Statement by Person(s) Receiving Gambling Winnings

ICR 201211-1545-016

OMB: 1545-0239

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supporting Statement A
2012-11-30
IC Document Collections
ICR Details
1545-0239 201211-1545-016
Historical Active 200908-1545-041
TREAS/IRS
Statement by Person(s) Receiving Gambling Winnings
Extension without change of a currently approved collection   No
Regular
Approved without change 01/29/2013
Retrieve Notice of Action (NOA) 11/30/2012
  Inventory as of this Action Requested Previously Approved
01/31/2016 36 Months From Approved 01/31/2013
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.

US Code: 26 USC 3402 (q)(6) Name of Law: Statement by recipient
  
None

Not associated with rulemaking

  77 FR 60023 10/01/2012
77 FR 71208 11/29/2012
No

1
IC Title Form No. Form Name
Statement by Person(s) Receiving Gambling Winnings Form 5754 Statement by Person(s) Receiving Gambling Winnings

  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

$8,930
No
No
No
No
No
Uncollected
Janice Martin 202 622-3312

  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.
11/30/2012


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