Department of the Treasury—Internal Revenue Service OMB No. 1545-0235 Form 730 Expires 08-31-94 Tax on Wagering (Section 4401 of the Internal Revenue Code) (Rev. October 1991) For IRS Use Only

Your name and address (Please type or print) Employer T

identification number

FF

FP

For month of I

19 T

If your business records are not available at the address

shown, enter address where records are maintained.

For Paperwork

Reduction Act Notice,

see instructions.

Under penalties of perjury, I declare that I have examined this return $

and any accompanying certificates and statements, and, to the best

of my knowledge and belief, they are true, correct, and complete.

1 Gross wagers accepted during month (not including layoffs)

2 Gross amount of layoff wagers accepted during month

$ 3 Add lines 1 and 2

Signature 4a Tax on wagers authorized under the law of the state in which

accepted (.0025 of such amounts included on line 3) $

Date Title (Owner, etc.) b Tax on wagers, other than wagers described on line 4a (.02 of such amounts on line 3)

ORIGINAL.—File this return and your payment with the IRS as shown

under Where To File on page 4. Include your employer identification

or social security number on your check or money order.

5 Layoff credits (No credit is allowed unless supported by evidence.)

6 Net tax due (Subtract line 5 from line 4a and/or 4b.) $

Cat. No. 20585U
Form 730 (10-91) Page 2

● 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.

Who Must File.—You must file Form 730 and pay

the tax on wagers under section 4401(a) if you:

Instructions

(Section references are to the Internal Revenue

Code unless otherwise noted.) ● Are in the business of accepting wagers, or

● Conduct a wagering pool or lottery. Paperwork Reduction Act Notice.—We ask for the

information on this form to carry out the Internal

Revenue laws of the United States. You are required

to give us the information. We need it to ensure that

you are complying with these laws and to allow us

to figure and collect the right amount of tax.

● 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.

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 Not Taxed.—The tax is not imposed on the

following: The time needed to complete and file this form

will vary depending on individual circumstances. The

estimated average time is: Recordkeeping, 3 hr., 26

min.; Learning about the law or the form, 1 hr., 4

min.; Preparing the form, 2 hr., 6 min.; Copying,

assembling, and sending the form to the IRS, 16

min.

● Parimutuel wagering, including horse racing, dog

racing, and jai alai, when it is licensed under state

law.

What is Taxed.—This return covers most wagers

and lotteries, including the following:

● Wagers on a sports event or contest placed with ● Coin-operated devices, such as pinball machines.

a person engaged in the business of accepting

wagers. ● 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.

● 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.

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, the IRS may be granted

authority to require a return to be filed and tax to be

paid immediately.) The IRS will not send you a

notice that a return is due. File a return whether or

If you have comments concerning the accuracy of

these time estimates or suggestions for making this

form more simple, we would be happy to hear from

you. You can write to both the Internal Revenue

Service, Washington, DC 20224, Attention: IRS

Reports Clearance Officer, T:FP; and the Office of

Management and Budget, Paperwork Reduction

Project (1545-0235), Washington, DC 20503. DO

NOT send this tax form to either of these offices.

Instead, see Where To File on page 4.

The tax applies only to wagers accepted in the

United States or placed by a person who is in the

U. S. with a person who is a U.S. citizen or resident.

The return covers lotteries including the numbers

game, policy, punchboards, and similar types of

wagering. It does not include the following:

(Continued on page 4)
Department of the Treasury—Internal Revenue Service OMB No. 1545-0235 Form 730 Expires 08-31-94 Tax on Wagering (Section 4401 of the Internal Revenue Code) (Rev. October 1991)

Your name and address (as shown on original) Employer

identification number

For month of

19 

If your business records are not available at the address

shown, enter address where records are maintained.

For Paperwork

Reduction Act Notice,

see instructions.

Gross wagers accepted during month (not including layoffs) $ 1

2 Gross amount of layoff wagers accepted during month

$ 3 Add lines 1 and 2

4a Tax on wagers authorized under the law of the state in which

accepted (.0025 of such amounts included on line 3) $

b Tax on wagers, other than wagers described on line 4a (.02 of such amounts on line 3)

5 Layoff credits (No credit is allowed unless supported by evidence.)

6 Net tax due (Subtract line 5 from line 4a and/or 4b.) $

Important.—File the original Form 730 with the IRS as shown

under Where To File on page 4. Keep this copy for your

records. Make your check or money order payable to the

Internal Revenue Service. If you have nothing to report, write

‘‘None’’ on the original Form 730 and return it to the IRS.

Regulations section 301.6091-1(c) defines hand-carried

returns that may be filed with your District Director or at a

permanent post of duty.
Form 730 (10-91) Page 4

Instructions (Continued)

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.

Records.—Keep a complete and detailed record of

all taxes paid for at least 3 years from the date the

tax is due. Also, keep copies of the returns. These

records must be available to the IRS at all times.

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.

Where To File.—File your return with the Internal

Revenue Service Center, Ogden, UT 84201. You

may also hand carry your return to the District

Director’s office or to any permanent post of duty

within your Internal Revenue district.

Penalties and Interest.—If you file or pay late, you

may be charged penalties and interest on the

amount you owe. The law provides a penalty of 5%

to 25% of the unpaid tax for late filing of the return.

You can also be charged 1⁄2 of 1% of the unpaid

amount for each month or part of a month for taxes

not paid. The maximum penalty is 25% of the

unpaid amount.

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 layoff 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 tax was paid for more than 1 month.

Completing the Form.— Enter the month for which

this form is being filed, your employer identification

number, name, and address, and sign and date the

return.

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.

Line 1.—Enter the gross amount of wagers

accepted during the month. (See line 2 for layoff

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.

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.

Line 2.—Enter the gross amount of any layoff

wagers you accepted from someone else during the

month. Keep a copy of the certificate you give the

person making the layoff wager. See Regulations

Instead of taking the credit, you may file a claim

for refund on Form 843, Claim for Refund and

Request for Abatement. If you do, attach the same

information as required for a credit, as explained

above.

section 44.6419-2 for a sample and suggested

format for the certificate.