| Field Name | Size | Type | Description | Notes |
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 Amount | 12 | Amount | Box 1: Reportable winnings |
|
| Box 2 Date | 10 | Date | Box 2: Date Won | MM/DD/YYYY or M/D/YYYY |
| Box 3 Wager Type | 15 | Text | Box 3: Type of wager |
|
| Box 4 Amount | 12 | Amount | Box 4: Federal income tax withheld |
|
| Box 5 Transaction | 15 | Text | Box 5: Transaction |
|
| Box 6 Race | 5 | Text | Box 6: Race |
|
| Box 7 Amount | 12 | Amount | Box 7: Winnings from identical wagers |
|
| Box 8 Cashier | 5 | Text | Box 8: Cashier |
|
| Box 10 Window | 5 | Text | Box 10: Window |
|
| Box 11 1st ID | 15 | Text | Box 11: First I.D. |
|
| Box 12 2nd ID | 15 | Text | Box 12: Second I.D. |
|
| Box 13 State | 2 | Text | Box 13: State/Payer's state | Use state abbreviation |
| Box 13 ID Number | 20 | Text | Box 13: State/Payer's state identification number | Given by State Department of Revenue |
| Box 14 Amount | 12 | Amount | Box 14: State Winnings |
|
| Box 15 Amount | 12 | Amount | Box 15: State income tax withheld |
|
| Box 16 Amount | 12 | Amount | Box 16: Local Winnings |
|
| Box 17 Amount | 12 | Amount | Box 17: Local income tax withheld |
|
| Box 18 Locality | 14 | Text | Box 18: Name of locality |
|
| Asset Number | 14 | Text | Asset Number | (CS Only) ID Number of Asset that Paid Winnings |
See Form Common Fields
| Form fields common to all form types |
|
