Employee Stock Ownership Plan
Report your participation in an employee stock ownership plan (ESOP) in Part 3. In addition, report the employee stock ownership plan in Part 2 (see Part 2 of this guide for details).
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Employer or Party
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City/State
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Status and Terms
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Date
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Widgets Unlimited
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Grand Rapids, MI
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My participation in the employee stock ownership plan will cease upon my separation from the firm.
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2/2010
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For You
Part 3
Report your participation in an employee stock ownership plan. In addition, if you are an Annual or Termination filer, report an employee stock ownership plan in which you participated at any point during the reporting period.
Employer or Party: Provide the name of the employer.
City/State: Provide the city and state in which the employer is located.
Status and Terms: Report your participation in the employee stock ownership plan and indicate whether you will continue to participate.
Date: Provide the month and year in which you began participating in the employee stock ownership plan.
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