Instructions for Employee
You have received this form because your employer (or transfer
agent) transferred your employer’s stock to you pursuant to your
exercise of an incentive stock option (ISO). You must recognize
(report) gain or loss on your tax return for the year in which you
sell or otherwise dispose of the stock. Keep this form and use it to
figure the gain or loss. For more information, see Pub. 525,
Taxable and Nontaxable Income.
When you exercise an ISO, you may have to include in
alternative minimum taxable income a portion of the fair market
value of the stock acquired through the exercise of the option. For
more information, see Form 6251, Alternative Minimum
Tax—Individuals, and its instructions.
Employee’s taxpayer identification number (TIN). For your
protection, this form may show only the last four digits of your
social security number (SSN), individual taxpayer identification
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.
Box 1. Shows the date the option to purchase the stock was
granted to you.
Box 2. Shows the date you exercised the option to purchase the
stock.
Box 3. Shows the exercise price per share of stock.
Box 4. Shows the fair market value (FMV) of a share of stock on
the date the option was exercised.
Box 5. Shows the number of shares of stock transferred to you
pursuant to the exercise of the option.
Box 6. Shows the name, address, and TIN of the corporation
whose stock is being transferred (if other than the corporation
shown in TRANSFEROR boxes in the upper left corner of the
form).
Future developments. For the latest information about
developments related to Form 3921 and its instructions, such as
legislation enacted after they were published, go to
www.irs.gov/Form3921.