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Get 1545-0236 (rev

Nternal Revenue Service , to June 30, (Month and day) (Year) (Year) Name Use IRS label. Otherwise, please print or type. Check one: Employer identification number (See instructions.) Number, street, and room or suite no. City, state, and ZIP code First return Renewal return Supplemental registration return (Do not complete lines 1, 2, 4, 5, and 6.) Business address For IRS Use Only Date letter issued 1 2 3 Occupational Tax Enter month you will start accepting wagers during the ta.

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