Common use of Election Form Clause in Contracts

Election Form. TO: Internal Revenue Service Center [Address where the employee files his or her personal income tax return] ELECTION UNDER SECTION 83(b) OF THE INTERNAL REVENUE CODE OF 1986 Name: __________________________________________________________________ Address: __________________________________________________________________ __________________________________________________________________ Social Security Number ____ - __ - ____ Property with respect to which this Election is made: _____ shares of the common stock of Banner Corporation. Date of Grant or Transfer: ____________, _____. Taxable Year for which Election is made: Calendar Year _____. Nature of the Restrictions to which the Property is Subject: (i) a vesting schedule pursuant to which the taxpayer will not be fully vested in the property until ___________. Fair Market Value of the Property upon receipt by taxpayer ______. Amount Paid for the Property: ____________. Copies of this Election have been furnished to ___________________________. A copy of this Election also shall be attached to my IRS Form 1040 for calendar year _____. __________ _____________________________________ Date Signature

Appears in 2 contracts

Samples: Restricted Stock Award Agreement (Banner Corp), Restricted Stock Award Agreement (Banner Corp)

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Election Form. TO: Internal Revenue Service Center [Address where the employee files his or her personal income tax return] ELECTION UNDER SECTION 83(b) OF THE INTERNAL REVENUE CODE OF 1986 Name: __________________________________________________________________ Address: ________________________________________________________________ ________________________________________________________________ __________________________________________________________________ Social Security Number ____ - __ - ____ Property with respect to which this Election is made: _______ shares of the common stock of Banner CorporationAnchor Bancorp. Date of Grant or Transfer: ____________, _____. Taxable Year for which Election is made: Calendar Year _____. Nature of the Restrictions to which the Property is Subject: (i) a vesting schedule pursuant to which the taxpayer will not be fully vested in the property until ___________. Fair Market Value of the Property upon receipt by taxpayer $___________. Amount Paid for the Property: ____________. Copies of this Election have been furnished to ___________________________. A copy of this Election also shall be attached to my IRS Form 1040 for calendar year _____. __________ _____________________________________ Date Signature_

Appears in 1 contract

Samples: Restricted Stock Award Agreement (Anchor Bancorp)

Election Form. TO: Internal Revenue Service Center [Address where the employee files his or her personal income tax return] ELECTION UNDER SECTION 83(b) OF THE INTERNAL REVENUE CODE OF 1986 Name: __________________________________________________________________ Address: __________________________________________________________________ __________________________________________________________________ Social Security Number ____ - __ - ____ Property with respect to which this Election is made: _______ shares of the common stock of Banner Corporation. Capitol Federal Financial, Inc. Date of Grant or Transfer: ____________, _____. Taxable Year for which Election is made: Calendar Year _____. Nature of the Restrictions to which the Property is Subject: (i) a vesting schedule pursuant to which the taxpayer will not be fully vested in the property until ___________. Fair Market Value of the Property upon receipt by taxpayer $___________. Amount Paid for the Property: ____________. Copies of this Election have been furnished to ___________________________. A copy of this Election also shall be attached to my IRS Form 1040 for calendar year _____. __________ _____________________________________ Date Signature

Appears in 1 contract

Samples: Equity Incentive Plan (Capitol Federal Financial Inc)

Election Form. TO: Internal Revenue Service Center [Address where the employee files his or her personal income tax return] ELECTION UNDER SECTION 83(b) OF THE INTERNAL REVENUE CODE OF 1986 Name: __________________________________________________________________ Address: __________________________________________________________________ __________________________________________________________________ Social Security Number ____ - __ - ____ Property with respect to which this Election is made: _______ shares of the common stock of Banner Corporation. FS Bancorp, Inc. Date of Grant or Transfer: ____________, _____. Taxable Year for which Election is made: Calendar Year _____. Nature of the Restrictions to which the Property is Subject: (i) a vesting schedule pursuant to which the taxpayer will not be fully vested in the property until ___________. Fair Market Value of the Property upon receipt by taxpayer $___________. Amount Paid for the Property: ____________. Copies of this Election have been furnished to ___________________________. A copy of this Election also shall be attached to my IRS Form 1040 for calendar year _____. __________ _____________________________________ Date Signature

Appears in 1 contract

Samples: Restricted Stock Award Agreement (FS Bancorp, Inc.)

Election Form. TO: Internal Revenue Service Center [Address where the employee files his or her personal income tax return] ELECTION UNDER SECTION 83(b) OF THE INTERNAL REVENUE CODE OF 1986 Name: __________________________________________________________________ Address: __________________________________________________________________ ___________________________________________________________________ Social Security Number ____ - __ - ____ Property with respect to which this Election is made: _______ shares of the common stock of Banner Corporation. Sound Financial Bancorp, Inc. Date of Grant or Transfer: ____________, _____. Taxable Year for which Election is made: Calendar Year _____. Nature of the Restrictions to which the Property is Subject: (i) a vesting schedule pursuant to which the taxpayer will not be fully vested in the property until ___________. Fair Market Value of the Property upon receipt by taxpayer $___________. Amount Paid for the Property: ____________. Copies of this Election have been furnished to ___________________________. A copy of this Election also shall be attached to my IRS Form 1040 for calendar year _____. __________ _____________________________________ Date Signature

Appears in 1 contract

Samples: Sound Financial (Sound Financial Bancorp, Inc.)

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Election Form. TO: Internal Revenue Service Center [Address where the employee files his or her personal income tax return] ELECTION UNDER SECTION 83(b) OF THE INTERNAL REVENUE CODE OF 1986 Name: __________________________________________________________________ Address: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Social Security Number ____ - __ - ____ Property with respect to which this Election is made: _____ shares of the common stock of Banner Corporation. Date of Grant or Transfer: ____________, _____. Taxable Year for which Election is made: Calendar Year _____. Nature of the Restrictions to which the Property is Subject: (i) a vesting schedule pursuant to which the taxpayer will not be fully vested in the property until ___________. Fair Market Value of the Property upon receipt by taxpayer ______. Amount Paid for the Property: ____________. Copies of this Election have been furnished to ___________________________. A copy of this Election also shall be attached to my IRS Form 1040 for calendar year _____. __________ _____________________________________ Date Signature

Appears in 1 contract

Samples: Restricted Stock Award Agreement (Banner Corp)

Election Form. TO: Internal Revenue Service Center [Address where the employee files his or her personal income tax return] ELECTION UNDER SECTION 83(b) OF THE INTERNAL REVENUE CODE OF 1986 Name: __________________________________________________________________ Address: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Social Security Number ____ - __ - ____ Property with respect to which this Election is made: _______ shares of the common stock of Banner CorporationFirst Northwest Bancorp. Date of Grant or Transfer: ____________, _____. Taxable Year for which Election is made: Calendar Year _____. Nature of the Restrictions to which the Property is Subject: (i) a vesting schedule pursuant to which the taxpayer will not be fully vested in the property until ___________. Fair Market Value of the Property upon receipt by taxpayer $___________. Amount Paid for the Property: ____________. Copies of this Election have been furnished to ___________________________. A copy of this Election also shall be attached to my IRS Form 1040 for calendar year _____. __________ _____________________________________ Date Signature_

Appears in 1 contract

Samples: Restricted Stock Award Agreement (First Northwest Bancorp)

Election Form. TO: Internal Revenue Service Center [Address where the employee files his or her personal income tax return] ELECTION UNDER SECTION 83(b) OF THE INTERNAL REVENUE CODE OF 1986 Name: __________________________________________________________________ Address: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Social Security Number _____ - ____ - _____ Property with respect to which this Election is made: _________ shares of the common stock of Banner Corporation. LegacyTexas Financial Group, Inc. Date of Grant or Transfer: ____________, _____. Taxable Year for which Election is made: Calendar Year _____. Nature of the Restrictions to which the Property is Subject: (i) a vesting schedule pursuant to which the taxpayer will not be fully vested in the property shares of common stock Shares until ___________. Fair Market Value of the Property upon receipt by taxpayer taxpayer: $___________. Amount Paid for the Property: ____________. Copies of this Election have been furnished to ___________________________. _ at LegacyTexas Financial Group, Inc. A copy of this Election also shall be attached to my IRS Form 1040 for calendar year _____. ___________________ ___________________________________________ Date Signature

Appears in 1 contract

Samples: Legacytexas Financial (LegacyTexas Financial Group, Inc.)

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