CALCULATOR FOR TAX-FREE STOCK SPLIT-OFFS |
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| Enter your data separately for each tax lot (i.e. purchase date): |
1. Name of split-off stock
or enter your own data:
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| 2. Name of original stock
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| 3. Date of split-off (mm/dd/yyyy) |
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| 4. Split-off exchange ratio (number of split-off shares received for each original share exchanged) |
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| 5. Purchase date for original stock (mm/dd/yyyy) |
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| 6. Number of shares of original stock submitted for exchange prior to split-off |
(no commas) |
| 7. Total cost basis for original stock submitted for exchange, including commissions and fees, adjusted for previous spinoffs (total, not per share) |
$ (no commas) |
| 8. Number of shares of original stock accepted for exchange after prorations, if any |
(no commas) |
| 9. Cash received in lieu of fractional shares (often denoted as CIL) (enter 0.00 if none) |
$ (no commas) |
| 10. Percentage of shares that were accepted for split-off exchange |
% |
| 11. Fair market value per share of split-off stock on date of exchange |
(no commas) |
| 12. Fair market value per share of original stock on date of exchange |
(no commas) |
| 13. Comments or additional information on terms of split-off (optional) |
(no commas) |
| 14. Name of tax information statement if available |
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| 15. Tax status: 1=fair market value allocation or 2=taxable or 3=specific identification carryover |
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| 16. Account or Owner Name (optional) |
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