Monthly Tax Return for Wagers

• Legal Form Number: 730
• Year: 2017
• Issuer: Treasury Department
• Section: Treasury Department

Form 730

(Rev. December 2017)

Department of the Treasury

Internal Revenue Service

Monthly Tax Return for Wagers

(Section 4401 of the Internal Revenue Code)

▶Go to www.irs.gov/Form730 for the latest information.

OMB No. 1545-0235

For IRS Use Only

Enter your

name,

address,

employer

identification

number,

and

month and

year of

return.

▲

Name

Number, street, and room or suite no.

City or town, state or province, country, and ZIP or foreign postal code

Month and year

Employer identification number

T

FF

FD

FP

I

T

Check applicable boxes: Final return Address change

1

Gross amount of wagers accepted during month (not including laid-off wagers) (see instructions) ..

1

2 Gross amount of laid-off wagers accepted during month (see instructions) ........2

3 Add lines 1and 2...........................3

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

accepted. Enter the amount of these wagers included in line

3;multiply by the amount shown and enter the result ...$ ×

0.0025 =

4a

b Tax on wagers other than wagers described on line 4a.Enter

the amount of these wagers included in line 3;multiply by the

amount shown and enter the result .........$ ×0.02 = 4b

c Tax on wagers. Add lines 4aand 4b.....................4c

5 Credits. No credit is allowed unless supported by evidence (see instructions) .......5

6 Balance due. Subtract line 5from line 4c(see instructions) .............6

File this return, your payment, and voucher with the IRS as shown under Where to file in the instructions. Make your check or money

order payable to “United States Treasury.” Write your name, address, EIN, “Form 730,” and the tax period on it.

Sign

Here

Under penalties of perjury, I declare that I have examined this return, including any accompanying certificates and statements, 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.

Keep a copy

of this return

for your

records.

▲

Signature

Type or print your name below signature.

▲

Date

Paid

Preparer

Use Only

Print/Type preparer’s namePreparer’s signatureDateCheck if

self-employed

PTIN

Firm’s name ▶

Firm’s address ▶

Firm’s EIN ▶

Phone no.

For Paperwork Reduction Act Notice, see instructions. Cat. No. 20585U Form 730 (Rev. 12-2017)

▼Detach Here and Mail With Your Payment and Form 730. ▼Form 730-V

Form

730-V

(Rev. December 2017)

Department of the Treasury

Internal Revenue Service

Payment Voucher

▶ Don’t staple or attach this voucher to your payment.

OMB No. 1545-0235

1 Enter your employer identification

number.

2

Enter the amount of your payment.▶

Make your check or money order payable to “United States Treasury”

Dollars Cents

3 Enter year and month as shown on Form 730.

Y Y Y Y M M

Send Form 730, this voucher, and payment to:

Department of the Treasury

Internal Revenue Service

Ogden, UT 84201-0100

4 Enter your business name (individual name if sole proprietor).

Enter your address.

Enter your city, state, and ZIP code.