**Adjustments**

This sheet is to be filled out if you’ve adjusted the option price or description of shares under option following a variation in the company’s share capital in this tax year. If no adjustments have been made in this tax year, leave this sheet blank and move on to the relevant sheet.

A variation in the company’s share capital is anything that adjusts the number of shares in issue, the value of the shares or a combination of the two. Some examples of this are share splits, share consolidations, and share buybacks. **Only fill in this sheet if you’ve adjusted the option price or description of the shares under option because of this variation.**

Each employee gets a new row, starting with row 10. Fill in the answers to the questions on the excel sheet. If you get stuck, please have a look at our guidance below:

1. Has there been any adjustment of options following a variation in the share capital of the company?

Answer yes or no

2. Has there been a change to the description of the shares under option?

Answer yes or no

3. Is the adjustment a disqualifying event?

Please see above list of disqualifying events in general guidance. Enter yes if one applies, enter no if none apply and then skip question 4.

4. If a disqualifying event, enter a number 1 to 8

Please see above list of disqualifying events.

Questions 5-10 are self explanatory. Please see excel spreadsheet.

11. Exercise price per share under option before adjustment

Enter the figure to 4 decimal places, rounding where necessary. If less than 4 decimal places, enter 0 to fill remaining decimal places.

12. Number of shares under the option after adjustment

Enter the figure to 2 decimal places, rounding where necessary. If less than 2 decimal places, enter 0 to fill remaining decimal places.

13. Exercise price per share under option after adjustment

Enter the figure to 4 decimal places, rounding where necessary. If less than 4 decimal places, enter 0 to fill remaining decimal places.

14. Actual market value of a share at the date of grant

This is the AMV that HMRC would have approved before you granted these options. Enter the figure to 4 decimal places, rounding where necessary. If less than 4 decimal places, enter 0 to fill remaining decimal places.

**Replacements**

Fill in this sheet for options replaced in relation to a company reorganisation in the tax year. If no replacements have been made this tax year, then leave this sheet blank and move on to the relevant sheet.

Each employee gets a new row, starting with row 10. Fill in the answers to the questions on the excel sheet. If you get stuck, please have a look at our guidance below:

1. Date of grant of old option

Date the original EMI option was granted to the employees. If multiple options were replaced by a single grant, then enter the date of the oldest EMI option being replaced.

Questions 2-7 are self explanatory. Please see excel spreadsheet.

8. Actual Market value of original shares at the date the option(s) were replaced

This is the AMV that HMRC would have approved before you granted these options. Enter the figure to 4 decimal places, rounding where necessary. If less than 4 decimal places, enter 0 to fill remaining decimal places.

Questions 9-16 are self explanatory. Please see excel spreadsheet.

17. Company Reference Number (CRN)

This is the specific number issued by Companies House to UK registered companies. If the company is not UK registered or does not have this number then leave this space blank. If you have the number, enter it without CRN in front.