Exhibit EE Form W-2G
Publication 1179 — General Rules and Specifications For Substitute Forms 1096, 1098, 1099, 5498, and Certain Other Information Returns · 2026-10-03 edition · updated 2026-10-04 · United States
Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page
Cat. No. 10138V
Department of the Treasury - Internal Revenue Service
OMB No. 1545-0238
Form W-2G
Certain Gambling
Winnings
(Rev. January 2026)
For calendar year
20
For Privacy Act and Paperwork
Reduction Act
Notice, see
Pub. 1099,
General Instructions
for Certain Information
Returns .
File with Form 1096
Copy A For Internal Revenue
Service Center
| 3232 VOID CORREC | CTED | ||||
|---|---|---|---|---|---|
PAYER’S name |
PAYER’S name |
PAYER’S name |
PAYER’S name |
1 Reportable winnings $ |
2 Date won |
| Street address | Street address | Room or suite no. | Room or suite no. | 3 Type of wager | 4 Federal income tax withheld $ |
| City or town | City or town | City or town | City or town | 5 Transaction | 6 Race |
| State or province | Country | ZIP or foreign postal code | ZIP or foreign postal code | 7 Winnings from identical wagers $ |
8 Cashier |
N I T S ’ R E Y A P |
. o n e n o h p ele t S ’ R E Y A P |
. o n e n o h p ele t S ’ R E Y A P |
. o n e n o h p ele t S ’ R E Y A P |
9 WINNER’S TIN | 10 Window |
| WINNER’S name | WINNER’S name | WINNER’S name | WINNER’S name | 11 First identification no. | 12 Second identification no. |
| Street address | Street address | Street address | Apt. no. | 13 State/ identification no. |
14 State winnings $ |
| City or town | City or town | City or town | City or town | City or town | City or town |
| City or town | City or town | City or town | City or town | 15 State income tax withheld $ |
16 Local winnings $ |
| State or province | Country | ZIP or foreign postal code | ZIP or foreign postal code | ZIP or foreign postal code | ZIP or foreign postal code |
| 17 Local income tax withheld $ |
18 Name of locality |
Under penalties of perjury, I declare that, to the best of my knowledge and belief, the name, address, and taxpayer identification number that I have furnished correctly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is entitled to any part of these payments.
Signature: Date:
Form W-2G (Rev. 1-2026) Created 11/24/25 Cat. No. 10138V www.irs.gov/FormW2G
66
Department of the Treasury - Internal Revenue Service
Get a plain-English answer with a citation back to this text.
Ask AI about this code