3232                  VOID                  CORRECTED
PAYER’S name, street address, city or town, state or province, country,  1  Reportable winnings                      2  Date won                    OMB No. 1545-0238
and ZIP or foreign postal code
                                                                                                                                                    Form W-2G
                                                                         $                                                                          Certain 
                                                                         3  Type of wager                            4  Federal income tax withheld Gambling 
                                                                                                                     $                              Winnings
                                                                         5  Transaction                              6  Race                        (Rev. December 2023)
                                                                                                                                                    For calendar year
                                                                         7   Winnings from identical wagers          8  Cashier                     20
PAYER’S TIN                         PAYER’S telephone no.                $
                                                                         9   WINNER’S TIN                            10  Window
                                                                                                                                                    For Privacy Act 
                                                                                                                                                    and Paperwork 
                                                                                                                                                    Reduction Act 
WINNER’S name                                                            11  First identification no.                12  Second identification no.  Notice, see the 
                                                                                                                                                    current General 
                                                                                                                                                    Instructions for 
                                                                                                                                                    Certain Information 
Street address (including apt. no.)                                      13   State/Payer’s state identification no. 14  State winnings               Returns.

                                                                                                                     $
City or town, state or province, country, and ZIP or foreign postal code 15  State income tax withheld               16  Local winnings
                                                                                                                                                    File with Form 1096
                                                                         $                                           $
                                                                         17  Local income tax withheld               18  Name of locality           Copy A 
                                                                                                                                                    For Internal Revenue 
                                                                         $                                                                          Service Center
Under penalties of perjury, I declare that, to the best of my knowledge and belief, the name, address, and taxpayer identification number that I have furnished 
correctly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is entitled to any part of these payments.
Signature:                                                                                             Date: 
Form W-2G (Rev. 12-2023)            Cat. No. 10138V                      www.irs.gov/FormW2G                          Department of the Treasury - Internal Revenue Service
     Do Not Cut or Separate Forms on This Page  —  Do Not Cut or Separate Forms on This Page

                                    VOID                  CORRECTED
PAYER’S name, street address, city or town, state or province, country,  1  Reportable winnings                      2  Date won                    OMB No. 1545-0238
and ZIP or foreign postal code
                                                                                                                                                    Form W-2G
                                                                         $                                                                           Certain 
                                                                         3  Type of wager                            4  Federal income tax withheld  Gambling 
                                                                                                                     $                               Winnings
                                                                         5  Transaction                              6  Race                        (Rev. December 2023)
                                                                                                                                                     For calendar year
                                                                         7   Winnings from identical wagers          8  Cashier                      20
PAYER’S TIN                         PAYER’S telephone no.                $
                                                                         9   WINNER’S TIN                            10  Window

WINNER’S name                                                            11  First identification no.                12  Second identification no. 

                                                                                                                                                       Copy 1 
Street address (including apt. no.)                                      13   State/Payer’s state identification no. 14  State winnings              For State, City, 
                                                                                                                                                     or Local Tax 
                                                                                                                     $                               Department
City or town, state or province, country, and ZIP or foreign postal code 15  State income tax withheld               16  Local winnings

                                                                         $                                           $
                                                                         17  Local income tax withheld               18  Name of locality

                                                                         $
Under penalties of perjury, I declare that, to the best of my knowledge and belief, the name, address, and taxpayer identification number that I have furnished 
correctly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is entitled to any part of these payments.
Signature:                                                                                             Date:
Form W-2G (Rev. 12-2023)                 www.irs.gov/FormW2G                                                          Department of the Treasury - Internal Revenue Service

                                                          CORRECTED (if checked)
PAYER’S name, street address, city or town, state or province, country,  1  Reportable winnings                      2  Date won                    OMB No. 1545-0238
and ZIP or foreign postal code
                                                                                                                                                    Form W-2G
                                                                         $                                                                          Certain 
                                                                         3  Type of wager                            4  Federal income tax withheld Gambling 
                                                                                                                     $                              Winnings
                                                                         5  Transaction                              6  Race                        (Rev. December 2023)
                                                                                                                                                    For calendar year
                                                                         7   Winnings from identical wagers          8  Cashier                     20
PAYER’S TIN                         PAYER’S telephone no.                $
                                                                         9   WINNER’S TIN                            10  Window

                                                                                                                                                    This information 
                                                                                                                                                    is being furnished 
WINNER’S name                                                            11  First identification no.                12  Second identification no.  to the IRS.

Street address (including apt. no.)                                      13   State/Payer’s state identification no. 14  State winnings
                                                                                                                                                    Copy B 
                                                                                                                     $                              Report this income 
City or town, state or province, country, and ZIP or foreign postal code 15  State income tax withheld               16  Local winnings             on your federal tax 
                                                                                                                                                    return. If this form 
                                                                         $                                           $                              shows federal 
                                                                         17  Local income tax withheld               18  Name of locality           income tax 
                                                                                                                                                    withheld in box 4, 
                                                                                                                                                    attach this copy 
                                                                         $                                                                          to your return.
Under penalties of perjury, I declare that, to the best of my knowledge and belief, the name, address, and taxpayer identification number that I have furnished 
correctly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is entitled to any part of these payments.
Signature:                                                                                             Date:
Form W-2G (Rev. 12-2023)            www.irs.gov/FormW2G                                                               Department of the Treasury - Internal Revenue Service

                                                          CORRECTED (if checked)
PAYER’S name, street address, city or town, state or province, country,  1  Reportable winnings                      2  Date won                    OMB No. 1545-0238
and ZIP or foreign postal code
                                                                                                                                                    Form W-2G
                                                                         $                                                                              Certain 
                                                                         3  Type of wager                            4  Federal income tax withheld     Gambling 
                                                                                                                     $                                  Winnings
                                                                         5  Transaction                              6  Race                        (Rev. December 2023)
                                                                                                                                                        For calendar year
                                                                         7   Winnings from identical wagers          8  Cashier                         20
PAYER’S TIN                         PAYER’S telephone no.                $
                                                                         9   WINNER’S TIN                            10  Window
                                                                                                                                                    This is important tax 
                                                                                                                                                    information and is 
                                                                                                                                                    being furnished to 
WINNER’S name                                                            11  First identification no.                12  Second identification no.  the IRS. If you are 
                                                                                                                                                    required to file a 
                                                                                                                                                    return, a negligence 
                                                                                                                                                        penalty or other 
                                                                                                                                                    sanction may be 
Street address (including apt. no.)                                      13   State/Payer’s state identification no. 14  State winnings             imposed on you if 
                                                                                                                                                        this income is 
                                                                                                                                                        taxable and the 
                                                                                                                     $                                  IRS determines 
City or town, state or province, country, and ZIP or foreign postal code 15  State income tax withheld               16  Local winnings                 that it has not 
                                                                                                                                                        been reported.
                                                                         $                                           $
                                                                         17  Local income tax withheld               18  Name of locality
                                                                                                                                                        Copy C 
                                                                         $                                                                          For Winner’s Records
Under penalties of perjury, I declare that, to the best of my knowledge and belief, the name, address, and taxpayer identification number that I have furnished 
correctly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is entitled to any part of these payments.
Signature:                                                                                             Date:
Form W-2G (Rev. 12-2023)            www.irs.gov/FormW2G                                                               Department of the Treasury - Internal Revenue Service

Instructions to Winner                                       Box 4. Any federal income tax withheld on these winnings 
Box 1. The payer must furnish a Form W-2G to you if you      is shown in this box. Federal income tax must be withheld 
receive:                                                     on certain winnings less the wager.
1. $1,200 or more in gambling winnings from bingo or            Certain winnings that are not subject to regular gambling 
slot machines;                                               withholding may be subject to backup withholding if you 
                                                             did not provide your taxpayer identification number (TIN) to 
2. $1,500 or more in winnings (reduced by the wager)         the payer.
from keno;
                                                                Include the amount shown in box 4 on your Form 1040 
3. More than $5,000 in winnings (reduced by the wager        or 1040-SR as federal income tax withheld. See Pub. 505 
or buy-in) from a poker tournament;                          for additional information.
4. $600 or more in gambling winnings (except winnings 
from bingo, keno, slot machines, and poker tournaments)      Signature. You must sign Form W-2G if you are the only 
and the payout is at least 300 times the amount of the       person entitled to the winnings and the winnings are 
wager; or                                                    subject to regular gambling withholding. Return the signed 
                                                             form to the payer, who will give you your copies.
5. Any other gambling winnings subject to federal 
income tax withholding.                                      Other winners. Prepare Form 5754 if another person is 
                                                             entitled to any part of these winnings. Give Form 5754 to 
Generally, report all gambling winnings under the “Other     the payer,  who will use Form 5754 to prepare Form W-2G 
income” line of Schedule 1 (Form 1040). You can deduct       for each person listed as a winner.
gambling losses as an itemized deduction, but you cannot 
deduct more than your winnings. Keep an accurate record      Future developments. For the latest information about 
of your winnings and losses, and be able to prove those      developments related to Form W-2G and its instructions, 
amounts with receipts, tickets, statements, or similar items such as legislation enacted after they were published, go 
that you have saved. For additional information, see Pub.    to www.irs.gov/FormW2G. 
529 and Pub. 525.

                                                          CORRECTED (if checked)
PAYER’S name, street address, city or town, state or province, country,  1  Reportable winnings                      2  Date won                    OMB No. 1545-0238
and ZIP or foreign postal code
                                                                                                                                                    Form W-2G
                                                                         $                                                                          Certain 
                                                                         3  Type of wager                            4  Federal income tax withheld Gambling 
                                                                                                                     $                              Winnings
                                                                         5  Transaction                              6  Race                        (Rev. December 2023)
                                                                                                                                                    For calendar year
                                                                         7   Winnings from identical wagers          8  Cashier                     20
PAYER’S TIN                         PAYER’S telephone no.                $
                                                                         9   WINNER’S TIN                            10  Window

WINNER’S name                                                            11  First identification no.                12  Second identification no.
                                                                                                                                                      Copy 2 
                                                                                                                                                    Attach this copy 
Street address (including apt. no.)                                      13   State/Payer’s state identification no. 14  State winnings             to your state, 
                                                                                                                                                      city, or 
                                                                                                                                                    local income 
                                                                                                                     $                              tax return, 
City or town, state or province, country, and ZIP or foreign postal code 15  State income tax withheld               16  Local winnings             if required.

                                                                         $                                           $
                                                                         17  Local income tax withheld               18  Name of locality

                                                                         $
Under penalties of perjury, I declare that, to the best of my knowledge and belief, the name, address, and taxpayer identification number that I have furnished 
correctly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is entitled to any part of these payments.
Signature:                                                                                             Date:
Form W-2G (Rev. 12-2023)            www.irs.gov/FormW2G                                                               Department of the Treasury - Internal Revenue Service

                                    VOID                  CORRECTED
PAYER’S name, street address, city or town, state or province, country,  1  Reportable winnings                      2  Date won                    OMB No. 1545-0238
and ZIP or foreign postal code
                                                                                                                                                    Form W-2G
                                                                         $                                                                           Certain 
                                                                         3  Type of wager                            4  Federal income tax withheld Gambling 
                                                                                                                     $                              Winnings
                                                                         5  Transaction                              6  Race                        (Rev. December 2023)
                                                                                                                                                    For calendar year
                                                                         7   Winnings from identical wagers          8  Cashier                     20
PAYER’S TIN                         PAYER’S telephone no.                $
                                                                         9   WINNER’S TIN                            10  Window

                                                                                                                                                    For Privacy Act 
WINNER’S name                                                            11  First identification no.                12  Second identification no.  and Paperwork 
                                                                                                                                                    Reduction Act 
                                                                                                                                                    Notice, see the 
                                                                                                                                                    current General 
Street address (including apt. no.)                                      13   State/Payer’s state identification no. 14  State winnings             Instructions for 
                                                                                                                                                    Certain Information 
                                                                                                                     $                                Returns.
City or town, state or province, country, and ZIP or foreign postal code 15  State income tax withheld               16  Local winnings

                                                                         $                                           $
                                                                         17  Local income tax withheld               18  Name of locality
                                                                                                                                                     Copy D 
                                                                         $                                                                           For Payer
Under penalties of perjury, I declare that, to the best of my knowledge and belief, the name, address, and taxpayer identification number that I have furnished 
correctly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is entitled to any part of these payments.
Signature:                                                                                             Date:
Form W-2G (Rev. 12-2023)                 www.irs.gov/FormW2G                                                          Department of the Treasury - Internal Revenue Service

Instructions for Payer                                         Foreign winners. Use Form 1042-S to report gambling 
To complete Form W-2G, use:                                    winnings paid to nonresident aliens and foreign 
                                                               corporations. See the Instructions for Form 1042-S and  
• The current General Instructions for Certain Information     Pub. 515 for more information. 
Returns, and
                                                               Form 5754. If the person receiving the winnings is not the 
• The current Instructions for Forms W-2G and 5754.            actual winner or is a member of a group of winners, see 
To order these instructions and additional forms, go to        Specific Instructions for Form 5754 in the current 
www.irs.gov/OrderForms.                                        Instructions for Forms W-2G and 5754.
Filing and furnishing. For filing and furnishing instructions, Need help? If you have questions about reporting on Form 
including due dates, and to request filing or furnishing       W-2G, call the Technical Services Operation (TSO) toll free 
extensions, see the current General Instructions for Certain   at 866-455-7438 or 304-263-8700 (not toll free). Deaf or 
Information Returns.                                           hard-of-hearing customers may call any of our toll-free 
Withholding. You may be required to withhold federal           numbers using their choice of relay service. 
income tax from cash or noncash gambling winnings. See         Future developments. For the latest information about 
the current Instructions for Forms W-2G and 5754 for more      developments related to Form W-2G and its instructions, 
information, including the withholding rates.                  such as legislation enacted after they were published, go 
                                                               to www.irs.gov/FormW2G.