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⚠️ Notice: This information collection may be referencing outdated material.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 Form 5754.pdf Form and Instruction
brdn_spec.pdf 2012 Burden IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Statement by Person(s) Receiving Gambling Winnings	Agency IC Tracking Number:

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	Form 5754.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
2012 Burden	brdn_spec.pdf	11/14/2012

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