Shows the fair market value (FMV) of a share of

dispose of the stock. Keep this form and use it to figure

stock on the date the option was exercised.

the gain or loss. For more information, see Pub. 525,

Box 5. Shows the number of shares of stock transferred

Taxable and Nontaxable Income.

to you pursuant to the exercise of the option.

When you exercise an ISO, you may have to include

Box 6. Shows the name, address, and employer

in alternative minimum taxable income a portion of the

identification number (EIN) of the corporation whose

fair market value of the stock acquired through the

stock is being transferred (if other than the corporation

exercise of the option. For more information, see Form

shown in TRANSFEROR boxes in the upper left corner

6251, Alternative Minimum Tax—Individuals, and its

of the form).

instructions.

Future developments. For the latest information about

Account number. May show an account or other

developments related to Form 3921 and its instructions,

unique number your employer or transfer agent

such as legislation enacted after they were published,

assigned to distinguish your account.

go to

Form 3921 - Exercise Of An Incentive Stock Option Under Section 422(B) Page 4