Form W-2 Certain Gambling Winnings

3232

VOID

CORRECTED

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

1 Reportable winnings

2 Date won

$
3 Type of wager

4 Federal income tax withheld

$

PAYER’S federal identification number

PAYER’S telephone number

5 Transaction

6 Race

7 Winnings from identical wagers

8 Cashier

OMB No. 1545-0238

Form W-2G
Certain
Gambling
Winnings
(Rev. January 2021)
For calendar year
20

$
9 Winner’s taxpayer identification no. 10 Window

WINNER’S name

11 First identification

12 Second identification

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

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

$
File with Form 1096

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 (Rev. 1-2021)

Date ▶
Cat. No. 10138V

www.irs.gov/FormW2G

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

CORRECTED

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

1 Reportable winnings

2 Date won

$
3 Type of wager

4 Federal income tax withheld

$

PAYER’S federal identification number

PAYER’S telephone number

5 Transaction

6 Race

7 Winnings from identical wagers

8 Cashier

OMB No. 1545-0238

Form W-2G
Certain
Gambling
Winnings
(Rev. January 2021)
For calendar year
20

$
9 Winner’s taxpayer identification no. 10 Window

WINNER’S name

11 First identification

12 Second identification

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

Copy 1

$

For State, City,
or Local Tax
Department

16 Local winnings

$

$

17 Local income tax withheld

18 Name of locality

$
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 (Rev. 1-2021)

Date ▶
www.irs.gov/FormW2G

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

1 Reportable winnings

2 Date won

$
3 Type of wager

4 Federal income tax withheld

$

PAYER’S federal identification number

PAYER’S telephone number

5 Transaction

6 Race

7 Winnings from identical wagers

8 Cashier

OMB No. 1545-0238

Form W-2G
Certain
Gambling
Winnings
(Rev. January 2021)
For calendar year
20

$
9 Winner’s taxpayer identification no. 10 Window

WINNER’S name

11 First identification

12 Second identification

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

$

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 (Rev. 1-2021)

Date ▶
www.irs.gov/FormW2G

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

1 Reportable winnings

2 Date won

$
3 Type of wager

4 Federal income tax withheld

$

PAYER’S federal identification number

PAYER’S telephone number

5 Transaction

6 Race

7 Winnings from identical wagers

8 Cashier

OMB No. 1545-0238

Form W-2G
Certain
Gambling
Winnings
(Rev. January 2021)
For calendar year
20

$
9 Winner’s taxpayer identification no. 10 Window

WINNER’S name

11 First identification

12 Second identification

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

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 (Rev. 1-2021)

Date ▶
www.irs.gov/FormW2G

Department of the Treasury - Internal Revenue Service

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 winnings (reduced by 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 Schedule 1 (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
or 1040-SR 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.
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/FormW2G.

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

1 Reportable winnings

2 Date won

$
3 Type of wager

4 Federal income tax withheld

$

PAYER’S federal identification number

PAYER’S telephone number

5 Transaction

6 Race

7 Winnings from identical wagers

8 Cashier

OMB No. 1545-0238

Form W-2G
Certain
Gambling
Winnings
(Rev. January 2021)
For calendar year
20

$
9 Winner’s taxpayer identification no. 10 Window

11 First identification

WINNER’S name

12 Second identification

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

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 (Rev. 1-2021)

Date ▶
www.irs.gov/FormW2G

Department of the Treasury - Internal Revenue Service

VOID

CORRECTED

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

1 Reportable winnings

2 Date won

$
3 Type of wager

4 Federal income tax withheld

$

PAYER’S federal identification number

PAYER’S telephone number

5 Transaction

6 Race

7 Winnings from identical wagers

8 Cashier

OMB No. 1545-0238

Form W-2G
Certain
Gambling
Winnings
(Rev. January 2021)
For calendar year
20

$
9 Winner’s taxpayer identification no. 10 Window

WINNER’S name

11 First identification

12 Second identification

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

$

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

16 Local winnings

$

$

17 Local income tax withheld

18 Name of locality

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 (Rev. 1-2021)

Date ▶
www.irs.gov/FormW2G

Department of the Treasury - Internal Revenue Service

Instructions for Payer
To complete Form W-2G, use:
• The current General Instructions for Certain Information
Returns, and
• The current Instructions for Forms W-2G and 5754.
To order these instructions and additional forms, go to
www.irs.gov/FormsPubs.
Due dates. For filing and furnishing instructions, including
due dates, and to request filing or furnishing extensions,
see the current General Instructions for Certain Information
Returns.
To file electronically, you must have software that
generates a file according to the specifications in Pub. 1220.
Withholding. You may be required to withhold federal
income tax from cash or noncash gambling winnings. See
the current 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
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 current Instructions
for Forms W-2G and 5754.
Need help? If you have questions about reporting on Form
W-2G, call the information reporting customer service site
toll free at 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/FormW2G.