Information Collection

Form 3921 - Exercise of an Incentive Stock Option Under Section 422(b).

IC 186590 under ICR 201409-1545-016 · OMB 1545-2129.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-2129 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3921 Form 3921 - Exercise of an Incentive Stock Option Under Section 422(b).	Form
i3921_and_3922--2013.pdf	Instruction
3921 Excise of an Incentive Stock Option Under Section 422(b) f3921-cycle 2.pdf	Form
brdn_spec FORM 3921.PDF Burden for Form 3921	IC Document

IC Title:

Form 3921 - Exercise of an Incentive Stock Option Under Section 422(b).

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	3921	Excise of an Incentive Stock Option Under Section 422(b)	f3921-cycle 2.pdf		Yes	Yes	Fillable Fileable
Instruction			i3921_and_3922--2013.pdf		Yes	No	Printable Only

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	95	95
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Burden for Form 3921	brdn_spec FORM 3921.PDF	11/28/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.