STATEMENT BY PERSON(S) RECEIVING GAMBLING WINNINGS

ICR 198311-1545-017

OMB: 1545-0239

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
129515 Migrated
ICR Details
1545-0239 198311-1545-017
Historical Active 198110-1545-004
TREAS/IRS
STATEMENT BY PERSON(S) RECEIVING GAMBLING WINNINGS
Revision of a currently approved collection   No
Regular
Approved without change 12/12/1983
Retrieve Notice of Action (NOA) 11/29/1983
  Inventory as of this Action Requested Previously Approved
12/31/1986 12/31/1986 09/30/1984
306,000 0 306,000
203,699 0 138,000
0 0 0

SECTION 3402(Q)(6) REQUIRES A STATEMENT BY THE PERSON RECEIVING THE WINNINGS WHEN THAT PERSON IS NOT THE WINNER, OR IS ONE OF A GROUP OF WINNERS ENTILTLED TO A SHARE OF THE WINNINGS. IT ENABLES THE PAYER TO PROPERLY APPORTION THE WINNINGS AND WITHHOLDING TAX WHEN PREPARING FORMS W-2G. WE USE THE INFORMATION TO ENSURE INCOME-REPORTING COMPLIANCE BY RECIPIENTS.

None
None


No

1
IC Title Form No. Form Name
STATEMENT BY PERSON(S) RECEIVING GAMBLING WINNINGS 5754

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 306,000 306,000 0 0 0 0
Annual Time Burden (Hours) 203,699 138,000 0 13,140 52,559 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
11/29/1983


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