Fillable Form 11-C (Rev. October 2003) (Fill-in Version). Occupational Tax and Registration Return for Wagering
Form (Rev. October 2003)
Occupational Tax and Registration Return for Wagering
OMB No. 1545-0236
Department of the Treasury Internal Revenue Service
Return for period from
(Month and day)
to June 30,
(Year) Employer identification number
Number, street, and room or suite no. Type or print. City, state, and ZIP code
First return Renewal return Supplemental registration (Do not...
Application for Admission
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