IRS Tax Forms - 2003 - Part 2
Form (Rev. October 2003) 11-C Name 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) , (Year) to June 30, (Year) Employer identification number Number, street, and room or suite no. 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.) Daytime telephone number ( ) Business address
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