Enter the amount paid from line 6 of page 1 of Form 730. Box 4. Enter your name and address as shown on Form 730. Y Form 730 Rev. 12-2017 Payment Voucher PTIN Cat. No. 20585U Detach Here and Mail With Your Payment and Form 730. 730-V Form 730-V Don t staple or attach this voucher to your payment. Enter your employer identification Enter the amount of your payment. Don t send cash. Don t staple this voucher or your payment to Form 730 or to each other. Detach the completed voucher and send it with your payment and Form 730. Complete Form 730-V if you re making a payment by check or money order with Form 730. We will use the completed voucher to credit your payment more promptly and accurately and to improve our service to you. Make your check or money order payable to United States Treasury Enter year and month as shown on Form 730. If you have your return prepared by a third party and a payment is required provide this Don t file Form 730-V if you re paying the balance due on Form 730 line 6 using the Electronic Federal Tax Payment System EFTPS. For the latest Form 730 and its instructions such as legislation enacted after they were published What s New Effective January 2018 send Form 730 and/or See Where to file later for the updated General Instructions Who must file. Monthly Tax Return for Wagers Form Rev* December 2017 Department of the Treasury Internal Revenue Service Enter your name address employer identification number and month and year of return* OMB No* 1545-0235 Section 4401 of the Internal Revenue Code For IRS Use Only Go to www*irs*gov/Form730 for the latest information* Name Month and year Number street and room or suite no. Employer identification number T FF FD FP I City or town state or province country and ZIP or foreign postal code Check applicable boxes Final return Address change Gross amount of wagers accepted during month not including laid-off wagers see instructions. 4a Add lines 1 and 2. Tax on wagers authorized under the law of the state in which accepted* Enter the amount of these wagers included in line 3 multiply by the amount shown and enter the result. the amount of these wagers included in line 3 multiply by the amount shown and enter the result. c 0. 0025 4b 4c. Credits. No credit is allowed unless supported by evidence see instructions Tax on wagers. Add lines 4a and 4b. Balance due. Subtract line 5 from line 4c see instructions. File this return your payment and voucher with the IRS as shown under Where to file in the instructions. Under penalties of perjury I declare that I have examined this return including any accompanying certificates and statements and to the best of my knowledge and belief it is true correct and complete. Declaration of preparer other than taxpayer is based on all information of which preparer has any knowledge. Keep a copy of this return for your records. Paid Preparer Use Only Print/Type preparer s name Sign Here Signature Preparer s signature Firm s EIN Phone no. Check if self-employed Firm s address Date Firm s name For Paperwork Reduction Act Notice see instructions.
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