SWY » Topics » ELECTION UNDER INTERNAL REVENUE CODE SECTION 83(B)

This excerpt taken from the SWY 8-K filed May 18, 2007.

ELECTION UNDER INTERNAL REVENUE CODE SECTION 83(B)

The undersigned taxpayer hereby elects, pursuant to Section 83(b) of the Internal Revenue Code of 1986, as amended, to include in taxpayer’s gross income for the current taxable year the amount of any compensation taxable to taxpayer in connection with taxpayer’s receipt of shares (the “Shares”) of common stock, par value $0.01 per share, of Safeway Inc., a Delaware corporation (the “Company”).

 

1. The name, address and taxpayer identification number of the undersigned taxpayer are:

__________________________________________

__________________________________________

__________________________________________

SSN:                                                                            

The name, address and taxpayer identification number of the taxpayer’s spouse are (complete if applicable):

__________________________________________

__________________________________________

__________________________________________

SSN:                                                                            

 

2. Description of the property with respect to which the election is being made:

                     shares of common stock, par value $0.01 per share, of the Company.

 

3. The date on which the property was transferred was                     , 20    .

 

4. The taxable year to which this election relates is calendar year 20    .

 

5. Nature of restrictions to which the property is subject:

The Shares may not be transferred and are subject to forfeiture if taxpayer’s employment or service with the Company and its majority-owned subsidiaries terminates for any reason. The forfeiture restriction applicable to the Shares will lapse in a series of              cumulative installments of     % each on                     , 20    ,                     , 20    ,                     , 20     and                     , 20     or, if earlier, upon liquidation or dissolution of the Company or the occurrence of a qualifying change in ownership or control of the Company.

 

6. The fair market value at the time of transfer (determined without regard to any lapse restrictions, as defined in Treasury Regulation Section 1.83-3(a)) of the Shares was $             per Share.

 

7. No amount was paid by the taxpayer for the Shares.

 

8. A copy of this statement has been furnished to the Company.

Dated:                     , 20     Taxpayer Signature                                                                          

The undersigned spouse of Taxpayer joins in this election. (Complete if applicable).

Dated:                     , 20     Spouse’s Signature                                                                          


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