Federal Free Printable Form 11-C (Rev. September 2016) for 2017 Federal Occupational Tax and Registration Return for Wagering

It appears you don't have a PDF plugin for this browser. Please use the link below to download 2016-federal-form-11-c.pdf, and you can print it directly from your computer.

Occupational Tax and Registration Return for Wagering
Form 11-C (Rev. September 2016)

11-C Form (Rev. September 2016) Department of the Treasury Internal Revenue Service Occupational Tax and Registration Return for Wagering ▶ Information about Form 11-C and its instructions is at www.irs.gov/form11c. Return for period from (Month and day) (Year) (Year) Employer identification number Name Type or Print Number, street, and room or suite no. City or town, state or province, country, and ZIP or foreign postal code Check one: First return Renewal return Supplemental registration (Do not complete lines 1, 2, 4, 5, and 6.) Daytime telephone number Business address (if different from your home address or address entered above) For IRS Use Only T $ FF FP I T $ Alias, style, or trade name, if any Part I Occupational Tax 1 Enter the date (month and day) you will start accepting wagers during the tax period . . . 2 Tax (see instructions) . . . . . . . . . . . . . . . . . . . . . . See the attached Form 11-C(V), Payment Voucher, for how to make your payments. . . 3 Check one: Part II 4 Principal 1 2 3 4 5 $ Agent accepting wagers for another (see instructions) Additional Information (for principal only) If the taxpayer is a firm, partnership, or corporation, give the true name of each member or officer. True name 5 OMB No. 1545-0236 to June 30, , Title Home address Are you or will you be engaged in the business of accepting wagers on your own account? . If “Yes,” complete a, b, and c. a Name and address where each business is or will be conducted: Name of location Address (number and street) Social security number . . . . Yes No City or town, state or province, country, and ZIP or foreign postal code b Number of agents engaged in receiving wagers on your behalf ▶ c True name, address, and employer identification number of each agent: True name For Privacy Act and Paperwork Reduction Act Notice, see instructions. Address Employer identification number Cat. No. 16166V Form 11-C (Rev. 9-2016) Form 11-C (Rev. 9-2016) Part III 6 Page If you receive or will be receiving wagers on behalf of, or as an agent for, some other person or persons, give the true name, address, and employer identification number of each person. True name Part IV 7 2 Additional Information (for agents accepting wagers on behalf of others) Address Employer identification number Supplemental Registration (see instructions) Explain why you are filing a supplemental registration. Include the date of the event. Signature of officer Print/Type preparer’s name Date Preparer’s signature ▲ Paid Preparer Use Only ▲ Sign Here Under penalties of perjury, I declare that I have examined this return and/or registration (including any accompanying statements or lists), and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Title Date Check if self-employed Firm’s name ▶ Firm’s EIN Firm’s address ▶ Phone no. PTIN ▶ Form 11-C (Rev. 9-2016) Form 11-C (Rev. 9-2016) Section references are to the Internal Revenue Code unless otherwise noted. Future Developments For the latest information about developments related to Form 11-C and its instructions, such as legislation enacted after they were published, go to www.irs.gov/ form11c. General Instructions Purpose of form. Form 11-C is used to register certain information with the IRS and to pay the occupational tax on wagering. You must pay the occupational tax if you accept taxable wagers for yourself or another person. There are two amounts of occupational tax ($50 or $500). One or the other applies depending on whether the wagers you accept are authorized by the laws of the state in which you accept the wager. See Line 2 later to determine your occupational tax. Your cancelled check is proof of registration and payment. Who must file. File Form 11-C if you are a principal or an agent. 1. A principal is a person who is in the business of accepting taxable wagers for his or her own account. This is the person who makes a profit or risks loss depending on the outcome of the event or contest for which the wager is accepted. 2. An agent is a person who accepts taxable wagers on the principal’s behalf. Taxable wagers include those placed: • On a sports event or contest with a person engaged in the business of accepting wagers on a sports event or contest. • In a wagering pool on a sports event or contest if the pool is conducted for profit. • In a lottery conducted for profit (other than a stateconducted lottery). The term lottery includes the numbers game, policy, punch boards, and similar types of wagering. What is not taxed. The tax is not imposed on the following five items. • A parimutuel wagering enterprise, including horse racing, dog racing, and jai alai, when licensed under the laws of the state in which accepted. • Coin-operated devices, such as pinball machines. • Sweepstakes, wagering pools, or lotteries that are conducted by an agency of a state, if the wager is placed with the state agency or its authorized agents or employees. • Games of the type in which usually 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 or 521, as long as the net proceeds of the drawing do not inure to the benefit of a private shareholder or individual. Page 3 Definitions. See the Instructions for Form 730, Monthly Tax Return for Wagers, for the definition of sports event, contest, wagering pool, and lottery. When to file. File the first return before wagers are accepted. After that, file a renewal return by July 1 for each year wagers are accepted. A first return is also due in certain situations in which there has been a change in ownership or control. The return must be filed within 30 days after new members are admitted to a firm or partnership, a corporation is formed to continue the business of a partnership, or a stockholder continues the business of a dissolved corporation. Employer Identification Number (EIN). Enter your EIN. If you do not have an EIN, apply for one online. Go to the IRS website at www.irs.gov/businesses/small and click on the "Employer ID Numbers" link. You may also apply for an EIN by faxing or mailing Form SS-4, Application for Employer Identification Number, to the IRS. Address. If you are an individual, enter your home address. Signature. Form 11-C must be signed by a person who has authority to sign for the taxpayer. Where to file. Send Form 11-C, your check or money order, and Form 11-C(V) to: Department of the Treasury Internal Revenue Service Cincinnati, OH 45999-0101 Send the return using the U.S. Postal Service or other designated private delivery service. See the instructions for your income tax return for more information about private delivery services. Penalties. There are penalties for not filing on time, for accepting wagers before paying the tax, and for willfully failing to file the return. There are also penalties for making, or helping to make, false returns, documents, or statements. If you receive a notice about a penalty after you file this return, reply to the notice with an explanation and we will determine if you meet reasonable-cause criteria. Do not attach an explanation when you file your 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. Also, 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 nontax criminal proceeding. See section 4424 for more details. Refund. A refund for an overpayment of the occupational tax may be claimed on Form 8849, Claim for Refund of Excise Taxes, using Schedule 6 (Form 8849), Other Claims. See the Instructions for Form 8849 for details. Specific Instructions Return period. Enter the month, day, and year the return period begins. Also, enter the ending year. Write the year as a four-digit number (for example, 2016 or 2017). Form 11-C (Rev. 9-2016) Line 1. Enter the day and month that you will start accepting wagers. A full month’s tax is due regardless of which day you start accepting wagers during a month. Line 2. Use the table below to determine the tax. The $50 tax applies if all wagers (including those accepted by an agent for another) are authorized under the laws of the state in which accepted. If you intend to accept wagers that are not authorized by the state, the $500 tax applies. The tax is payable for the period that begins July 1 of each year. If you start accepting wagers after July 31, the tax is prorated for the first year. Note: This tax is paid once for each period that begins July 1. If you are required to file a supplemental registration, do not pay the tax a second time. If you start $500 $50 accepting tax tax wagers in July . . . . . . . $500.00 . . . . $50.00 August . . . . . . 458.33 . . . . 45.83 September . . . . 416.66 . . . . 41.66 October . . . . . 375.00 . . . . 37.50 November . . . . 333.33 . . . . 33.33 December . . . . 291.66 . . . . 29.16 January . . . . . 250.00 . . . . 25.00 February . . . . . 208.33 . . . . 20.83 March . . . . . . 166.66 . . . . 16.66 April . . . . . . . 125.00 . . . . 12.50 May . . . . . . . 83.33 . . . . 8.33 June . . . . . . 41.66 . . . . 4.16 Payment voucher. Complete Form 11-C(V), Payment Voucher, and file it with Form 11-C and your payment. Line 3. You must check one of the boxes. See Who must file for the definition of principal and agent. Principals are liable for the excise tax on wagers, which is reported and filed monthly on Form 730. Lines 4 and 5. These lines are to be completed by principals only. Enter applicable information for officers and/or partners of the company on line 4. Enter on line 5a the name and address of each location where business will be conducted. Enter the number of agents who accept wagers for you on line 5b and their names, addresses, and EINs on line 5c. Line 6. This line is to be completed by agents accepting wagers on behalf of another. Enter the name, address, and EIN of each person or company on whose behalf you accept wagers. Page 4 Supplemental Registration Line 7. If you, as a principal, change your home or business address, you must file a supplemental registration before accepting wagers at the new address or by the end of the 30-day period after the change, whichever occurs first. If you engage a new agent to receive wagers, you must file, within 10 days of engaging the agent, a supplemental registration reporting the agent's name, address, and EIN. You must file a supplemental registration within 30 days of the occurrence of any of the following events. • As the surviving spouse or child, executor, administrator, or other legal representative, you continue for the remainder of the period the business of a deceased person who paid the occupational tax. • As a receiver, trustee in bankruptcy, or assignee for creditors, you continue the business for the remainder of the period. • There is a change of members of a partnership which is a principal. • There is a name change of a corporation which is a principal. Agents. You must complete line 7 if you have previously filed Form 11-C and are engaged to receive wagers for another. You must register the name, address, and EIN of each new person who engaged you within 10 days after being engaged. How to file a supplemental registration. Complete the name, address, EIN, business address, and alias lines. • Check the “supplemental registration” box. • Check the applicable box on line 3 and enter the information that has changed on line 7, including the date of the event of change. • Do not complete lines 1, 2, 4, 5, or 6 for a supplemental registration. Paid Preparer Use Only A paid preparer must sign Form 11-C and provide the information in the Paid Preparer Use Only section at the end of the form if the preparer was paid to prepare the form and is not an employee of the filing entity. The preparer must give you a copy of the form in addition to the copy to be filed with the IRS. If you are a paid preparer, enter your Preparer Tax Identification Number (PTIN) in the space provided. Include your complete address. If you work for a firm, you also must enter the firm's name and the EIN of the firm. However, you cannot use the PTIN of the tax preparation firm in place of your PTIN. You can apply for a PTIN online or by filing Form W-12, IRS Paid Preparer Tax Identification Number (PTIN) Application and Renewal. For more information about applying for a PTIN online, visit the IRS website at www.irs.gov/ptin. Form 11-C (Rev. 9-2016) Privacy Act and Paperwork Reduction Act Notice We ask for the information on Form 11-C 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. Section 4411 imposes a special tax on each person who is engaged in receiving wagers for or on behalf of any person liable for the tax on wagers. Section 4412 requires that person to register with the IRS. Form 11-C is used to determine the amount of the tax you owe and to register certain information with the IRS. Section 6109 requires you to provide your identification number. Unless specifically prohibited by law, routine uses of this information include giving it to the Department of Justice for civil and criminal litigation; to cities, states, the District of Columbia, and U.S. commonwealths and possessions for use in administering their tax laws; to other countries under a tax treaty; to federal and state agencies to enforce federal nontax criminal laws; or to federal law enforcement and intelligence agencies to combat terrorism. If you fail to provide this information in a timely manner, you may be subject to penalties. You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax returns and return information are confidential, as required by section 6103. Page 5 The time needed to complete and file this form will vary depending on individual circumstances. The estimated burden for businesses is approved under OMB number 1545-0123, and the estimated burden for all others who file this form is: Recordkeeping, 3 hrs., 49 min.; Learning about the law or the form, 57 min.; Preparing the form, 2 hrs., 0 min.; and Copying, assembling, and sending the form to the IRS, 16 min. If you have suggestions for making this form simpler, we would be happy to hear from you. You can send us comments from www.irs.gov/formspubs/. Click on “More Information” and then on “Comment on Tax Forms and Publications.” Or you can send your comments to: Internal Revenue Service Tax Forms and Publications SE:W:CAR:MP:TFP 1111 Constitution Ave. NW, IR-6526 Washington, DC 20224 Do not send the form to this address. Instead, see Where to file, earlier. We respond to many letters by telephone. Therefore, it would be helpful if you would include your daytime phone number, including the area code, in your correspondence. Although we cannot respond individually to each comment received, we do appreciate your feedback and will consider your comments as we revise our tax products. Form 11-C(V), Payment Voucher Purpose of Form Complete Form 11-C(V), Payment Voucher, and file it with Form 11-C, Occupational Tax and Registration Return for Wagering. We will use Form 11-C(V) to credit your payment more promptly and accurately, and to improve our service to you. If you have your return prepared by a third party, provide Form 11-C(V) to the return preparer. Specific Instructions Box 1. If you do not have an EIN, apply for one online. Go to the IRS website at www.irs.gov/businesses/small and click on the “Employer ID Numbers” link. You may also apply for an EIN by faxing or mailing Form SS-4, Application for Employer Identification Number, to the IRS. Form ▼ Box 2. Enter the amount paid with Form 11-C. Box 3. Enter the same year and month you entered on the “Return for period from” line at the top of Form 11-C. For example, if your return is for the full period that begins July 1, 2017, enter 201707. Box 4. Enter your name and address as shown on Form 11-C. • Enclose your check or money order made payable to “United States Treasury.” Be sure to enter your EIN, “Form 11-C,” and the tax period on your check or money order. Do not send cash. Do not staple Form 11-C(V) or your payment to Form 11-C (or to each other). • Detach Form 11-C(V) and send it with your payment and Form 11-C. See Where to file earlier. Detach Here and Mail With Your Payment and Form 11-C. 11-C(V) ▼ Payment Voucher (Rev. September 2016) Department of the Treasury Internal Revenue Service ▶ OMB No. 1545-0236 Do not staple or attach this voucher to your payment or Form 11-C. 1 Enter your employer identification number. 2 Enter the amount of your payment. ▶ Dollars Make your check or money order payable to “United States Treasury” 4 3 Enter year and month as shown on Form 11-C. Y Y Y Y M Enter your business name (individual name if sole proprietor). M Enter your address. Send Form 11-C, this voucher, and payment to: Department of the Treasury Internal Revenue Service Cincinnati, OH 45999-0101 Enter your city or town, state or province, country, and ZIP or foreign postal code. Cents
Extracted from PDF file 2016-federal-form-11-c.pdf, last modified August 2016

More about the Federal Form 11-C Individual Income Tax TY 2016

We last updated the Occupational Tax and Registration Return for Wagering in January 2017, so this is the latest version of Form 11-C, fully updated for tax year 2016. You can download or print current or past-year PDFs of Form 11-C directly from TaxFormFinder. You can print other Federal tax forms here.

Other Federal Individual Income Tax Forms:

TaxFormFinder has an additional 774 Federal income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form 1040-V Payment Voucher
1040 (Schedule A) Itemized Deductions
Form 1040 U.S. Individual Income Tax Return
1040 (Schedule B) Interest and Ordinary Dividends
1040 (Schedule SE) Self-Employment Tax

Download all  tax forms View all 775 Federal Income Tax Forms


Form Sources:

The Internal Revenue Service usually releases income tax forms for the current tax year between October and January, although changes to some forms can come even later. We last updated Federal Form 11-C from the Internal Revenue Service in January 2017.

Show Sources >

About the Individual Income Tax

The IRS and most states collect a personal income tax, which is paid throughout the year via tax withholding or estimated income tax payments.

Most taxpayers are required to file a yearly income tax return in April to both the Internal Revenue Service and their state's revenue department, which will result in either a tax refund of excess withheld income or a tax payment if the withholding does not cover the taxpayer's entire liability. Every taxpayer's situation is different - please consult a CPA or licensed tax preparer to ensure that you are filing the correct tax forms!

Historical Past-Year Versions of Federal Form 11-C

We have a total of five past-year versions of Form 11-C in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2016 Form 11-C

Form 11-C (Rev. September 2016)

Occupational Tax and Registration Return for Wagering 2015 Form 11-C

Form 11-C (Rev. December 2013)

Occupational Tax and Registration Return for Wagering 2013 Form 11-C

Form 11-C (Rev. December 2013)

Occupational Tax and Registration Return for Wagering 2012 Form 11-C

Form 11-C (Rev. December 2012)

Occupational Tax and Registration Return for Wagering 2011 Form 11-C

Form 11-C (Rev. April 2008)


TaxFormFinder Disclaimer:

While we do our best to keep our list of Federal Income Tax Forms up to date and complete, we cannot be held liable for errors or omissions. Is the form on this page out-of-date or not working? Please let us know and we will fix it ASAP.

** This Document Provided By TaxFormFinder.org **
Source: http://www.taxformfinder.org/federal/form-11-c