Form 730 (6-86)

Page 4

Instructions (Continued)

Completing the Form.—in the appropriate spaces,
enter the month this form pertains to and your
employer identification number. Also, be sure to
enter your name, address, and sign and date the
return.

Line 1.—Enter the gross amount of wagers
accepted during the month. (See line 2 for lay-off
wagers.) Include all charges connected with placing
the wager. If you can prove that the person placing
the wager has paid a separate charge equal to the
tax, do not include that amount in the amount of the
wager.

Line 2.—Enter the gross amount of any lay-off
wagers you accepted from someone else during the
month. Keep a copy of the certificate you give the
person making the lay-off wager. See Regulations
section 44.6419-2 for a sample and suggested
format for certificate information,

Line 4a or 4b.—Enter the tax applicable in your
state for the type of wager accepted. A lower rate

is applicable to wagers that are authorized by state
law.

Line 5.—Enter any credit you claim for a tax you
paid or owe on any wager that is laid off with
someone else liable for the tax. To claim the credit,
attach a full explanation of the reason for claiming
the credit, certificates to support the lay-off wagers,
and a statement about whether a previous claim for
refund for any part of this amount has been filed.
The statement must show the following: (a) each
amount making up the total credit; (b) the monthly
return on which you reported the tax; (c) the date of
the payment; and (d) the amount chargeable to
each month if the tox was paid for more than one
month.

Keep a complete record of all credits for at least
3 years from the date the credit was taken. You are
not allowed interest on any credit.

Instead of taking the credit, you may file a claim
for refund on Form 843, Claim. If you do, attach the
same information as required above for a credit.

Records.—Keep a complete and detailed record of
all taxes paid for at least 3 years from the date the
taxis due, Also keep copies of the returns. These
records must be available to IRS at all times.

Penalties and Interest.—Avoid penalties and
interest by correctly filing returns and paying the tax
when due. The law provides a penalty of from 5% to
25% of the unpaid tax for late filing of the return,
and ¥% of 1% of the unpaid amount each month or
fraction of a month for taxes not paid when due, with
a total maximum of 25% of the unpaid amount.

Disclosure of Information on Wagering

Taxes.— Except for administering or enforcing
Internal Revenue taxes, neither the Treasury
Department nor any of its employees may disclose
documents, records, or information obtained through
them that a taxpayer supplies in connection with
wagering taxes. Except in administering or enforcing
Internal Revenue taxes, certain documents related to
wagering taxes and information obtained through
them that relates to wagering taxes may not be used
against the taxpayer in any criminal proceeding. See
section 4424 for more information.


rom 730

(Rev. June 1986)

Department of the Treasury—Internal Revenue Service

Tax on Wagering (Section 4401 of the Internal Revenue Code)

OMB No. 1545-0235,
Expires 4-30-89

| For IRS Use Only _
Your name and address (Please type or print) Employer identification | T
number FF
FP
For month of 1
- 19 T

For Paperwork Reduction
Act Notice, see
instructions.

IH your business records are not available at the address
shown above, enter address where records are maintained,

Under penalties of perjury, | declare that | have examined this return

and any accompanying cettificates and statements, and, tothe best of my |Z GfOSS Wagers accepted during month (not including layoffs) .
knowledge and belief, they are true, correct, and complete. 2 Gross amount of lay-off wagers accepted duringmonth . .

3 Addlinesland2. . . . rn $
Signature oo... eeeeeeneececeececeeeeceseseecercseee [4a Taxon wagers authorized under the aw ofthe state in which aceptd (0025 of such

amounts included inline 3).
Date Title (Owner, etc.) b Tax on wagers, other than wagers described online Aa (02 of such amounts in ne 3)
RIGINAL.—File this ret id it with Inte i Re

Savin Center (See Winere To Pe’ pee at ouaeternal Revenvels Lay-off credits (No credit is allowed unless supported by evidence.).
identification or social security number on your check or money grder.___|6__Net tax due (Subtract line 5 from line 4.) . $



Form 730 (6-86)

Page 2

Instructions

(Section references are to the Internal Revenue
Code, unless otherwise noted.)

Paperwork Reduction Act Notice.—We ask for this
information to carry out the Internal Revenue laws of
the United States. We need it to ensure that
taxpayers are complying with these laws and to allow
us to figure and collect the right amount of tax. You
are required to give us this information.

Who Must File.—You must file Form 730 and pay
the tax on wagers under section 4401(a) if you:

© Are in the business of accepting wagers, or
© Conduct a wagering pool or lottery,

You must also be registered under section 4412
See Form 11-C, Special Tax Return and Application
for Registry —Wagering. If you are registered under
section 4412 and receive wagers for or on behalf of
another person but fail to register that person's
name and address, you then become liable for the
tax and must file Form 730

What Is Taxed.—This return covers most wagers
and lotteries, including the following:

‘© Wagers on a sports event or contest placed with
a person engaged in the business of accepting
wagers.

© Wagers placed in a wagering pool on a sports
event or contest, if the pool is conducted for
profit.

Wagers placed in a lottery conducted for profit,
including punchboards.

The tax applies only to wagers accepted in the
United States, or placed by a person who is in the
United States with a person who isa USS. citizen or
resident.

The return covers lotteries including the
numbers game, policy, punchboards, and similar
types of wagering. It does not include the following:

Games in which all persons placing wagers in the
game are present when wagers are placed,
winners are determined, and prizes or other
property are distributed.

© Drawings conducted by an organization exempt
from tax under sections 501 and 521, as long as.
the net proceeds of the drawing do not benefit a
private shareholder or individual.

What Is Not Taxed.—The tax is not imposed on the
following:

© Parimutuel wagering, including horse racing, dog
racing, and jai alai, when itis licensed under state
law.

© Coin-operated devices, such as pinball machines.

© Sweepstakes, wagering pools, or lotteries
conducted by an agency of a state, if the wager is
placed with the state agency or its authorized
agents or employees

When To File.—You must file Form 730 each month
by the last day of the month following the month for
which you are reporting taxable wagers. (However, if
it becomes necessary, IRS may be granted authority
to require a return to be filed and tax to be paid
immediately.) IRS will not send you a notice that a
return is due. File a return whether or not you have
taxable wagers to report. If you have none to report,
write ‘‘None”’ on the return. If you do not expect to
file Form 730 in the future write “FINAL RETURN”
on the return.

Where To File.—For mailing addresses, see Form
11-C. You may also handcarry your return to the
District Director's office or to any permanent post of
duty within your Internal Revenue district.

(Continued on page 4)


rom 730

(Rev. June 1986)

Department of the Treasury—Internal Revenue Service

Tax on Wagering (Section 4401 of the Internal Revenue Code)

OMB No. 1545-0235
Expires: 4-30-89

For month of

For Paperwork Reduction
Act Notice, see
instructions.

Your name and address as shown on original

Employer identification
number

YOUR COPY

If your business records are not available at the address
shown above, enter address where records are maintained.

Important.—File this return with your Internal Revenue Service | 1 Gross wagers accepted during month (not including layoffs). }$o
Center. See Form 11-C for mailing addresses. Make your check A i
5 money order payable to the Internal Revenue Service. If you|> "SS amount of lay-off wagers accepted during month . kh
have nothing to report, write None" on this form andreturnitto|3 Addlinesland2. . 1 6 ee ee ee ee ee ee PR
your Internal Revenue Service Center. If this is a final return, in whi
ot TINAL RETURN,” 4a Taxon wagers authored under the lw ofthe statin which acepted (0025 of such $

amounts included inline3). 2 6 6 ee ee ee —_ _
Regulations section 301,6091-1(c) defines hand. carried returns that may | b Tax on wagers, other than wagers described on line 4a (.02 of such amounts in line 3) —

ror at a permanent post of

3 filed with your District Director or at @ permanent post O' CUS 5 _Lay-off credits (No credit is allowed unless supported by evidence.). _
Keep this copy for your records. 6 __Net tax due (Subtract line 5 from line 4.) Frere! $