Statement by Person(s) Receiving Gambling Winnings

ICR 200606-1545-006

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
43856 Migrated
ICR Details
1545-0239 200606-1545-006
Historical Active 200603-1545-042
TREAS/IRS
Statement by Person(s) Receiving Gambling Winnings
Extension without change of a currently approved collection   No
Regular
Approved without change 09/21/2006
Retrieve Notice of Action (NOA) 06/08/2006
This form is used by individual and other taxpayers. The portion of the burden imposed on individual taxpayers is approved under OMB Control Number 1545-0074, and that must be noted in the PRA Notice in the form instructions. In its next submission under this OMB Control Number, the agency is instructed to ensure that the estimate of burden associated with this Control Number includes only the burden imposed on non-individual taxpayers. If the agency finds that the current burden estimate includes burden imposed on individual taxpayers, it must immediately submit an adjustment request that eliminates this double-counting.
  Inventory as of this Action Requested Previously Approved
09/30/2009 36 Months From Approved 09/30/2006
204,000 0 204,000
40,800 0 40,800
0 0 0

Section 3402(q)(6) of the IRC requires a statement by the person receiving certain gambling winnings when that person is not the winner or is one of a group of winners. It enables the payer to properly apportion the winnings and withheld tax on Form W-2G. We use the information on Form W-2G to ensure that recipients are properly reporting their income.

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 204,000 204,000 0 0 0 0
Annual Time Burden (Hours) 40,800 40,800 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
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.
06/08/2006


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