Information Collection

Occupational Tax and Registration Return for Wagering

IC 17179 under ICR 201003-1545-002 · OMB 1545-0236.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-0236 can be found here:

Documents and Forms

Document Name Document Type
Form 11-C Occupational Tax and Registration Return for Wagering Form
Form 11-C (V) OTC voucher.pdf Other-Voucher
Form 11-C (V) Preprinted voucher.pdf Other-Voucher
11-C Occupational Tax and Registration Return for Wagering Form 11-C.pdf Form
2009 burden for Form 11-C (V) OTC voucher.PDF Burden IC Document
2009 burden for Form 11-C (V) OTC voucher.PDF Burden IC Document
2009 burden for Form 11-C (V) Preprinted voucher.PDF Burden IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Occupational Tax and Registration Return for Wagering	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 26 CFR 6103

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	11-C	Occupational Tax and Registration Return for Wagering	Form 11-C.pdf	No		Printable Only
Other-Voucher			Form 11-C (V) OTC voucher.pdf	Yes	No	Paper Only
Other-Voucher			Form 11-C (V) Preprinted voucher.pdf	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 11,500	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	23,000	23,000
Annual IC Time Burden (Hours)	126,175	126,175
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Burden	2009 burden for Form 11-C (V) OTC voucher.PDF	03/07/2010
Burden	2009 burden for Form 11-C (V) OTC voucher.PDF	03/07/2010
Burden	2009 burden for Form 11-C (V) Preprinted voucher.PDF	03/07/2010

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.