Statement by Person(s) Receiving Gambling Winnings

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-0239 can be found here:

Documents and Forms

Document Name Document Type
Form Form 5754 Statement by Person(s) Receiving Gambling Winnings Form and Instruction
Form 5754 Statement by Person(s) Receiving Gambling Winnings F5754_122008.pdf Form and Instruction
F5754_brdn_spec.PDF 2009 Burden IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Statement by Person(s) Receiving Gambling Winnings	Agency IC Tracking Number:	db-0239-041

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Form 5754	Statement by Person(s) Receiving Gambling Winnings	F5754_122008.pdf		Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 204,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	204,000	204,000
Annual IC Time Burden (Hours)	40,800	40,800
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
2009 Burden	F5754_brdn_spec.PDF	08/19/2009

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.