- The type of gambling.
- The amount of the gambling winnings.
- The ratio of the winnings to the wager.
Countries and Languages
| Countries | Languages |
|---|---|
| USA | English |
Extracted Fields
Form Status and Year
| Field | Description |
|---|---|
| Void | Indicates that a previously issued form is being voided. |
| Corrected | Indicates that the form being filed is a corrected version of a previously submitted form. |
| Year | The reporting fiscal year. |
Payer Information
| Field | Description |
|---|---|
| Payer Details - Name | The name, address, and phone number of the of the payer. |
| Payer Details - Street | The name, address, and phone number of the of the payer. |
| Payer Details - City | The name, address, and phone number of the of the payer. |
| Payer Details - State | The name, address, and phone number of the of the payer. |
| Payer Details - ZIP Code | The name, address, and phone number of the of the payer. |
| Payer Details - Country | The name, address, and phone number of the of the payer. |
| Payer Details - Phone | The name, address, and phone number of the of the payer. |
| Payer’s TIN | The tax identification number assigned to the payer. |
Winner Information
| Field | Description |
|---|---|
| Winner’s TIN | The tax identification number assigned to the recipient. |
| Winner Details - Name | The address of the recipient. |
| Winner Details - Street | The address of the recipient. |
| Winner Details - City | The address of the recipient. |
| Winner Details - State | The address of the recipient. |
| Winner Details - ZIP Code | The address of the recipient. |
| Winner Details - Country | The address of the recipient. |
Gambling and Winnings Information
| Field | Description |
|---|---|
| Reportable Winnings | The amount of gambling winnings received by the recipient to be reported to the Internal Revenue Service (IRS). |
| Date Won | The date on which the gambling winnings were obtained or won by the recipient. |
| Type of Wager | The particular type of gambling activity that led to the reported winnings. |
| Federal Income Tax Withheld | The amount of federal income tax that has been withheld from the gambling winnings reported on the form. |
| Transaction | The specific details of the gambling transaction or activity that resulted in the reported winnings. |
| Race | The race (or game) applicable to the winning ticket. |
| Winnings from Identical Wagers | The total amount of cash or prizes won from a single type of wager or bet. |
Payment Processing Information
| Field | Description |
|---|---|
| Cashier | The cashier and/or window number making the winning payment. |
| Window | The cashier and/or window number making the winning payment. |
| First ID | The first identification number associated with the recipient of the form. |
| Second ID | The second identification number associated with the recipient of the form. |
State and Local Tax Information
| Field | Description |
|---|---|
| State Identification Number | The identification number issued by the state where the gambling activity took place. |
| State Winnings | The amount of state winnings. |
| State Income Tax Withheld | The amount of state income tax that was withheld from your gambling winnings by the payer or gambling establishment. |
| Local Winnings | The amount of gambling winnings subject to local income taxes. |
| Local Income Tax Withheld | The amount of local income tax that has been withheld from certain gambling winnings. |
| Name of Locality | The specific location or jurisdiction where the gambling winnings were received. |
Signature Information
| Field | Description |
|---|---|
| Signature | The signature of the recipient. |
| Date | The date of signing. |
Key Fields
- Year
- Payer Details/Name
- Payer’s TIN
- Winner Details/Name
- Winner’s TIN
- Reportable Winnings
Validation Rules
| Rule | Description |
|---|---|
| Complete Form Year | Checks the value in the Year field. It removes any white spaces and converts a 2-digit year into a 4-digit format. If the last two digits are numeric and start with 9, it converts the value to the 1900’s (for example, 99 converts to 1999). Otherwise, it assumes the date is from the 2000’s (for example, 24 converts to 2024). |
