Form W-2G--Certain Gambling Winnings

VOID

3232

Version A, Cycle 2
Page Dimensions: 8.5" x 5.5"; Head margin: .5" to top rule;
Image Area: 7.3" x 4.5" (top rule to bottom rule)

CORRECTED

PAYER’S name, street address, city or town, province or state, country, and
ZIP or foreign postal code

1 Gross winnings

2 Date won

OMB No. 1545-0238

4 Federal income tax withheld

Form W-2G

2015

$
3 Type of wager

$
5 Transaction

6 Race

7 Winnings from identical wagers

8 Cashier

Internal Use Only
DRAFT AS OF
April 14, 2014

PAYER’S federal identification number

PAYER'S telephone number

Certain
Gambling
Winnings

$

9 Winner’s taxpayer identification no. 10 Window

11 First I.D.

12 Second I.D.

Street address (including apt. no.)

13 State/Payer’s state identification no.

14 State winnings

City or town, province or state, country, and ZIP or foreign postal code

15 State income tax withheld

WINNER’S name

For Privacy Act and
Paperwork Reduction
Act
Notice, see the 2015
General
Instructions for
Certain Information
Returns.

$

16 Local winnings

File with Form 1096

$

$

17 Local income tax withheld

18 Name of locality

$

Copy A
For Internal Revenue
Service Center

Under penalties of perjury, I declare that, to the best of my knowledge and belief, the name, address, and taxpayer identification number that I have furnished
correctly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is entitled to any part of these payments.

Signature ▶
Form W-2G

Date ▶
Cat. No. 10138V

www.irs.gov/w2g

Department of the Treasury - Internal Revenue Service

Do Not Cut or Separate Forms on This Page – Do Not Cut or Separate Forms on This Page

VOID

Version A, Cycle 2
Page Dimensions: 8.5" x 5.5"; Head margin: .5" to top rule;
Image Area: 7.3" x 4.5" (top rule to bottom rule)

CORRECTED

PAYER’S name, street address, city or town, province or state, country, and
ZIP or foreign postal code

1 Gross winnings

2 Date won

OMB No. 1545-0238

4 Federal income tax withheld

Form W-2G

$
3 Type of wager

$
5 Transaction

6 Race

7 Winnings from identical wagers

8 Cashier

Internal Use Only
DRAFT AS OF
April 14, 2014

PAYER’S federal identification number

PAYER'S telephone number

2015

Certain
Gambling
Winnings

$

9 Winner’s taxpayer identification no. 10 Window

11 First I.D.

12 Second I.D.

Street address (including apt. no.)

13 State/Payer’s state identification no.

14 State winnings

City or town, province or state, country, and ZIP or foreign postal code

15 State income tax withheld

16 Local winnings

$

$

17 Local income tax withheld

18 Name of locality

WINNER’S name

$

Copy 1
For State, City,
or Local Tax
Department

$
Under penalties of perjury, I declare that, to the best of my knowledge and belief, the name, address, and taxpayer identification number that I have furnished
correctly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is entitled to any part of these payments.

Signature ▶
Form W-2G

Date ▶
www.irs.gov/w2g

Department of the Treasury - Internal Revenue Service

CORRECTED (if checked)
PAYER’S name, street address, city or town, province or state, country, and
ZIP or foreign postal code

Version A, Cycle 2
Page Dimensions: 8.5" x 5.5"; Head margin: .5" to top rule;
Image Area: 7.3" x 4.5" (top rule to bottom rule)

1 Gross winnings

2 Date won

OMB No. 1545-0238

4 Federal income tax withheld

Form W-2G

2015

$
3 Type of wager

$
5 Transaction

6 Race

7 Winnings from identical wagers

8 Cashier

Internal Use Only
DRAFT AS OF
April 14, 2014

PAYER’S federal identification number

PAYER'S telephone number

$

9 Winner’s taxpayer identification no. 10 Window

WINNER’S name

Street address (including apt. no.)

11 First I.D.

12 Second I.D.

13 State/Payer’s state identification no.

14 State winnings

$

City or town, province or state, country, and ZIP or foreign postal code

Certain
Gambling
Winnings

15 State income tax withheld

16 Local winnings

$

$

17 Local income tax withheld

18 Name of locality

This information
is being furnished
to the Internal
Revenue Service

Copy B

Report this income
on your federal tax
return. If this form
shows federal
income
tax withheld in
box 4, attach this
copy to your return.

$
Under penalties of perjury, I declare that, to the best of my knowledge and belief, the name, address, and taxpayer identification number that I have furnished
correctly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is entitled to any part of these payments.

Signature ▶
Form W-2G

Date ▶
www.irs.gov/w2g

Department of the Treasury - Internal Revenue Service

CORRECTED (if checked)
PAYER’S name, street address, city or town, province or state, country, and
ZIP or foreign postal code

Version A, Cycle 2
Page Dimensions: 8.5" x 5.5"; Head margin: .5" to top rule;
Image Area: 7.3" x 4.5" (top rule to bottom rule)

1 Gross winnings

2 Date won

OMB No. 1545-0238

4 Federal income tax withheld

Form W-2G

2015

$
3 Type of wager

$
5 Transaction

6 Race

7 Winnings from identical wagers

8 Cashier

Internal Use Only
DRAFT AS OF
April 14, 2014

PAYER’S federal identification number

PAYER'S telephone number

Certain
Gambling
Winnings

$

9 Winner’s taxpayer identification no. 10 Window

11 First I.D.

12 Second I.D.

Street address (including apt. no.)

13 State/Payer’s state identification no.

14 State winnings

City or town, province or state, country, and ZIP or foreign postal code

15 State income tax withheld

16 Local winnings

$

$

17 Local income tax withheld

18 Name of locality

WINNER’S name

$

This is important tax
information and is
being
furnished to the
Internal
Revenue Service. If
you are required to
file a return, a
negligence penalty or
other sanction may
be imposed on you if
this income is taxable
and the IRS
determines that
it has not been
reported.

Copy C
For Winner's Records

$

Under penalties of perjury, I declare that, to the best of my knowledge and belief, the name, address, and taxpayer identification number that I have furnished
correctly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is entitled to any part of these payments.

Signature ▶
Form W-2G

Date ▶
www.irs.gov/w2g

Department of the Treasury - Internal Revenue Service

Version A, Cycle 2
Page Dimensions: 8.5" x 5.5"; Head margin: .5" to top rule;
Image Area: 7.3" x 4.5" (top rule to bottom rule)

Instructions to Winner
Box 1. The payer must furnish a Form W-2G to you if you
receive:
1. $1,200 or more in gambling winnings from bingo or slot
machines;
2. $1,500 or more in proceeds (the amount of winnings
minus the amount of the wager) from keno;
3. More than $5,000 in winnings (reduced by the wager or
buy-in) from a poker tournament;
4. $600 or more in gambling winnings (except winnings from
bingo, keno, slot machines, and poker tournaments) and the
payout is at least 300 times the amount of the wager; or
5. Any other gambling winnings subject to federal income
tax withholding.
Generally, report all gambling winnings on the “Other
income” line of Form 1040. You can deduct gambling losses
as an itemized deduction, but you cannot deduct more than
your winnings. Keep an accurate record of your winnings and
losses, and be able to prove those amounts with receipts,
tickets, statements, or similar items that you have saved. For
additional information, see Pub. 529, Miscellaneous
Deductions, and Pub. 525, Taxable and Nontaxable Income.

Box 4. Any federal income tax withheld on these winnings is
shown in this box. Federal income tax must be withheld on
certain winnings less the wager.
Certain winnings that are not subject to regular gambling
withholding may be subject to backup withholding if you did
not provide your federal identification number to the payer.
Include the amount shown in box 4 on your Form 1040 as
federal income tax withheld. See Pub. 505, Tax Withholding
and Estimated Tax, for additional information.
Signature. You must sign Form W-2G if you are the only
person entitled to the winnings and the winnings are subject
to regular gambling withholding. Return the signed form to the
payer, who will give you your copies.
Other winners. Prepare Form 5754, Statement by Person(s)
Receiving Gambling Winnings, if another person is entitled to
any part of these winnings. Give Form 5754 to the payer, who
will use Form 5754 to prepare Form W-2G for each person
listed as a winner.

Internal Use Only
DRAFT AS OF
April 14, 2014

Future developments. For the latest information about
developments related to Form W-2G and its instructions,
such as legislation enacted after they were published, go
to www.irs.gov/w2g.

CORRECTED (if checked)
PAYER’S name, street address, city or town, province or state, country, and
ZIP or foreign postal code

Version A, Cycle 2
Page Dimensions: 8.5" x 5.5"; Head margin: .5" to top rule;
Image Area: 7.3" x 4.5" (top rule to bottom rule)

1 Gross winnings

2 Date won

OMB No. 1545-0238

4 Federal income tax withheld

Form W-2G

2015

$
3 Type of wager

$
5 Transaction

6 Race

7 Winnings from identical wagers

8 Cashier

Internal Use Only
DRAFT AS OF
April 14, 2014

PAYER’S federal identification number

PAYER'S telephone number

Certain
Gambling
Winnings

$

9 Winner’s taxpayer identification no. 10 Window

11 First I.D.

12 Second I.D.

Street address (including apt. no.)

13 State/Payer’s state identification no.

14 State winnings

City or town, province or state, country, and ZIP or foreign postal code

15 State income tax withheld

16 Local winnings

$

$

17 Local income tax withheld

18 Name of locality

WINNER’S name

$

Copy 2

Attach this copy
to your state,
city, or local
income tax return,
if required.

$
Under penalties of perjury, I declare that, to the best of my knowledge and belief, the name, address, and taxpayer identification number that I have furnished
correctly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is entitled to any part of these payments.

Signature ▶
Form W-2G

Date ▶
www.irs.gov/w2g

Department of the Treasury - Internal Revenue Service

VOID

Version A, Cycle 2
Page Dimensions: 8.5" x 5.5"; Head margin: .5" to top rule;
Image Area: 7.3" x 4.5" (top rule to bottom rule)

CORRECTED

PAYER’S name, street address, city or town, province or state, country, and
ZIP or foreign postal code

1 Gross winnings

2 Date won

OMB No. 1545-0238

4 Federal income tax withheld

Form W-2G

2015

$
3 Type of wager

$
5 Transaction

6 Race

7 Winnings from identical wagers

8 Cashier

Internal Use Only
DRAFT AS OF
April 14, 2014

PAYER’S federal identification number

PAYER'S telephone number

Certain
Gambling
Winnings

$

9 Winner’s taxpayer identification no. 10 Window

11 First I.D.

12 Second I.D.

Street address (including apt. no.)

13 State/Payer’s state identification no.

14 State winnings

City or town, province or state, country, and ZIP or foreign postal code

15 State income tax withheld

16 Local winnings

$

$

17 Local income tax withheld

18 Name of locality

WINNER’S name

For Privacy Act and
Paperwork Reduction
Act
Notice, see the 2015
General Instructions
for Certain
Information Returns.

$

Copy D

For Payer
$
Under penalties of perjury, I declare that, to the best of my knowledge and belief, the name, address, and taxpayer identification number that I have furnished
correctly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is entitled to any part of these payments.

Signature ▶
Form W-2G

Date ▶
www.irs.gov/w2g

Department of the Treasury - Internal Revenue Service

Version A, Cycle 2
Page Dimensions: 8.5" x 5.5"; Head margin: .5" to top rule;
Image Area: 7.3" x 4.5" (top rule to bottom rule)

Instructions for Payer
To complete Form W-2G, use:
• The 2015 General Instructions for Certain Information
Returns, and
• The 2015 Instructions for Forms W-2G and 5754.

corporations. See the Instructions for Form 1042-S. Also
see Pub. 515, Withholding of Tax on Nonresident Aliens
and Foreign Entities.
Form 5754. If the person receiving the winnings is not the
actual winner or is a member of a group of winners, see the
instructions for Form 5754, Statement by Person(s)
Receiving Gambling Winnings, in the 2015 Instructions for
Forms W-2G and 5754.

Internal Use Only
DRAFT AS OF
April 14, 2014

To order these instructions and additional forms, go to
www.irs.gov/formspubs or call 1-800-TAX-FORM
(1-800-829-3676).
Due dates. Furnish Copies B and C of this form to the
winner by February 1, 2016.

File Copy A of this form with the IRS by
February 29, 2016. If you file electronically, the due date is
March 31, 2016.
Withholding. You may be required to withhold federal
income tax from cash or noncash gambling winnings. See
the 2015 Instructions for Forms W-2G and 5754 for the
rates.

Foreign winners. Use Form 1042-S, Foreign Person’s U.S.
Source Income Subject to Withholding, to report gambling
winnings paid to nonresident aliens and foreign

Need help? If you have questions about reporting on Form
W-2G, call the information reporting customer service site
toll free at 1-866-455-7438 or 304-263-8700 (not toll free).
If you are deaf, hard of hearing, or have a speech disability
and have access to TTY/TDD equipment, you can call
304-579-4827 (not toll free).
Future developments. For the latest information about
developments related to Form W-2G and its instructions,
such as legislation enacted after they were published, go
to www.irs.gov/2g.

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2015

Department of the Treasury
Internal Revenue Service

Instructions for Forms
W-2G and 5754
Section references are to the Internal Revenue Code unless
otherwise noted.

5. The winnings are subject to federal income tax
withholding (either regular gambling withholding or backup
withholding).

Future Developments

Information about any future developments affecting Form W-2G
or Form 5754 (such as legislation enacted after we release
them) will be posted at www.irs.gov/w2g and www.irs.gov/
form5754, respectively. Information about developments
affecting these instructions will be posted on both pages.

Reminder

In addition to these specific instructions, you should also use the
2015 General Instructions for Certain Information Returns.
Those general instructions include information about the
following topics.
Backup withholding.
Electronic reporting requirements.
Penalties.
When and where to file.
Taxpayer identification numbers.
Statements to recipients.
Corrected and void returns.
Other general topics.

You can get the general instructions at IRS.gov or by calling
1-800-TAX-FORM (1-800-829-3676).

Specific Instructions for Form W-2G

File Form W-2G, Certain Gambling Winnings, to report gambling
winnings and any federal income tax withheld on those winnings.
The requirements for reporting and withholding depend on the
type of gambling, the amount of the gambling winnings, and
generally the ratio of the winnings to the wager. File W-2G with
the IRS. You must provide a statement to the winner (Copies B
and C of Form W-2G).
The types of gambling are discussed in these instructions
under the following four headings.
1. Horse Racing, Dog Racing, Jai Alai, and Other Wagering
Transactions Not Discussed Later.
2. Sweepstakes, Wagering Pools, and Lotteries.
3. Bingo, Keno, and Slot Machines.
4. Poker Tournaments.

Reportable Gambling Winnings

Report gambling winnings on Form W-2G if:
1. The winnings (not reduced by the wager) are $1,200 or
more from a bingo game or slot machine,
2. The winnings (reduced by the wager) are $1,500 or more
from a keno game,
3. The winnings (reduced by the wager or buy-in) are more
than $5,000 from a poker tournament,
4. The winnings (except winnings from bingo, slot machines,
keno, and poker tournaments) reduced, at the option of the
payer, by the wager are:
a. $600 or more, and
b. At least 300 times the amount of the wager, or
Jul 11, 2014

Tax-Exempt Organizations

A tax-exempt organization conducting gaming activities may be
required to withhold income tax and report on Form W-2G. See
Pub. 3079, Tax-Exempt Organizations And Gaming.

Withholding

There are two types of withholding on gambling winnings: (a)
regular gambling withholding at 25% (33.33% for certain
noncash payments) and (b) backup withholding at 28%. If a
payment is already subject to regular gambling withholding, it is
not subject to backup withholding.

Regular Gambling Withholding for Certain Games
You may be required to withhold 25% of gambling winnings for
federal income tax. This is referred to as regular gambling
withholding. Withhold at the 25% rate if the winnings minus the
wager are more than $5,000 and are from:
Sweepstakes,
Wagering pools,
Lotteries (but not state-conducted lotteries), or
Wagering transactions in a pari-mutuel pool with respect to
horse races, dog races, or jai alai, if the winnings are at least 300
times the amount wagered.
Regular gambling withholding does not apply to winnings
from bingo, keno, or slot machines, nor does it apply to winnings
from other wagering transactions if the winnings are $5,000 or
less. However, see Backup Withholding, later.
Regular gambling withholding is figured on the total amount
of gross proceeds (the amount of winnings minus the amount
wagered), not merely on the amount in excess of $5,000.
Report the amount you withheld in box 4 of Form W-2G. Also
file Form 945, Annual Return of Withheld Federal Income Tax, to
report all your gambling withholding.
Noncash payments. A noncash payment, such as a car in a
sweepstakes, wagering pool or lottery, must be taken into
account at its fair market value (FMV) for purposes of reporting
and withholding. If the FMV exceeds $5,000, after deducting the
price of the wager, the winnings are subject to 25% regular
gambling withholding. The tax you must withhold is computed
and paid under either of the following two methods.
1. The winner pays the withholding tax to the payer. In this
case, the withholding is 25% of the FMV of the noncash payment
minus the amount of the wager.
2. The payer pays the withholding tax. In this case, the
withholding is 33.33% of the FMV of the noncash payment
minus the amount of the wager.
If you use method 2, enter the sum of the noncash payment
and the withholding tax in box 1 of Form W-2G and the
withholding tax paid by the payer in box 4.

Cat. No. 27989I

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Statements to Winners

Backup Withholding

If you are required to file Form W-2G, you must also provide a
statement to the winner. For information about the requirement
to furnish a statement to the winner, see part M in the 2015
General Instructions for Certain Information Returns. You may
furnish Copies B and C of Form W-2G to the winner.

You may be required to withhold 28% of gambling winnings
(including winnings from bingo, keno, slot machines, and poker
tournaments) for federal income tax. This is referred to as
backup withholding. You should backup withhold if:
The winner does not furnish a correct taxpayer identification
number (TIN),
25% has not been withheld, and
The winnings are at least $600 and at least 300 times the
wager (or the winnings are at least $1,200 from bingo or slot
machines or $1,500 from keno or more than $5,000 from a poker
tournament).

1. Horse Racing, Dog Racing, Jai Alai, and Other
Wagering Transactions Not Discussed Later

File Form W-2G for every person to whom you pay $600 or more
in gambling winnings if the winnings are at least 300 times the
amount of the wager. If the person presenting the ticket for
payment is the sole owner of the ticket, complete Form W-2G
showing the name, address, and TIN of the winner. If regular
gambling withholding is required, the winner must sign Form
W-2G, under penalties of perjury, stating that he or she is the
sole owner and that the information listed on the form is correct.
If more than one person shares in the winnings from a single
wager, see Withholding and Forms W-2G for Multiple Winners,
later.

Figure any backup withholding on the total amount of the
winnings reduced, at the option of the payer, by the amount
wagered. This means the total amount, not just the payments in
excess of $600, $1,200, $1,500, or $5,000, is subject to backup
withholding.
Report the amount you withheld in box 4 of Form W-2G. Also
file Form 945 to report all backup withholding. You may use
Form W-9, Request for Taxpayer Identification Number and
Certification, to request the TIN of the recipient.

Withholding
You must withhold federal income tax from the winnings if the
winnings minus the wager exceed $5,000 and the winnings are
at least 300 times the wager. Withhold 25% of the proceeds (the
winnings minus the wager). This is regular gambling withholding.

See the following instructions for each type of gambling for
detailed rules on backup withholding.

Foreign Persons

If the winner of reportable gambling winnings does not
provide a TIN, you must backup withhold at the rate of 28% on
any such winnings that are not subject to 25% regular gambling
withholding. That is, backup withholding applies if the winnings
are at least $600 but not more than $5,000 and are at least 300
times the wager. Figure backup withholding on the amount of the
winnings reduced, at the option of the payer, by the amount
wagered.

Payments of gambling winnings to a nonresident alien individual
or a foreign entity are not subject to reporting or withholding on
Form W-2G. Generally, gambling winnings paid to a foreign
person are subject to 30% withholding under sections 1441(a)
and 1442(a) and are reportable on Form 1042, Annual
Withholding Tax Return for U.S. Source Income of Foreign
Persons, and Form 1042-S, Foreign Person's U.S. Source
Income Subject to Withholding. Winnings of a nonresident alien
from blackjack, baccarat, craps, roulette, big-6 wheel, or a live
dog or horse race in the United States from legal wagers initiated
outside the United States in a parimutuel pool are not subject to
withholding or reporting. See Pub. 515, Withholding of Tax on
Nonresident Aliens and Foreign Entities.

Multiple Wagers
For multiple wagers sold on one ticket, such as the $12 box bet
on a Big Triple or Trifecta, the wager is considered as six $2 bets
and not one $12 bet for purposes of computing the amount to be
reported or withheld. Winnings on a $12 box bet must be
reported if they are $600 or more, and federal income tax must
be withheld if the proceeds total more than $5,000 or, if the
proceeds do not exceed $5,000, if the recipient fails to provide a
TIN.

State Tax Information
Boxes 13, 14, and 15 and Copies 1 and 2 are provided for your
convenience only and do not have to be completed for the IRS. If
you withheld state income tax on a payment of gambling
winnings, you may enter it in box 15 of Form W-2G. If you do,
also complete boxes 13 and 14. A state identification number
(box 13) is assigned by each individual state.

Identical Wagers
Winnings from identical wagers (for example, two $2 bets on a
particular horse to win the same race) are added together for
purposes of the reporting and withholding requirements. Also,
winnings from identical wagers that are not part of the payment
for which the Form W-2G is being prepared are added together
for purposes of withholding to determine if the total amount of
proceeds from identical wagers is more than $5,000.

If a state tax department requires you to send them a paper
copy of Form W-2G, use Copy 1 for that purpose. Give Copy 2
to the winner for use in filing a state income tax return.

Local Tax Information
Boxes 16, 17, and 18 and Copies 1 and 2 are provided for your
convenience only and do not have to be completed for the IRS. If
you withheld local income tax on a payment of gambling
winnings, you may enter it in box 17 of Form W-2G. If you do,
also complete boxes 16 and 18.

Box 1

Form 5754

Enter the date of the winning event. This is not the date the
money was paid if it was paid after the date of the race (or
game).

Enter payments of $600 or more if the payment is at least 300
times the wager.

Box 2

If the person receiving the winnings is not the actual winner, or is
a member of a group of winners, see Specific Instructions for
Form 5754, later.
-2-

Instructions for Forms W-2G and 5754 (2015)

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tickets, such as five for $1, the wager is considered as $.20 for
each ticket.

Box 3
Enter the type of wager if other than a regular race bet, for
example, Daily Double or Big Triple.

Withholding
You must withhold federal income tax from the winnings if the
winnings minus the wager exceed $5,000. Withhold 25% of the
proceeds (the winnings minus the wager). This is regular
gambling withholding. If the winner of reportable gambling
winnings does not provide a TIN, you must backup withhold at
the rate of 28% on any such winnings that are not subject to 25%
regular gambling withholding. That is, backup withholding
applies if the winnings are at least $600 but not more than
$5,000 and are at least 300 times the wager. Figure backup
withholding on the amount of the winnings reduced, at the option
of the payer, by the amount wagered.

Box 4
Enter any federal income tax withheld, whether regular gambling
withholding or backup withholding.

Box 5
Not applicable.

Box 6
Enter the race (or game) applicable to the winning ticket.

Installment payments of $5,000 or less are subject to regular
gambling withholding if the total proceeds from the wager will
exceed $5,000.

Box 7
Enter the amount of additional winnings from identical wagers.

If payments are to be made for the life of a person (or for the
lives of more than one person), and it is actuarially determined
that the total proceeds from the wager are expected to exceed
$5,000, such payments are subject to 25% regular gambling
withholding. When a third party makes the payments, for
example, an insurance company handling the winnings as an
annuity, that third party must withhold.

Box 8 or 10
Enter the cashier and/or window number making the winning
payment.

Box 9
This is required information. Enter the TIN of the person
receiving the winnings. For an individual this will be the social
security number (SSN) or individual taxpayer identification
number (ITIN). If the winner fails to give you a TIN, backup
withholding applies. See Withholding, earlier.

When Paid
A payment of winnings is considered made when it is paid, either
actually or constructively, to the winner. Winnings are
constructively paid when they are credited to, or set apart for,
that person without any substantial limitation or restriction on the
time, manner, or condition of payment. However, if not later than
60 days after the winner becomes entitled to the prize, the
winner chooses the option of a lump sum or an annuity payable
over at least 10 years, the payment of winnings is considered
made when actually paid. If the winner chooses an annuity, file
Form W-2G each year to report the annuity paid during that year.

Boxes 11 and 12
As verification of the name, address, and TIN of the person
receiving the winnings, enter the identification numbers from two
forms of identification. Acceptable forms of identification include
a driver's license, social security card, or voter registration. Enter
the number and the state or jurisdiction. In some instances, the
number may be the same number as in box 9.

Box 1

Boxes 13 Through 18

Enter payments of $600 or more if the payment is at least 300
times the wager.

These boxes are provided for your convenience only and need
not be completed for the IRS. See State Tax Information and
Local Tax Information, earlier.

Box 2

Box 13. Enter the abbreviated name of the state and your state
identification number.

Enter the date of the winning transaction, such as the date of the
drawing of the winning number. This might not be the date the
winnings are paid.

Box 14. Enter the amount of state winnings.
Box 15. Enter the amount of state income tax withheld.

Box 3

Box 16. Enter the amount of local winnings.

Enter the type of wager (such as raffle or 50-50 drawing) or the
name of the lottery (such as Instant, Big 50, Baker's Dozen, or
Powerball) and the price of the wager ($.50, $1, etc.).

Box 17. Enter the amount of local income tax withheld.
Box 18. Enter the name of your locality.

2. Sweepstakes, Wagering Pools, and Lotteries

Box 4

File Form W-2G for each person to whom you pay $600 or more
in gambling winnings from a sweepstakes, wagering pool, or
lottery (including a state-conducted lottery) if the winnings are at
least 300 times the amount of the wager. The wager must be
subtracted from the total winnings to determine whether
withholding is required and, at the option of the payer, to
determine whether reporting is required. The wager must be
subtracted at the time of the first payment.

Enter any federal income tax withheld, whether regular gambling
withholding or backup withholding.

Box 5
For a state lottery, enter the ticket number or other identifying
number.

Boxes 6 Through 8 and 10

The requirements in this section apply to church raffles,
charity drawings, etc. In the case of one wager for multiple raffle
Instructions for Forms W-2G and 5754 (2015)

Not applicable.
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Box 9

Box 4

This is required information. Enter the TIN of the person
receiving the winnings. For an individual this will be the social
security number (SSN) or individual taxpayer identification
number (ITIN). If the winner fails to give you a TIN, backup
withholding applies. See Withholding under Sweepstakes,
Wagering Pools, and Lotteries, earlier.

Enter any backup withholding.

Box 5
Enter the ticket number, card number (and color, if applicable),
machine serial number, or any other information that will help
identify the winning transaction.

Boxes 11 and 12

Boxes 6 and 7

Except for winnings from state lotteries, enter the identification
numbers from two forms of identification as verification of the
name, address, and TIN of the person receiving the winnings.
Acceptable forms of identification include a driver's license,
social security card, or voter registration. Enter the number and
the state or jurisdiction. In some instances, the number may be
the same number as in box 9.

Not applicable.

Box 8
Enter the initials of the person paying the winnings.

Box 9

Boxes 13 Through 18

This is required information. Enter the TIN of the person
receiving the winnings. For an individual this will be the social
security number (SSN) or individual taxpayer identification
number (ITIN). If the winner fails to give you a TIN, backup
withholding applies. See Withholding under Bingo, Keno, and
Slot Machines, earlier.

These boxes are provided for your convenience only and need
not be completed for the IRS. See State Tax Information and
Local Tax Information, earlier.
Box 13. Enter the abbreviated name of the state and your state
identification number.
Box 14. Enter the amount of state winnings.

Box 10

Box 15. Enter the amount of state income tax withheld.

Enter the location of the person paying the winnings, if
applicable.

Box 16. Enter the amount of local winnings.
Box 17. Enter the amount of local income tax withheld.

Boxes 11 and 12

Box 18. Enter the name of your locality.

As verification of the name, address, and TIN of the person
receiving the winnings, enter the identification numbers from two
forms of identification. Acceptable forms of identification include
a driver's license, social security card, or voter registration. Enter
the number and the state or jurisdiction. In some instances, the
number may be the same number as in box 9.

3. Bingo, Keno, and Slot Machines

File Form W-2G for every person to whom you pay $1,200 or
more in gambling winnings from bingo or slot machines, or
$1,500 or more from keno after the price of the wager for the
winning keno game is deducted. If the winnings are not paid in
cash, the FMV of the item won is considered the amount of the
winnings. Total all winnings from each bingo or keno game.
Winnings and losses from other wagering transactions are not to
be taken into account in arriving at the $1,200 or $1,500 figure.

Boxes 13 Through 18
These boxes are provided for your convenience only and need
not be completed for the IRS. See State Tax Information and
Local Tax Information, earlier.
Box 13. Enter the abbreviated name of the state and your state
identification number.

Withholding
Regular gambling withholding does not apply to winnings from
bingo, keno, or slot machines. However, if the recipient of
reportable gambling winnings from bingo, keno, or slot machines
does not provide a TIN, you must backup withhold. That is, if the
winnings are at least $1,200 from bingo or slot machines or
$1,500 from keno, backup withholding applies to the amount of
the winnings reduced, at the option of the payer, by the amount
wagered.

Box 14. Enter the amount of state winnings.
Box 15. Enter the amount of state income tax withheld.
Box 16. Enter the amount of local winnings.
Box 17. Enter the amount of local income tax withheld.
Box 18. Enter the name of your locality.

4. Poker Tournaments

Box 1

File Form W-2G for each person to whom you pay more than
$5,000 in winnings, reduced by the amount of the wager or
buy-in, from each poker tournament you have sponsored.
Winnings and losses of the participant from other poker
tournaments you have sponsored during the year are not taken
into account in arriving at the $5,000 amount.

Enter payments of $1,200 or more from bingo or slot machines
or payments of $1,500 or more from keno.

Box 2
Enter the date of the winning transaction.

Withholding and backup withholding. If you file Form W-2G
for the person to whom you pay more than $5,000 in net
winnings from a poker tournament, and provide a copy of Form
W-2G to such person, regular gambling withholding does not
apply to the winnings. However, if the person who wins more
than $5,000 does not provide a TIN, you must apply backup
withholding to the full amount of the winnings from the

Box 3
Enter the type of wager (that is, bingo, keno, or slot machines)
and the amount of the wager.

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tournament. Net winnings of $5,000 or less are not subject to
reporting, withholding, or backup withholding.

Box 16. Enter the amount of local winnings.

Box 1

Box 18. Enter the name of your locality.

Enter payments of more than $5,000 in net gambling winnings
from a poker tournament.

Specific Instructions for Form 5754

Box 17. Enter the amount of local income tax withheld.

Use Form 5754, Statement by Person(s) Receiving Gambling
Winnings, to prepare Form W-2G only when the person
receiving gambling winnings subject to reporting or withholding
is not the actual winner or is a member of a group of two or more
people sharing the winnings, such as by sharing the proceeds of
the same winning ticket. The payer is required to file Forms
W-2G based on Form 5754.

Box 2
Enter the date of the poker tournament.

Box 3
Enter “poker tournament” in the entry space.

The person receiving the winnings must furnish all the
information required by Form 5754. However, a recipient of
winnings from a state-conducted lottery need not provide
identification other than his or her taxpayer identification number
(TIN).

Box 4
Enter zero as the amount, unless the winning person has not
provided a TIN. If the winning person has not provided a TIN,
enter the backup withholding amount.

Part I lists the identification of the person to whom the
winnings are paid, and Part II lists the actual winners, their
respective shares of the winnings, and any additional winnings
from identical wagers. Identical wagers are defined earlier in the
Specific Instructions for Form W-2G.

Box 5
Enter the name of the tournament and its sponsor.

Boxes 6 Through 8 and Box 10

In Part II, the person receiving the winnings must provide the
name, address, TIN, respective share of the winnings, and
additional winnings from identical wagers for each of the
winners. In addition, if regular gambling withholding is required,
the form must be signed, under penalties of perjury, and dated
by the person receiving the winnings.

Not applicable.

Box 9
This is required information. Enter the TIN of the person
receiving the winnings. For an individual this will be the social
security number (SSN) or individual taxpayer identification
number (ITIN). If the winner fails to give you a TIN, backup
withholding applies. See Withholding and backup withholding,
earlier.

The form must be returned to the payer for preparation of
Form W-2G for each of the persons listed as winners. Forms
W-2G may be issued immediately or by January 31 following the
year of the payment.
Do not send Form 5754 to the IRS. Keep it for your records.

Boxes 11 and 12

Withholding and Forms W-2G for Multiple
Winners

As verification of the name, address, and TIN of the person
receiving the winnings, enter the identification numbers from two
forms of identification. Acceptable forms of identification include
a driver's license, social security card, or voter registration. Enter
the number and the state or jurisdiction. In some instances, the
number may be the same number as in box 9.

If more than one person shares in the winnings from a single
wager, the total amount of the winnings (minus the amount
wagered) will determine the amount of the proceeds for
purposes of reporting and withholding. Do not allocate winnings
to each winner before determining whether the withholding or
reporting thresholds were reached.

Boxes 13 Through 18
These boxes are provided for your convenience only and need
not be completed for the IRS. See State Tax Information and
Local Tax Information, earlier.

For example, E purchases a sweepstakes ticket for $1 on
behalf of himself and S, who contributes an equal amount of the
ticket price and who will share equally in any winnings. The ticket
wins $5,002. Because the winnings ($5,002 - $1 = $5,001) are
more than $5,000, you must withhold 25% of $5,001. You must
prepare Form W-2G for E and a separate Form W-2G for S using
the information furnished to you on Form 5754.

Box 13. Enter the abbreviated name of the state and your state
identification number.
Box 14. Enter the amount of state winnings.
Box 15. Enter the amount of state income tax withheld.

Instructions for Forms W-2G and 5754 (2015)

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