determining your 2017 stock plan tax requirements a step

10
When your restricted stock, restricted stock units, performance shares, or performance units vest, you may have taxable ordinary income to report when you file your tax return, in addition to any capital gains or losses upon sale of that stock. To determine your tax-reporting requirements, follow the steps outlined in this document. 1 4 4 Your Restricted Stock and Performance Awards INSIDE How to use the Supplemental Form to avoid overpaying taxes Determining your 2017 stock 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.

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Page 1: Determining your 2017 stock plan tax requirements a step

When your restricted stock, restricted stock units, performance shares, or performance units vest, you may have taxable ordinary income to report when you file your tax return, in addition to any capital gains or losses upon sale of that stock. To determine your tax-reporting requirements, follow the steps outlined in this document.

14

4Your Restricted Stock and Performance Awards

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.

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Page 2: Determining your 2017 stock plan tax requirements a step

Gather the following documents.1

Your Restricted Stock and Performance Awards

24

4

* 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 9001056927 Pages 4 of 12

Customer Service:Account No.MASKED NAME***-**-1500 Payer's Fed ID Number:

800-544-4442Recipient ID No. 04-3523567

X66-226289

0 0 0

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

Short-term transactions for which basis is not reported to the IRS --report on Form 8949 with Box B 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, CUSIPAction Quantity 1b Date

Acquired1c 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 05/10/17 19,461.75 0.00(e) 19,461.75Sale

78.00 02/17/17 21.00 02/19/17 05/10/17 5,269.56 0.00(e) 5,269.56

Subtotals 24,731.31 0.00- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

TOTALS 0.00 0.00 0.00 0.0024,731.31

24,731.31 Box B Short-Term Realized GainBox B Short-Term Realized Loss 0.00

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

Form 1099-B

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

2017 SUPPLEMENTAL INFORMATION

10/12/2017 9001056927 Pages 10 of 12

Customer Service:Account No.MASKED NAME***-**-1500 Payer's Fed ID Number:

800-544-4442Recipient ID No. 04-3523567

X66-226289

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. TTTRSU 78.00 02/17/17 05/10/17 19,461.75 18,962.70 18,962.70 0.00 499.04RSA 21.00 02/19/17 05/10/17 5,269.56 5,134.67 5,134.67 0.00 134.89

Totals 24,097.37633.93

0.00

24,731.31Short-Term Adjusted Realized Gain Short-Term Adjusted Realized Loss Wash Sale Loss Disallowed 0.00

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.Long-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. TTTRSU 91.000 02/17/16 04/26/17 22,716.55 17,295.46 17,295.46 0.00 5,421.09RSU 872.000 02/17/16 05/10/17 217,962.29 165,732.32 165,732.32 0.00 52,229.97RSU 15,174.000 02/17/16 05/10/17 3,793,417.30 2,883,970.44 2,883,970.44 0.00 909,446.86RSA 100.000 02/20/16 05/10/17 24,999.45 19,068.00 19,068.00 0.00 5,931.45RSA 2,139.000 02/20/16 05/10/17 534,738.34 407,864.52 407,864.52 0.00 126,873.82RSA 666.000 02/20/16 05/10/17 166,496.37 126,992.88 126,992.88 0.00 39,503.49RSA 4.000 02/20/16 05/10/17 999.97 762.72 762.72 0.00 237.25RSA 500.000 02/20/16 05/10/17 124,997.27 95,340.00 95,340.00 0.00 29,657.27RSA 200.000 02/20/16 05/10/17 49,998.91 38,136.00 38,136.00 0.00 11,862.91RSA 192.000 02/20/16 05/10/17 47,966.00 36,610.56 36,610.56 0.00 11,355.44

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

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

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Page 3: Determining your 2017 stock plan tax requirements a step

Example: IRS W-2 and Form 1040

Your Restricted Stock and Performance Awards

Your equity compensation awards are considered ordinary income to you and taxable in the year your grant vests and/or shares are delivered to you (assuming there is no deferral feature). Your compensation is the fair market value (FMV) of the stock at vesting, less the amount (if any) you paid for the shares, multiplied by the number of shares vested. If you are a salaried worker, your employer should have already included the value of your award in your W-2. If you are a nonemployee, you should have received a 1099-MISC. In addition to ordinary income, you may owe tax on any capital gains resulting from the sale of your stock, which is explained in later steps.

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

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

The value of the award is included in boxes 16 and 18, if state and local tax applies. Tax on the value is included in boxes 17 and 19, if applicable.

Report your ordinary income.2

34

4For illustrative purposes only.

For illustrative purposes only.

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.

2017

*

Your employer might use box 14 to also show the

income from stock compensation

(included in box 1).

Page 4: Determining your 2017 stock plan tax requirements a step

* 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 9001056927 Pages 4 of 12

Customer Service:Account No.MASKED NAME***-**-1500 Payer's Fed ID Number:

800-544-4442Recipient ID No. 04-3523567

X66-226289

0 0 0

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

Short-term transactions for which basis is not reported to the IRS --report on Form 8949 with Box B 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, CUSIPAction Quantity 1b Date

Acquired1c 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 05/10/17 19,461.75 0.00(e) 19,461.75Sale

78.00 02/17/17 21.00 02/19/17 05/10/17 5,269.56 0.00(e) 5,269.56

Subtotals 24,731.31 0.00- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

TOTALS 0.00 0.00 0.00 0.0024,731.31

24,731.31 Box B Short-Term Realized GainBox B Short-Term Realized Loss 0.00

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

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 taxes.

21 4 53 6 7

Your Restricted Stock and Performance Awards

Assemble information on the sale of your stock.

3

44

4

Example: Fidelity Brokerage 1099-B Tax-Reporting Statement

For illustrative purposes only.

Continues

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

2 — Quantity (number of shares sold)

3 — Date Acquired (also known as the date of vesting or distribution)

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). The IRS does not allow brokers to report the basis for this type of stock compen-sation. (See the FAQs at the end of this guide for details.)

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

* 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 9001029539 Pages 4 of 8

Customer Service:Account No.MASKED NAME***-**-8644 Payer's Fed ID Number:

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

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 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

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TOTALS 42,500.73 31,904.53 0.00 0.00 0.00Box A Short-Term Realized Gain 10,596.20Box 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

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Your Restricted Stock and Performance Awards

Assemble information on the sale of your stock.

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Example: 2017 Supplemental Information Form

For illustrative purposes only.

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

2017 SUPPLEMENTAL INFORMATION

10/12/2017 9001056927 Pages 10 of 12

Customer Service:Account No.MASKED NAME***-**-1500 Payer's Fed ID Number:

800-544-4442Recipient ID No. 04-3523567

X66-226289

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. TTTRSU 78.00 02/17/17 05/10/17 19,461.75 18,962.70 18,962.70 0.00 499.04RSA 21.00 02/19/17 05/10/17 5,269.56 5,134.67 5,134.67 0.00 134.89

Totals 24,097.37633.93

0.00

24,731.31Short-Term Adjusted Realized Gain Short-Term Adjusted Realized Loss Wash Sale Loss Disallowed 0.00

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.Long-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. TTTRSU 91.000 02/17/16 04/26/17 22,716.55 17,295.46 17,295.46 0.00 5,421.09RSU 872.000 02/17/16 05/10/17 217,962.29 165,732.32 165,732.32 0.00 52,229.97RSU 15,174.000 02/17/16 05/10/17 3,793,417.30 2,883,970.44 2,883,970.44 0.00 909,446.86RSA 100.000 02/20/16 05/10/17 24,999.45 19,068.00 19,068.00 0.00 5,931.45RSA 2,139.000 02/20/16 05/10/17 534,738.34 407,864.52 407,864.52 0.00 126,873.82RSA 666.000 02/20/16 05/10/17 166,496.37 126,992.88 126,992.88 0.00 39,503.49RSA 4.000 02/20/16 05/10/17 999.97 762.72 762.72 0.00 237.25RSA 500.000 02/20/16 05/10/17 124,997.27 95,340.00 95,340.00 0.00 29,657.27RSA 200.000 02/20/16 05/10/17 49,998.91 38,136.00 38,136.00 0.00 11,862.91RSA 192.000 02/20/16 05/10/17 47,966.00 36,610.56 36,610.56 0.00 11,355.44

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

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Your Restricted Stock and Performance Awards

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

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For 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 vesting/distribution date)

• The value of the stock at vesting/distribution

• The date of sale

• The sale price and whether it is net of commission

• Your cost basis (from the Supplemental Form)

Example: Restricted Stock and Performance Awards: Hold at vesting and sell before one year (short term)

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Your Restricted Stock and Performance Awards

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

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For 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 vesting/distribution date)

• The value of the stock at vesting/distribution

• The date of sale

• The sale price and whether it is net of commission

• Your cost basis (from the Supplemental Form)

Example: Restricted Stock and Performance Awards: Hold at vesting and sell after one year (long term)

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Your Restricted Stock and Performance Awards

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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For illustrative purposes only.

For illustrative purposes only.

Example: Short-Term Gains or Losses

Example: Long-Term Gains or Losses

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Your Restricted Stock and Performance Awards

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: Why does my cost basis show up as zero?

A: Most restricted stock and performance share awards provided by a company do not require you to “pay” a price for it. Rather, they provide the award to you without cost. As a result, your cost basis is zero and reflected as such in your 1099-B because IRS rules do not let us adjust it. However, your employer will include the Fair Market Value (less any amount you paid, if any) of the award as com-pensation income on your W-2. Therefore, your Supplemental Information Form issued by Fidelity shows the adjusted cost basis and adjusted gain/loss needed for you to properly file your taxes so you don’t overpay tax.

Q: How do I determine if the capital gain or loss on the sale of my restricted stock, restricted stock units, performance shares, or performance units should be treated as long term or short term?

A: When you subsequently sell the shares received upon vesting/distribution, the difference between your sale price and your cost basis in the stock will be treated as a capital gain (or loss). If your holding period of the stock is longer than one year from the vesting/distribution date, your gain (or loss) will be treated as long term. If your holding period is less than one year, your gain (or loss) will be treated as short term and taxed as ordinary income. The sale proceeds are shown on Form 1099-B. If you received restricted stock and made a Section 83(b) election, you will need to consult your tax advisor.

Q: Which form do I use to report my capital gain or loss?

A: You need to complete two forms: Form 8949, with its column totals going onto Schedule D (Form 1040) for the year in which you sold your stock. These forms are filed with your Form 1040 federal income tax return. This is required even when you are only selling shares to pay the taxes at vesting/distribution (or if you have no gain at sale beyond what already appears on your W-2).

Note: When you report the sale of the shares you acquired when your grant vested or was paid out on Form 8949 and Schedule D, you avoid double taxation by including its value at vesting/payout in the cost basis column. Any income you realized at vesting (or payout after a tax deferral) is treated as compensation income, was already reported to the IRS on Form W-2 (or on Form 1099-MISC if you are a nonemployee, such as a director), and was included in your income for the year of vesting/distribution.

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Your Restricted Stock and Performance Awards

Go back to the Fidelity SPS Resource Center

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.710947.5.0 07/34129 RS-TAX-PDF-0118

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

Frequently Asked QuestionsQ: What about when my grant vests/distributes over time?

A: When you have an award that vests/distributes in stages or portions (e.g., 25% a year or 25% for meeting certain targeted performance goals), each portion has its own tax basis that depends on its value at vesting/payout. Your tax basis is equal to the amount (if any) you paid for the shares plus the amount that was treated as compensation for each portion. Your capital gain or loss is the difference between the net sale price and your tax basis for each portion.

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.

Q: How are dividend equivalents taxed?

A: When dividend equivalents are paid at vesting through additional shares or cash, these are reported as part of your ordinary W-2 compensation income and withholding applies at that time. With non-employees, such as directors and independent contractors, this income goes on Form 1099-MISC. The full value of the shares when received is their tax basis when you sell them. Should the cash- dividend payout occur earlier when shareholders receive dividends, this compensation income will be taxed and withholding applies at that time.

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