Form 3921 Data Fields¶
Data fields for Form 3921 are listed in the table below. For the most up-to-date information you should also consult the statement documentation available in GraphQL.
| Identifier | Type | Description | Years Used | Sample Value | Notes |
|---|---|---|---|---|---|
| accountNumber | text | Shown in unnumbered box labeled Account number (see instructions). | 2018-2021 | "1234-5678" | |
| corporationInfo | array | Shown in box number 6 labeled If other than transferor, name, address, and TIN of corporation whose stock is being transferred. | 2018-2021 | ["Cassatt and Company", "TIN: 10-5123456"] | |
| corrected | boolean | True for corrected forms; the corrected box at the top of the form is checked if this is true. Shown in unnumbered box labeled CORRECTED (if checked). | 2018-2021 | true | |
| dateOptionExercised | date | Date option exercised. Box 2. Shown in box number 2 labeled Date option exercised. | 2018-2021 | "2019-06-01" | |
| dateOptionGranted | date | Date option granted. Box 1. Shown in box number 1 labeled Date option granted. | 2018-2021 | "2019-01-01" | |
| exercisePricePerShare | money | Shown in box number 3 labeled Exercise price per share. | 2018-2021 | "100.0" | |
| fmvPerShare | money | Shown in box number 4 labeled Fair market value per share on exercise date. | 2018-2021 | "200.0" | |
| numberSharesTransferred | integer | Shown in box number 5 labeled Number of shares transferred. | 2018-2021 | 500 | |
| recipientAddress1 | text | First line of the employee's address. Part of information shown in unnumbered box labeled EMPLOYEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code. | 2018-2021 | "784 East 77th Street" | Recipient is referred to as employee on form. |
| recipientAddress2 | text | Second line of the employee's address, if any. Part of information shown in unnumbered box labeled EMPLOYEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code. | 2018-2021 | "Apt. 5J" | Recipient is referred to as employee on form. |
| recipientAddress3 | text | Third line of employee's address. Use for foreign addresses only. For foreign addresses, complete this field and leave city, state, and zip code blank. Part of information shown in unnumbered box labeled EMPLOYEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code. | 2018-2021 | "Toronto ON M4Y 1J7" | Recipient is referred to as employee on form. |
| recipientCity | text | Employee's city. Part of information shown in unnumbered box labeled EMPLOYEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code. | 2018-2021 | "New York" | Recipient is referred to as employee on form. |
| recipientEntityName | text | Name of company or other entity receiving the form. Complete this field only if the recipient is not a person. For people, use first name, last name, and, optionally, middle name and suffix. Part of information shown in unnumbered box labeled EMPLOYEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code. | 2018-2021 | "Flemings Gourmet Foods" | Recipient is referred to as employee on form. |
| recipientFirstName | text | Employee's first name. Part of information shown in unnumbered box labeled EMPLOYEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code. | 2018-2021 | "Leif" | Recipient is referred to as employee on form. |
| recipientLastName | text | Employee's last name. Part of information shown in unnumbered box labeled EMPLOYEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code. | 2018-2021 | "Babson" | Recipient is referred to as employee on form. |
| recipientMiddleName | text | Employee's middle name or initial, if provided. Part of information shown in unnumbered box labeled EMPLOYEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code. | 2018-2021 | "Augustus" | Recipient is referred to as employee on form. |
| recipientNameSuffix | text | Name suffix for employee (Jr., Sr. III, etc), if provided. Part of information shown in unnumbered box labeled EMPLOYEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code. | 2018-2021 | "Jr." | Recipient is referred to as employee on form. |
| recipientState | state | Employee's state. Part of information shown in unnumbered box labeled EMPLOYEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code. | 2018-2021 | "NY" | Recipient is referred to as employee on form. |
| recipientTin | tin | Employee's social security number or other TIN. Shown in unnumbered box labeled EMPLOYEE'S TIN. | 2018-2021 | "200213492" | Recipient is referred to as employee on form. |
| recipientTinType | character | Type of taxpayer identification number (TIN). Valid values are '1' for EIN or '2' for any other type of TIN, including SSN. When not supplied, the TIN is formatted as an SSN on the statement. | 2018-2021 | "2" | Recipient is referred to as employee on form. |
| recipientZipCode | zip_code | Employee's zip code. Part of information shown in unnumbered box labeled EMPLOYEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code. | 2018-2021 | "10162" | Recipient is referred to as employee on form. |
| senderAddress1 | text | First line of the transferor's address. Part of information shown in unnumbered box labeled TRANSFEROR'S name, street address, city or town, state or province, country, and ZIP or foreign postal code. | 2018-2021 | "179 N. 13th Street" | Sender is referred to as transferor on form. |
| senderAddress2 | text | Second line of the transferor's address. Part of information shown in unnumbered box labeled TRANSFEROR'S name, street address, city or town, state or province, country, and ZIP or foreign postal code. | 2018-2021 | "Suite 14C" | Sender is referred to as transferor on form. |
| senderCity | text | Transferor's city. Part of information shown in unnumbered box labeled TRANSFEROR'S name, street address, city or town, state or province, country, and ZIP or foreign postal code. | 2018-2021 | "Brooklyn" | Sender is referred to as transferor on form. |
| senderName | text | Transferor's name. Part of information shown in unnumbered box labeled TRANSFEROR'S name, street address, city or town, state or province, country, and ZIP or foreign postal code. | 2018-2021 | "Big Apple Analytics" | Sender is referred to as transferor on form. |
| senderState | state | Transferor's state. Part of information shown in unnumbered box labeled TRANSFEROR'S name, street address, city or town, state or province, country, and ZIP or foreign postal code. | 2018-2021 | "NY" | Sender is referred to as transferor on form. |
| senderTin | tin | Transferor's EIN. Shown in unnumbered box labeled TRANSFEROR'S TIN. | 2018-2021 | "101123456" | Sender is referred to as transferor on form. |
| senderZipCode | zip_code | Transferor's ZIP code. Part of information shown in unnumbered box labeled TRANSFEROR'S name, street address, city or town, state or province, country, and ZIP or foreign postal code. | 2018-2021 | "11249" | Sender is referred to as transferor on form. |