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Field NameSizeType DescriptionNotes
See Form Filer Common Fields  Filer fields common to all form types. 
See Recipient Common Fields  Recipient fields common to all form types. 
Box 1 Amount16AmountBox 1: Gross winnings 
Box 2 Date8NumberBox 2: Date Won 
Box 3 Wager Type15CharacterBox 3: Horse Racing / Dog Racing / Jai Alai / Lotteries / Keno / Bingo / Slot Machine / Poker Tournament / Any other type of gambling winnings 
Box 4 Amount16AmountBox 4: Federal income tax withheld 
Box 5 Transaction15CharacterBox 5: Transaction 
Box 6 Race5CharacterBox 6: Race 
Box 7 Amount16AmountBox 7: Winnings from identical wagers 
Box 8 Cashier5CharacterBox 8: Cashier 
Box 10 Window5CharacterBox 10: Window 
Box 11 1st ID15CharacterBox 11: First ID 
Box 12 2nd ID15CharacterBox 12: Second ID 
Box 13 State2CharacterBox 13: State abbreviation code 
Box 13 ID Number20CharacterBox 13: State ID no. 
Box 14 Amount12AmountBox 14: State Winnings 
Box 15 Amount16AmountBox 15: State Income Tax Withheld 
Box 16 Amount12NumberBox 16: Local Winnings 
Box 17 Amount12AmountBox 17: Local Income Tax Withheld 
Box 18 Locality14CharacterBox 18: Name of locality 
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