determining your 2017 stock plan tax requirements a step ... · stock plan tax requirements — a...

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When you exercise or sell shares acquired from

a stock-settled plan, you may have taxable

ordinary compensation income to report

when you file your tax return, in addition to

any capital gains or losses. To determine your

tax-reporting requirements, follow the steps

outlined in this document.

Your Stock Appreciation Rights (for stock-settled plans)

INSIDEHow to use the

Supplemental Form to avoid

overpaying taxes

Determining your 2017stock plan tax requirements— a step-by-step guide

Alert: The tax-reform legislation adopted in December 2017 does not affect the 2017 tax year or the federal tax return for 2017 that you file in 2018.

Gather the following documents.1


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†You will not receive a 1099-B for cash-settled or “phantom” shares. This form only applies to any shares of stock you held and subsequently sold.

* Fidelity is not involved in the preparation of the content supplied at the third-party unaffiliated website and does not guarantee or assume any responsibility for its content.

* This is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a return, a negligence penalty or other sanction may be imposed on youif this income is taxable and the IRS determines that it has not been reported.

2017 TAX REPORTING STATEMENT

10/12/2017 9001068158 Pages 4 of 8

Customer Service:Account No.MASKED NAME***-**-6310 Payer's Fed ID Number:

800-544-6666Recipient ID No. 04-3523567

X48-462934

0 0 0

FORM 1099-B* 2017 Proceeds from Broker and Barter Exchange Transactions Copy B for Recipient OMB No. -

Short-term transactions for which basis is reported to the IRS --report on Form 8949 with Box A checked and/or Schedule D, Part IProceeds are reported as gross proceeds unless otherwise indicated (a).(This Label is a Substitute for Boxes 2, 3, 5 & 6)

(IRS Form 1099-B box numbers are shown below in bold type)

1a Description of property, Stock or Other Symbol, CUSIP

Action Quantity 1b DateAcquired

1c Date Soldor Disposed

1d Proceeds 1e Cost orOther Basis (b)

1f AccruedMarket

Discount

1g Wash SaleLoss

Disallowed

Gain/Loss (-) 4 FederalIncome Tax

Withheld

14 State16 State Tax

Withheld

Theta Corp. TTT

Sale 876.000 01/17/17 01/19/17 22,820.11 12,579.36(e) 10,240.75- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

TOTALS 22,820.11 12,579.36 0.00 0.00 0.00Box A Short-Term Realized Gain 10,240.75Box A Short-Term Realized Loss 0.00

For any transaction listed on Form 1099-B in a section indicating that "basis is reported to the IRS", we are reporting to the IRS: 1a Description of Property, 2 type of gain or loss (i.e. short-term orlong-term), 3 basis reported to IRS, 6 Gross or Net Proceeds, and columns 1b, 1c, 1d, 1e, 1f, 1g, 4, 7, 14, 15 and 16. We are not reporting to the IRS: the Action, the Gain/Loss, and all subtotals andtotals.

For any section 1256 option contracts we are reporting to the IRS: 1a Description of Property and totals for boxes 8, 9, 10 and 11.

For any transaction listed on Form 1099-B in a section indicating that "basis is not reported to the IRS", we are reporting to the IRS: 1a Description of Property, 5 Noncovered security, 6 Gross or NetProceeds, and columns 1c, 1d, 4, 14, 15 and 16. We are not reporting to the IRS: 2 type of gain or loss (i.e. short-term or long-term), the Action, the Gain/Loss, columns 1b, 1e, 1f, 1g, 2, 3 and 7 and allsubtotals and totals.

Although Fidelity makes every effort to provide accurate information, please bear in mind that you, the taxpayer, are ultimately responsible for the accuracy of your tax returns.

(b) Cost or other basis provided may include adjustments including, but not limited to, dividend reinvestment, return of capital/principal, wash sale loss disallowed, amortization, accretion, acquisitionpremium, bond premium, market discount, market premium, and option premium.

(e) Your 1099-B reflects shares disposed of that were acquired through your employers stock plan. Cost basis associated with these shares may not have been adjusted for any compensation incomethat was associated with those shares in the year of acquisition or disposal. Please consult a tax advisor for the rules specific to your grant and plan. Refer to the Supplemental Stock Plan ServiceLot Detail section of this form for additional detail.

Amortization, accretion, and similar adjustments to cost basis are not provided for short-term instruments, unit investment trusts, or securities of foreign issuers.

Account No. XXX-XXXXXX Customer Service: XXX-XXX-XXXXRecipient ID No. XXX-XX-XXXX Payer’s Fed ID Number: XX-XXXXXXX

Form 1099-B

Important Tax Return Document Enclosed.

Note: This information is not reported to the IRS. It may assist you in tax return preparation.

2017 SUPPLEMENTAL INFORMATION

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800-544-6666Recipient ID No. 04-3523567

X48-462934

0

Detail Information Supplemental Stock Plan Lot DetailBased on the disposal method you have selected, the lots that appear on your 1099 Supplemental may differ from the lots on the 1099-B.Short-Term TransactionsDescription of Property, Stock or Other Symbol, Cusip

GrantType (w)

Quantity Date ofAcquisition (x)

Date Soldor Disposed

Proceeds Ordinary IncomeReported (y)

Adjusted Cost orOther Basis (z)

Wash Sale LossDisallowed

Adjusted Gain/Loss

Theta Corp. TTT SAR 876.000 01/17/17 01/19/17 22,820.11 11,151.48 23,730.84 0.00 -910.73

Totals 22,820.11 23,730.84Short-Term Adjusted Realized Gain 0.00

Short-Term Adjusted Realized Loss -910.73

Wash Sale Loss Disallowed 0.00

(w) Grant Type describes the equity award source of the lot you sold this tax year. Please see the Grant Type table for additional description.xxxxxx

Grant Type Equity Award Type Acquisition date represents:DO Deposit Only Shares Deposit DateNQSOP Non Qualified Stock Option Shares Exercise DateNQSP Non Qualified ESPP Shares Purchase DateNSR Non-Incentive SAR (NSR) Exercise DateQSOP Qualified Stock Option Shares Exercise DateQSP Qualified ESPP Shares Purchase DateRSA Restricted Awards Vesting DateRSU Restricted Units Distribution DateRSU Performance Units Distribution DateRSU Total Shareholder Return Units Distribution DateSAR Stock Appreciation Rights Exercise Datexxxxxxxxxxxx

(x) Date of Acquisition is the date that shares were acquired from your Equity Plan and deposited into your brokerage account.(y) Fidelity-calculated ordinary income that was reported on the W2 from the year you acquired the shares. Fidelity-calculated ordinary income does not include any adjustments that your company

has made. Fidelity is not responsible for any adjustments that your company may have made to this number.(z) Adjusted cost or other basis provided may include the following adjustments: ordinary income reported, dividend reinvestment, return of capital/principal and wash sale loss disallowed.


Form 1099-Supplemental

Participant uses these Fidelity forms…

to complete…

Rolls up

into

Rolls up

into

Form 8949Department of the Treasury Internal Revenue Service

Sales and Other Dispositions of Capital Assets▶ Go to www.irs.gov/Form8949 for instructions and the latest information.

▶ File with your Schedule D to list your transactions for lines 1b, 2, 3, 8b, 9, and 10 of Schedule D.

OMB No. 1545-0074

2017Attachment Sequence No. 12A

Name(s) shown on return Social security number or taxpayer identification number

Before you check Box A, B, or C below, see whether you received any Form(s) 1099-B or substitute statement(s) from your broker. A substitute statement will have the same information as Form 1099-B. Either will show whether your basis (usually your cost) was reported to the IRS by your broker and may even tell you which box to check.

Part I Short-Term. Transactions involving capital assets you held 1 year or less are short term. For long-term transactions, see page 2. Note: You may aggregate all short-term transactions reported on Form(s) 1099-B showing basis was reported to the IRS and for which no adjustments or codes are required. Enter the totals directly on Schedule D, line 1a; you aren't required to report these transactions on Form 8949 (see instructions).

You must check Box A, B, or C below. Check only one box. If more than one box applies for your short-term transactions, complete a separate Form 8949, page 1, for each applicable box. If you have more short-term transactions than will fit on this page for one or more of the boxes, complete as many forms with the same box checked as you need.

(A) Short-term transactions reported on Form(s) 1099-B showing basis was reported to the IRS (see Note above)(B) Short-term transactions reported on Form(s) 1099-B showing basis wasn't reported to the IRS(C) Short-term transactions not reported to you on Form 1099-B

1

(a) Description of property

(Example: 100 sh. XYZ Co.)

(b) Date acquired (Mo., day, yr.)

(c) Date sold or disposed of

(Mo., day, yr.)

(d) Proceeds

(sales price) (see instructions)

(e) Cost or other basis. See the Note below and see Column (e)

in the separate instructions

Adjustment, if any, to gain or loss. If you enter an amount in column (g),

enter a code in column (f). See the separate instructions.

(f) Code(s) from instructions

(g) Amount of adjustment

(h) Gain or (loss).

Subtract column (e) from column (d) and combine the result

with column (g)

2 Totals. Add the amounts in columns (d), (e), (g), and (h) (subtract negative amounts). Enter each total here and include on your Schedule D, line 1b (if Box A above is checked), line 2 (if Box B above is checked), or line 3 (if Box C above is checked) ▶

Note: If you checked Box A above but the basis reported to the IRS was incorrect, enter in column (e) the basis as reported to the IRS, and enter an adjustment in column (g) to correct the basis. See Column (g) in the separate instructions for how to figure the amount of the adjustment.

For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 37768Z Form 8949 (2017)

SCHEDULE D (Form 1040)

Department of the Treasury Internal Revenue Service (99)

Capital Gains and Losses▶ Attach to Form 1040 or Form 1040NR.

▶ Go to www.irs.gov/ScheduleD for instructions and the latest information. ▶ Use Form 8949 to list your transactions for lines 1b, 2, 3, 8b, 9, and 10.

OMB No. 1545-0074

2017Attachment Sequence No. 12

Name(s) shown on return Your social security number

Part I Short-Term Capital Gains and Losses—Assets Held One Year or Less

See instructions for how to figure the amounts to enter on the lines below. This form may be easier to complete if you round off cents to whole dollars.

(d) Proceeds

(sales price)

(e) Cost

(or other basis)

(g) Adjustments

to gain or loss from Form(s) 8949, Part I,

line 2, column (g)

(h) Gain or (loss) Subtract column (e) from column (d) and

combine the result with column (g)

1a Totals for all short-term transactions reported on Form 1099-B for which basis was reported to the IRS and for which you have no adjustments (see instructions). However, if you choose to report all these transactions on Form 8949, leave this line blank and go to line 1b .

1b Totals for all transactions reported on Form(s) 8949 with Box A checked . . . . . . . . . . . . .

2

Totals for all transactions reported on Form(s) 8949 with Box B checked . . . . . . . . . . . . .

3

Totals for all transactions reported on Form(s) 8949 with Box C checked . . . . . . . . . . . . .

4 Short-term gain from Form 6252 and short-term gain or (loss) from Forms 4684, 6781, and 8824 . 4 5

Net short-term gain or (loss) from partnerships, S corporations, estates, and trusts from Schedule(s) K-1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

6

Short-term capital loss carryover. Enter the amount, if any, from line 8 of your Capital Loss Carryover Worksheet in the instructions . . . . . . . . . . . . . . . . . . . . . . . 6 ( )

7 Net short-term capital gain or (loss). Combine lines 1a through 6 in column (h). If you have any long-term capital gains or losses, go to Part II below. Otherwise, go to Part III on the back . . . . . 7

Part II Long-Term Capital Gains and Losses—Assets Held More Than One Year

See instructions for how to figure the amounts to enter on the lines below. This form may be easier to complete if you round off cents to whole dollars.

(d) Proceeds

(sales price)

(e) Cost

(or other basis)

(g) Adjustments

to gain or loss from Form(s) 8949, Part II,

line 2, column (g)

(h) Gain or (loss) Subtract column (e) from column (d) and

combine the result with column (g)

8a Totals for all long-term transactions reported on Form 1099-B for which basis was reported to the IRS and for which you have no adjustments (see instructions). However, if you choose to report all these transactions on Form 8949, leave this line blank and go to line 8b .

8b Totals for all transactions reported on Form(s) 8949 with Box D checked . . . . . . . . . . . . .

9

Totals for all transactions reported on Form(s) 8949 with Box E checked . . . . . . . . . . . . .

10

Totals for all transactions reported on Form(s) 8949 with Box F checked. . . . . . . . . . . . . .

11

Gain from Form 4797, Part I; long-term gain from Forms 2439 and 6252; and long-term gain or (loss) from Forms 4684, 6781, and 8824 . . . . . . . . . . . . . . . . . . . . . . 11

12 Net long-term gain or (loss) from partnerships, S corporations, estates, and trusts from Schedule(s) K-1 12

13 Capital gain distributions. See the instructions . . . . . . . . . . . . . . . . . . 13 14

Long-term capital loss carryover. Enter the amount, if any, from line 13 of your Capital Loss Carryover Worksheet in the instructions . . . . . . . . . . . . . . . . . . . . . . . 14 ( )

15

Net long-term capital gain or (loss). Combine lines 8a through 14 in column (h). Then go to Part III onthe back . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 11338H Schedule D (Form 1040) 2017

Form 8949

Form 1040 Department of the Treasury—Internal Revenue Service (99)

U.S. Individual Income Tax Return 2016 OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.

For the year Jan. 1–Dec. 31, 2016, or other tax year beginning , 2016, ending , 20 See separate instructions.Your first name and initial Last name Your social security number

If a joint return, spouse’s first name and initial Last name Spouse’s social security number

▲ Make sure the SSN(s) above and on line 6c are correct.

Home address (number and street). If you have a P.O. box, see instructions. Apt. no.

City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions).

Foreign country name Foreign province/state/county Foreign postal code

Presidential Election Campaign

Check here if you, or your spouse if filing jointly, want $3 to go to this fund. Checking a box below will not change your tax or refund. You Spouse

Filing Status

Check only one box.

1 Single

2 Married filing jointly (even if only one had income)

3 Married filing separately. Enter spouse’s SSN above and full name here. ▶

4 Head of household (with qualifying person). (See instructions.) If

the qualifying person is a child but not your dependent, enter this

child’s name here. ▶

5 Qualifying widow(er) with dependent child

Exemptions 6a Yourself. If someone can claim you as a dependent, do not check box 6a . . . . .

b Spouse . . . . . . . . . . . . . . . . . . . . . . . .}

c Dependents: (1) First name Last name

(2) Dependent’s social security number

(3) Dependent’s relationship to you

(4) ✓ if child under age 17 qualifying for child tax credit

(see instructions)

If more than four dependents, see instructions and check here ▶

d Total number of exemptions claimed . . . . . . . . . . . . . . . . .

Boxes checked on 6a and 6bNo. of children on 6c who: • lived with you • did not live with you due to divorce or separation (see instructions)

Dependents on 6c not entered above

Add numbers on lines above ▶

Income

Attach Form(s) W-2 here. Also attach Forms W-2G and 1099-R if tax was withheld.

If you did not get a W-2, see instructions.

7 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . 7

8a Taxable interest. Attach Schedule B if required . . . . . . . . . . . . 8a

b Tax-exempt interest. Do not include on line 8a . . . 8b

9 a Ordinary dividends. Attach Schedule B if required . . . . . . . . . . . 9a

b Qualified dividends . . . . . . . . . . . 9b

10 Taxable refunds, credits, or offsets of state and local income taxes . . . . . . 10

11 Alimony received . . . . . . . . . . . . . . . . . . . . . 11

12 Business income or (loss). Attach Schedule C or C-EZ . . . . . . . . . . 12

13 Capital gain or (loss). Attach Schedule D if required. If not required, check here ▶ 13

14 Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . 14

15 a IRA distributions . 15a b Taxable amount . . . 15b

16 a Pensions and annuities 16a b Taxable amount . . . 16b

17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E 17

18 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . 18

19 Unemployment compensation . . . . . . . . . . . . . . . . . 19

20 a Social security benefits 20a b Taxable amount . . . 20b

21 Other income. List type and amount 21 22 Combine the amounts in the far right column for lines 7 through 21. This is your total income ▶ 22

Adjusted Gross Income

23 Educator expenses . . . . . . . . . . . 23

24 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 or 2106-EZ 24

25 Health savings account deduction. Attach Form 8889 . 25

26 Moving expenses. Attach Form 3903 . . . . . . 26

27 Deductible part of self-employment tax. Attach Schedule SE . 27

28 Self-employed SEP, SIMPLE, and qualified plans . . 28

29 Self-employed health insurance deduction . . . . 29

30 Penalty on early withdrawal of savings . . . . . . 30

31 a Alimony paid b Recipient’s SSN ▶ 31a

32 IRA deduction . . . . . . . . . . . . . 32

33 Student loan interest deduction . . . . . . . . 33

34 Tuition and fees. Attach Form 8917 . . . . . . . 34

35 Domestic production activities deduction. Attach Form 8903 35

36 Add lines 23 through 35 . . . . . . . . . . . . . . . . . . . 36 37 Subtract line 36 from line 22. This is your adjusted gross income . . . . . ▶ 37

For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 11320B Form 1040 (2016)

17

Form 1040Schedule D

Form W-2 (or 1099-MISC if you are a nonemployee)

This form will be provided by your company.Your company’s payroll department

IRS Form 1040 (the full 1040, not the 1040EZ or the 1040A), including Schedule D Capital Gains and Losses

Forms are available online at www.irs.gov,* by calling 800.TAX.FORM (800.829.3676), or by visiting your local IRS office.

Your local IRS office or your tax advisor

IRS Form 8949 This form is available online at www.irs.gov,* by calling 800.TAX.FORM (800.829.3676), or by visiting your local IRS office.

Your local IRS office or your tax advisor

Form 1099-B†

You can access the form online at Fidelity.com/taxforms at the end of January. In addition, a form will be mailed to you no later than mid-February, if applicable.

A Fidelity Stock Plan Services Representative at the number provided on the statement

2017 Supplemental Information (Fidelity is providing you with additional information to supplement your 1099-B due to cost basis regulations that no longer permit brokers to include ordinary income.)

You can access the form online at Fidelity.com/taxforms at the end of January. In addition, a form will be mailed to you no later than mid-February, if applicable.

A Fidelity Stock Plan Services Representative at the number provided on the statement

FORM/DATA WHERE TO FIND IT WHO TO CALL

www.fidelity.com/taxforms

www.fidelity.com/taxforms

www.irs.gov

www.irs.gov

For illustrative purposes only.


The exercise of a Stock Appreciation Right (SAR) is treated as compensation, and you will be required to pay ordinary income tax on the spread at exercise. This amount should be reported on your W-2 or 1099-MISC (if you are a nonemployee of the company) provided by your company along with any tax withholding that may have occurred. It is the spread (the difference between the fair market value at exercise and your exercise price) that is treated as taxable compensation. In addition, you may owe tax on any capital gains resulting from the sale of your stock from the exercise, which is explained in later steps.

The amount of the spread is included in boxes 1 and 5 and also in box 3 up to the maximum wage base.

Federal taxes withheld are included in boxes 2 and 6 and in box 4 up to the maximum wage base.

SARs spread is included in boxes 16 and 18. Boxes 17 and 19 show any state and local tax withholdings.

Report your ordinary income.2

34

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Example: IRS W-2 for SARs and Form 1040


W-2 income is reported on line 7 of

Form 1040. (Income from 1099-MISC is reported

on Schedule C.)

* Fidelity is not involved in the preparation of the content supplied at the third-party unaffiliated website and does not guarantee or assume any responsibility for its content.

a Employee’s social security number

OMB No. 1545-0008

Safe, accurate, FAST! Use

Visit the IRS website at www.irs.gov/efile

b Employer identification number (EIN)

c Employer’s name, address, and ZIP code

d Control number

e Employee’s first name and initial Last name Suff.

f Employee’s address and ZIP code

1 Wages, tips, other compensation 2 Federal income tax withheld

3 Social security wages 4 Social security tax withheld

5 Medicare wages and tips 6 Medicare tax withheld

7 Social security tips 8 Allocated tips

9 10 Dependent care benefits

11 Nonqualified plans 12a See instructions for box 12Co d e

12bCo d e

12cCo d e

12dCo d e

13 Statutory employee

Retirement plan

Third-party sick pay

14 Other

15 State Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name

Form W-2 Wage and Tax Statement 2014

Department of the Treasury—Internal Revenue Service

Copy B—To Be Filed With Employee’s FEDERAL Tax Return. This information is being furnished to the Internal Revenue Service.

2015

*

2017

Your employer may also use box 14 to show the

income from stock compensation

(included in box 1).

www.irs.gov/efile



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800-544-6666Recipient ID No. 04-3523567

X48-462934

0 0 0

FORM 1099-B* 2017 Proceeds from Broker and Barter Exchange Transactions Copy B for Recipient OMB No. -







1f AccruedMarket

Discount

1g Wash SaleLoss

Disallowed


Withheld


Withheld

Theta Corp. TTT

Sale 876.000 01/17/17 01/19/17 22,820.11 12,579.36(e) 10,240.75- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -











44

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You will need to refer to two documents this year. Your Fidelity Brokerage 1099-B Tax-Reporting Statement and your 2017 Supplemental Information Form. The Supplemental Form may contain information that is not reported on your 1099-B due to cost basis regulations. If the amounts on these two forms differ, you’ll need to use information from both to complete your tax forms to ensure that you don’t overpay in taxes.

Assemble information on the purchase and sale of your stock.

3

Example: Fidelity Brokerage 1099-B Tax-Reporting Statement


Continues

1 — CUSIP (your company’s ticker/ trading symbol)

2 — Quantity (number of shares sold)

3 — Date Acquired (date you exercised the grant)

4 — Date Sold or Disposed

5 — Proceeds (gross proceeds from stock sale)

6 — Cost or Other Basis (this is provided to the IRS, as directed, and may need to be adjusted—see the Supplemental Form)

7 — Gain/Loss (from the proceeds of the sale and may also need to be adjusted—see the Supplemental Form)

21 4 53 6 7



10/12/2017 9001029539 Pages 4 of 8


800-544-6666Recipient ID No. 04-3523567

X27-495794

0 0 0

FORM 1099-B* 2017 Proceeds from Broker and Barter Exchange Transactions Copy B for Recipient OMB No. XXXX-XXXX







1f AccruedMarket

Discount

1g Wash SaleLoss

Disallowed


Withheld


Withheld

THETA CORP, TTT

Sale 160.000 01/24/17 01/24/17 25,581.35 19,409.60(e) 6,171.75Sale 103.000 01/27/17 01/27/17 16,919.38 12,494.93(e) 4,424.45Subtotals 42,500.73 31,904.53

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -










Important Tax Return Document Enclosed.

Note: This information is not reported to the IRS. It may assist you in tax return preparation.

2017 SUPPLEMENTAL INFORMATION

10/12/2017 9001068158 Pages 7 of 8


800-544-6666Recipient ID No. 04-3523567

X48-462934

0

Detail Information Supplemental Stock Plan Lot DetailBased on the disposal method you have selected, the lots that appear on your 1099 Supplemental may differ from the lots on the 1099-B.Short-Term TransactionsDescription of Property, Stock or Other Symbol, Cusip

GrantType (w)

Quantity Date ofAcquisition (x)

Date Soldor Disposed

Proceeds Ordinary IncomeReported (y)

Adjusted Cost orOther Basis (z)

Wash Sale LossDisallowed

Adjusted Gain/Loss

Theta Corp. TTT SAR 876.000 01/17/17 01/19/17 22,820.11 11,151.48 23,730.84 0.00 -910.73

Totals 22,820.11 23,730.84Short-Term Adjusted Realized Gain 0.00

Short-Term Adjusted Realized Loss -910.73

Wash Sale Loss Disallowed 0.00

(w) Grant Type describes the equity award source of the lot you sold this tax year. Please see the Grant Type table for additional description.xxxxxx

Grant Type Equity Award Type Acquisition date represents:DO Deposit Only Shares Deposit DateNQSOP Non Qualified Stock Option Shares Exercise DateNQSP Non Qualified ESPP Shares Purchase DateNSR Non-Incentive SAR (NSR) Exercise DateQSOP Qualified Stock Option Shares Exercise DateQSP Qualified ESPP Shares Purchase DateRSA Restricted Awards Vesting DateRSU Restricted Units Distribution DateRSU Performance Units Distribution DateRSU Total Shareholder Return Units Distribution DateSAR Stock Appreciation Rights Exercise Datexxxxxxxxxxxx

(x) Date of Acquisition is the date that shares were acquired from your Equity Plan and deposited into your brokerage account.(y) Fidelity-calculated ordinary income that was reported on the W2 from the year you acquired the shares. Fidelity-calculated ordinary income does not include any adjustments that your company

has made. Fidelity is not responsible for any adjustments that your company may have made to this number.(z) Adjusted cost or other basis provided may include the following adjustments: ordinary income reported, dividend reinvestment, return of capital/principal and wash sale loss disallowed.



Assemble information on the purchase and sale of your stock.

3

Example: 2017 Supplemental Information Form


9 108

8 — Ordinary Income Reported (cross-reference this with your company W-2 and input in column (g) of Form 8949)

— Adjusted Cost Basis (this amount is used to recalculate your gain/loss and is equal to the ordinary income plus the cost basis on your 1099-B)

— Adjusted Gain/Loss (recalculated per your new basis; proceeds minus your adjusted cost basis — this amount goes on column (h) of Form 8949)

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4


Use the information from IRS Form 1099-B and Fidelity’s Supplemental Information form to complete IRS Form 8949.

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4For illustrative purposes only.

To complete Form 8949 and Schedule D, you need to know:

• Which shares you sold from which grant

• When you acquired those shares (i.e., the exercise date)

• The fair market value of the stock at exercise

• The date of sale

• The sale price and whether it is net of commission

• Your cost basis

• Amount of ordinary income (from the Supplemental Form)

Example: SAR Exercise and Hold with sale within one year (short term)

Continues


Use the information from IRS Form 1099-B and Fidelity’s Supplemental Information form to complete IRS Form 8949.

4

74

4For illustrative purposes only.

To complete Form 8949 and Schedule D, you need to know:

• Which shares you sold from which grant

• When you acquired those shares (i.e., the exercise date)

• The fair market value of the stock at exercise

• The date of sale

• The sale price and whether it is net of commission

• Your cost basis

• Amount of ordinary income (from the Supplemental Form)

Example: SAR Exercise and Hold with sale after one year (long term)


Gain or loss from the sale of the stock should be reflected on Form 8949 and Schedule D. How this is reflected depends on whether the sale is short term (less than one year from the date the stock was acquired to the date it was sold) or long term (more than one year from the date acquired to the date of sale).

Use IRS Form 8949 to calculate your capital gains and/or losses on Schedule D.

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Example: Short-Term Gains or Losses

Example: Long-Term Gains or Losses


Frequently Asked QuestionsQ: Does the tax-reform legislation adopted in December 2017 affect my 2017 taxes?

A: No. The tax-reform legislation adopted in December 2017 does not affect the 2017 tax year or the federal tax return for 2017 that you file in 2018.

Q: I also receive cash-settled SARs. Why didn’t I receive a 1099-B after I exercised those?

A: Cash-settled SAR transactions result in no sale of stock; instead, you are given the cash value of the stock. As a result, your W-2 or 1099-MISC will show the income from the transaction (similar to a bonus payment). For stock-settled SARs, you will receive a W-2 or 1099-MISC in the year of exercise, as well as a Fidelity-issued 1099-B in the year you sell the stock you received from the exercise.

Q: Where can I see how much tax my employer withheld on my SAR exercise?

A: You should be able to see these amounts reflected on your W-2. Also, if your employer provided this information to Fidelity, tax withholding amounts will be listed on your monthly statement or your transaction confirmation.

Q: If I already had money taken from my brokerage account at exercise to pay withholding taxes, will I owe more taxes when I sell those shares?

A: The spread at exercise should have already been reported to the IRS on Form W-2 (and was included in your income for the year of exercise). At sale, your capital gain or loss is calculated by the difference between the net sale price and your adjusted cost basis per share (i.e., the total spread at exercise divided by the number of shares received for the spread, which equals the stock price at exercise). When you report the sale of the shares acquired in the SARs exercise on Form 8949 and Schedule D, you avoid paying tax twice on the spread by adding it to your cost basis.

Q: Will I owe other taxes beyond federal tax when I sell my stock?

A: State and local taxes may also apply, and the rules governing such taxes may vary from federal income tax rules. Please consult your tax advisor for more information.

For specifics on what your company uses as fair market value, please see your plan documents, as the fair market value may vary.Tax laws are complex and subject to change. State and local taxes may also apply, and the rules governing such taxes may vary from federal income tax rules. Your actual income tax consequences depend on your individual circumstances. Therefore, you should always consult a qualified tax advisor regarding your particular tax situation.

Fidelity Brokerage Services LLC, Member NYSE, SIPCFidelity Stock Plan Services, LLC© 2018 FMR LLC. All rights reserved.710948.5.0 08/34129 SAR-TAX-PDF-0118

If you have any questions, a Fidelity Stock Plan Services Representative can help. Call 800.544.9354.

Go back to the Fidelity SPS Resource Center

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