You may omit
printing the expiration date on this form.
Inventory as of this Action
Requested
Previously Approved
03/31/1998
03/31/1998
06/30/1995
11,500
0
0
108,560
0
108,560
0
0
0
FORM 11-C IS USED TO REGISTER PERSONS
ACCEPTING WAGERS (IRC SECTION 4412). IRS USES THIS FORM TO REGISTER
THE RESPONDENT, COLLECT THE ANNUAL STAMP TAX (IRC SECTION 4412),
AND TO VERIFY THAT THE TAX ON WAGERS IS REPORTED ON FORM
730.
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.