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Federal forms, ICRs, and supporting documents

Information Collection Request

Form 3921 - Exercise of an Incentive Stock Option Under...; Form 3922 - Transfer of Stock Acquired Through an ...; TD 9470 - Information Reporting Requirements Under Code Sec. 6039

ICR 201712-1545-014 · OMB 1545-2129 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 3922 Form 3922 - Transfer of Stock Acquired Through an Employee Stock Purchase Plan Under Section 423(c) Form Modified Available
Form 3921 Form 3921 - Exercise of an Incentive Stock Option Under Section 422(b). Form Modified Available
2018-02-06_SS_1545-2129rMB.docx Supporting Statement A Uploaded 2018-02-06 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
186592 TD 9470 - Information Reporting Requirements Under Internal Revenue Service Code Sec. 6039 Modified
186591 Form 3922 - Transfer of Stock Acquired Through an Employee Stock Purchase Plan Under Section 423(c) Form Modified
186590 Form 3921 - Exercise of an Incentive Stock Option Under Section 422(b). Form Modified
ICR Details
1545-2129 201712-1545-014
Active 201409-1545-016
TREAS/IRS
Form 3921 - Exercise of an Incentive Stock Option Under...; Form 3922 - Transfer of Stock Acquired Through an ...; TD 9470 - Information Reporting Requirements Under Code Sec. 6039
Extension without change of a currently approved collection   No
Regular
Approved without change 04/26/2018
Retrieve Notice of Action (NOA) 02/14/2018
  Inventory as of this Action Requested Previously Approved
04/30/2021 36 Months From Approved 04/30/2018
51,000 0 51,000
25,205 0 25,205
0 0 0
Form 3921 is a copy of the information return filed with the IRS which transferred shares of stock to a recipient through exercise of an incentive stock option under section 422(b). Form 3922 is used to record a transfer of the legal title of a share of stock acquired by the employee where the stock was acquired pursuant to the exercise of an option described in section 423(c). Previously approved REG-103146-08 reflects the changes to section 6039 of the Internal Revenue Code made by section 403 of the Tax Relief and Health Care Act of 2006.
US Code: 26 USC 6039 Name of Law: Information required in connection with certain options
   PL: Pub.L. 109 - 432 403 Name of Law: Tax Relief and Health Care Act of 2006
   US Code: 26 USC 7805 Name of Law: Rules and regulations
  
None
Not associated with rulemaking
  82 FR 55714 11/22/2017
83 FR 6732 02/14/2018
No
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 51,000 51,000 0 0 0 0
Annual Time Burden (Hours) 25,205 25,205 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$6,500
No
    Yes
    Yes
No
No
No
Uncollected
Melody Devoe 2022837635
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
02/14/2018