If that's your only lot then I can tell you that you have a "real' loss of ($442.74) on the Sec 351 portion, but since you can't take that loss you'd report a basis of $1,149.69 against the proceeds of $1,149.69 for no gain or loss, and you have a loss of ($67.36) on the Redemption portion, so you'd report a basis of $288.52 against proceeds of $221.16.
Be sure and check these figures against your own calculations.
