Internal Revenue Service United States Department of the Treasury

Instructions for Forms 3921 and 3922 (12/2011)

Section references are to the Internal Revenue Code unless otherwise noted.

Revised: 12/2011


Table of Contents

  • Instructions for Forms 3921 and 3922 - Introductory Material
    • Reminders
    • Instructions for Forms 3921 and 3922 - Main Contents
      • Specific Instructions for Form 3921
        • Who Must File
        • Statements to Transferees
        • Employee's Name, Address, and Identification Number
        • Account Number
        • Box 1. Date option granted
        • Box 2. Date option exercised
        • Box 3. Exercise price per share
        • Box 4. Fair market value per share on exercise date
        • Box 5. Number of shares transferred
        • Box 6. If other than TRANSFEROR, name, address, and EIN of corporation whose stock is being transferred
      • Specific Instructions for Form 3922
        • Who Must File
        • Statements to Transferors
        • Employee's Name, Address, and Identification Number
        • Account Number
        • Box 1. Date option granted
        • Box 2. Date option exercised
        • Box 3. Fair market value per share on grant date
        • Box 4. Fair market value per share on exercise date
        • Box 5. Exercise price paid per share
        • Box 6. Number of shares transferred
        • Box 7. Date legal title transferred
        • Box 8. Exercise price per share determined as if the option was exercised on the date shown in box 1
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