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PRINTED: 09/30/2015 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION
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Printed 0930 department is related to tax form 0930 which is used for reporting excise tax on wagering.
Any entity or individual who is engaged in the business of accepting wagers and is subject to the excise tax on wagering is required to file form 0930.
Form 0930 should be completed with accurate information regarding the amount of wagers received and the corresponding excise tax owed.
The purpose of form 0930 is to report and pay the excise tax on wagering activities.
The form requires information about the total amount of wagers received and the corresponding excise tax calculated based on the wagering activities.
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