3. Date of distribution of spinoff (mm/dd/yyyy) |
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4. Purchase date of original stock (tax lot) |
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5. Spinoff ratio (for example .5 in a 1 for 2 spinoff) |
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6. Percent allocation of cost basis to new spinoff stock (for example, .2 for 20%) |
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7. Percent allocation of cost basis to original stock (for example .8 for 80%) |
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8. Number of shares of original stock, adjusted for splits since purchase |
(no commas) |
9. Total cost of original stock purchase, including commissions and fees, adjusted for previous spinoffs and return of capital payments. For double spins use same cost basis for both calculations. |
$ (no commas) |
10. Cash received in lieu of fractional shares (often denoted as CIL) (enter 0.00 if none) |
$ |
11. Tax status of spinoff, enter 1 for tax-free, 2 for taxable, 3 for return of capital, 4 for mixed status |
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12. If tax status is taxable or mixed, enter market value per share on date of distribution of spinoff stock received. If tax status is tax-free, enter 0.00 |
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13. If tax status is return of capital or mixed, enter any return of capital per share of original stock. If tax status is tax-free or if there was no return of capital, enter 0.00 |
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14. Account or owner name (optional) |
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15. Additional information |
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16. Name of tax information statement if available |
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