Form 11 C PDF Details

The Form 11-C, known as the Occupational Tax and Registration Return for Wagering, is a critical document for individuals involved in the business of accepting wagers. This form, which underwent its last revision in January 2001, serves a dual purpose. It registers the wagering business with the Internal Revenue Service (IRS) and facilitates the payment of the occupational tax tied to the wagering activities. Required for both principals—those who accept wagers for their own accounts—and agents—who accept wagers on behalf of others—the form meticulously details the obligations and tax rates applicable, with a distinction made between general wagering and those activities authorized under state laws. It is instrumental in maintaining compliance with the IRS, outlining not only the initial registration requirements but also circumstances under which renewal or supplemental registration is necessary. The complexity of the form is mirrored by its comprehensive instructions, indicating the types of wagers subject to tax, exemptions, due dates for filing, and the penalties associated with non-compliance. Furthermore, it encapsulates a commitment to privacy while emphasizing the legalities around the sharing of information provided on the form, thus balancing the regulatory requirements with the rights of the registrants. This balanced approach ensures that while the IRS exercises oversight over wagering activities, it also respects the confidentiality of the information received, ensuring it is used solely for tax administration purposes.

QuestionAnswer
Form NameForm 11 C
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesprorated, Cordova, false, 4-digit

Form Preview Example

Form 1 1 - C

 

 

Occupational Tax and Registration Return for Wagering

 

(Rev. January 2001)

 

 

 

 

 

 

 

OMB No. 1545-0236

Department of the Treasury

 

Return for period from

,

to June 30,

 

 

Internal Revenue Service

 

 

(Month and day)

(Year)

 

 

(Year)

 

 

 

Name

 

 

 

Employer identification number

Use IRS label.

 

 

 

 

 

 

 

 

 

 

Number, street, and room or suite no.

 

 

Daytime telephone number

Otherwise,

 

 

 

 

 

 

 

 

 

(

)

 

type or print.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City, state, and ZIP code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Check one:

First return

Renewal return

Supplemental registration (Do not complete lines 1, 2, 4, 5, and 6.)

Business address (if different from your home address or address entered above)

Alias, style, or trade name, if any

Part I Occupational Tax

1Enter the date (month and day) you will start accepting wagers during the tax period

2Tax (See instructions.)

 

 

For IRS Use Only

 

 

 

 

 

T $

 

 

1

FF

 

 

2

FP

 

 

3

I

 

 

 

4

T $

 

 

5

 

 

 

 

 

 

 

 

$

 

Make your check or money order payable to the "United States Treasury" for the tax due and send with the return.

3 Check one:

Principal

Agent accepting wagers for another (See instructions.)

Part II Additional Information (for principal only)

4If taxpayer is a firm, partnership, or corporation, give true name of members or officers.

True name

Title

Home address

 

 

 

Social security number

5Are 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:

Yes

No

Name of location

Address (number and street)

 

 

bNumber of agents engaged in receiving wagers on your behalf

cTrue name, address, and employer identification number of each agent:

City, state, and ZIP code

True name

Address

Employer identification number

Part III Additional Information (for agents accepting wagers on behalf of others)

6If you receive or will be receiving wagers on behalf of or as agent for some other person or persons, give true name, address, and employer identification number of each person.

True name

Address

Employer identification number

Part IV Supplemental Registration (See instructions.)

7 Explain why you are filing a supplemental registration. Include the date of the event.

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.

 

 

 

Signature

Date

Title

For Privacy Act and Paperwork Reduction Act Notice, see page 2.

Cat. No. 16166V

Form 11- C (Rev. 1-2001)
2. You continue for the remainder of the period, as the surviving spouse or child,

Form 11-C (Rev. 1-2001)

Page 2

 

 

General Instructions

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

Caution: The IRS will no longer issue a letter as proof of registration and payment. Your canceled check is proof of registration and payment.

Purpose of form. Form 11-C is used to register certain information with the IRS and to pay the occupational tax on wagering.

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.

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 state-conducted 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.

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, use Form SS- 4, Application for Employer Identification Number, to apply for one. You can get this form at Social Security Administration offices or by calling 1- 800- TAX- FORM (1-800-829-3676). You can ask for an EIN by calling the Tele-TIN phone number for your service center listed in the instructions for Form SS-4.

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. Mail the return to

 

executor, administrator, or other legal

Internal Revenue Service Center

 

representative, the business of a deceased

 

person who paid the occupational tax.

Cincinnati, OH 45999- 0101

 

 

 

Mail the return using the U.S. Postal Service

3. You continue for the remainder of the

period the business as a receiver or trustee in

or other designated private delivery service. See

bankruptcy.

the instructions for your income tax return for

 

more information.

 

 

4. You continue for the remainder of the

Penalties. There are penalties for not filing on

period the business as an assignee for creditors.

 

time, for accepting wagers before paying the tax,

5. One or more members withdraws from a

and for willfully failing to file the return. There are

firm or partnership.

also penalties for making or helping to make

6. The corporate name is changed.

false returns, documents, or statements.

 

7. You engage a new agent to receive wagers.

 

 

 

Confidentiality of information. No Treasury

You must file a supplemental registration to

Department employee may disclose information

report the name, address, and EIN of each new

you supply in relation to wagering tax except

agent within 10 days after you engage the agent.

when needed to administer or enforce the tax

Agents must complete line 7 if you have

law. See section 4424 for more information.

previously filed Form 11-C and are engaged to

 

 

 

Specific Instructions

 

receive wagers for another. You must register

 

the name, address, and EIN of each new person

Return period. Enter the month, day, and year

who engaged you within 10 days after being

engaged.

that begins the return period. Also, enter the

How to file a supplemental registration.

ending year. Write the year as a 4-digit number,

Complete the name, address, EIN, business

i.e., 2000, 2001, etc.

 

 

address, and alias lines. Also, be sure to check

Line 1. Enter the day and month that you will

the “ supplemental registration” box. Then check

start accepting wagers. A full month’s tax is due

the applicable box on line 3 and enter the

regardless of which day you start accepting

information that has changed on line 7, including

wagers during a month.

 

 

the date of the event of change. Do not

Line 2. There are two amounts of tax, $500 and

complete lines 1, 2, 4, 5, or 6 for a supplemental

$50, payable for the year that begins July 1. The

registration.

$50 tax applies only if all wagers (including those

 

accepted by an agent for another) are authorized

 

 

under the laws of the state in which accepted. If

Privacy Act and Paperwork Reduction Act

you start accepting wagers after July 31, the tax

Notice. We ask for the information on this form

is prorated for the first year. Use the table below

to carry out the Internal Revenue laws of the

to determine the tax.

 

 

United States. We need it to figure and collect

Note: This tax is paid once for each taxable

the right amount of tax. Subtitle D,

period. If you are required to file a supplemental

Miscellaneous Excise Taxes, Chapter 35, Section

registration, do not pay the tax a second time.

4411 imposes a special tax on each person who

 

 

 

If you start

 

 

is engaged in receiving wagers for or on behalf

accepting

$500

$50

of any person liable for the tax on wagers.

wagers in

tax

tax

Section 4412 requires that person to register

July

$500.00

$50.00

with the IRS. This form is used to determine the

August

458.33

45.83

amount of the tax that you owe and to register

September

416.66

41.66

certain information with the IRS. Section 6011

October

375.00

37.50

requires you to provide the requested

November

333.33

33.33

information if this tax is applicable to you.

December

291.66

29.16

Section 6109 requires you to provide your

January

250.00

25.00

taxpayer identification number. Routine uses of

February

208.33

20.83

this information include giving it to the

March

166.66

16.66

Department of Justice for civil and criminal

April

125.00

12.50

litigation, and to cities, states, and the District of

May

83.33

8.33

Columbia for use in administering their tax laws.

June

41.66

4.16

If you fail to provide this information in a timely

 

 

 

Line 3. You must check one of the boxes. See

manner, you may be subject to penalties and

Who must file for the definition of principal and

interest.

agent. Principals are liable for the excise tax on

You are not required to provide the

wagers, which is reported and filed monthly on

information requested on a form that is subject

Form 730, Tax on Wagering.

 

 

to the Paperwork Reduction Act unless the form

 

 

 

Lines 4 and 5. These lines are to be completed

displays a valid OMB control number. Books or

by principals only. Enter applicable information

records relating to a form or its instructions must

for officers and/or partners of the company on

be retained as long as their contents may

line 4. Enter on line 5a the name and address of

become material in the administration of any

each location where business will be conducted.

Internal Revenue law. Generally, tax returns and

Enter the number of agents who accept wagers

return information are confidential, as required

for you on line 5b and their names, addresses,

by section 6103.

and EINs on line 5c.

 

 

The time needed to complete and file this

 

 

 

Line 6. This line is to be completed by agents

form will vary depending on individual

accepting wagers on behalf of another. Enter the

circumstances. The estimated average time is:

name, address, and EIN of each person or

 

Recordkeeping, 7 hr. 24 min.; Learning about

company on whose behalf you accept wagers.

the law or the form, 57 min.; Preparing the

Supplemental Registration

form, 2 hr., 3 min.; and Copying, assembling,

and sending the form to the IRS, 16 min.

Line 7. A supplemental registration must be filed

If you have comments concerning the

accuracy of these time estimates or suggestions

by principals within 30 days (except see Agents

for making this form simpler, we would be happy

below) when any of the following events occur.

to hear from you. You can write to the Tax

 

1.You change your business or home address. Forms Committee, Western Area Distribution

Center, Rancho Cordova, CA 95743-0001. Do not send the form to this address. Instead, see Where to file above.

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