A 1099 Express source record for Form 3921 looks like this:
B|N|SSN|Cor|Frgn|Bar|CS|Name1|Name2|Addr|City|State|Zip|Account|Date1|Date2|Amt3|Amt4|Shares|Other
Field 1: Capital "B", This is the Record Identifier.
Field 2: Capital "N", Identifies the type of form as 3921.
Filed 3: Employee's Social Security Number.
Field 4: Correction Indicator.
Field 5: Set to "1" if payee is Foreign (outside USA).
Field 6: Not used - Reserved for Barcode.
Field 7: Not used - Reserved for Combined State Code on other forms.
Field 8: Payee Name 1 Field.
Field 9: Payee Name 2 Field, usually empty.
Field 10: Payee Address.
Field 11: Payee City.
Field 12: Payee State Code.
Field 13: Payee Zip Code.
Field 14: Account Information. Must be unique to distinguish corrections for duplicate recipients.
Field 15: Box 1 Date Option Granted, Pos 547-554(8).
Field 16: Box 2 Date Option exercised, pos 555-562(8).
Field 17: Box 3 Amt03 Exercise price per share (money).
Field 18: Box 4 Amt04 Fair market value per share on exercise date (money).
Field 19: Box 5 Number of shares transferred, pos 563-510(8) rjust, zfill.
Field 20: Box 6 If other than Transferor,
name, address and EIN of corporation whose stock is being transferred, 575-614 (40) Ljust.
See Form 3921 Instructions
for rules.
All Fields are normal Ascii strings, without a Ascii Zero trailer. Each record is terminated by a
carriage return, line feed sequence