Fillable Fincen Form 103 - Currency Transaction Report By Casinos (Page 4 of 4) in pdf

FinCEN Form103 (Rev. 3-03)

Page 4

or Items 31a through 31i, specify the type of transaction

from a wire transfer (one Cash Out entry); and presents

Part III. Casino Reporting Transaction(s)

and the amount of currency in Item 30h or 31j,

$2,000 in small denomination U.S. currency to be

respectively. Enter the total amount of the reportable

exchanged for an equal amount in U.S. $100 bills.

Item 34. Casino’s trade name.—Enter the name by

Cash In transaction(s) in Item 30i. Enter the total amount

Complete Form 103 as follows:

which the casino does business and is commonly

of the reportable Cash Out transaction(s) in Item 31k.

Cash In of “$5,000” is entered in Item 30b

known. Do not enter a corporate, partnership, or other

If less than a full dollar amount is involved increase

(deposit), “$10,000” is entered in Item 30c (payment

entity name, unless such name is the one by which the

the figure to the next higher dollar. For example, if

on credit), “$2,000” is entered in Item 30g (currency

casino is commonly known.

the currency total is $20,500.25, show it as

exchange), and Cash In Total of “$17,000” is entered

$20,501.00.

in Item 30i. In determining whether the transactions

Item 35. Casino’s legal name.—Enter the legal name

If there is a currency exchange, list it separately

are reportable, the currency exchange is aggregated

as shown on required tax filings, only if different from

with both the Cash In and Cash Out totals. If foreign

with both the Cash In and the Cash Out amounts.

the trade name shown in Item 34. This name will be

currency is exchanged, use the U.S. dollar equivalent

The result is a reportable $17,000 Cash In transaction.

defined as the name indicated on a charter or other

on the day of the transaction.

No entry is made for Cash Out. The total Cash Out

document creating the entity, and which is identified

Payment(s) on credit, Item 30c, includes all forms

amount only equals $9,000, which does not meet the

with the casino’s established EIN.

of cash payments made by a customer on a credit

BSA reporting threshold.

account or line of credit, or in redemption of markers

Example 3. Person C deposits $7,000 in currency

Item 36. Employer identification number (EIN).—

or counter checks. Currency received from wire

to his front money account and pays $9,000 in currency

Enter the casino’s EIN.

transfer(s) out, Item 30e, applies to cash received from

to pay off an outstanding credit balance (two Cash In

a customer when the casino sends a wire transfer on

entries); receives $2,500 in currency from a withdrawal

Items 37, 38, 39, and 40. Address.—Enter the street

behalf of a customer.

from a safekeeping account, $2,500 in currency from

address, city, state, and ZIP code of the casino (or

Currency paid from wire transfer(s) in, Item 31e,

a wire transfer and cashes a personal check of $7,500

branch) where the transaction occurred. Do not use a

applies to cash paid to a customer when the casino

(three Cash Out entries); and presents Canadian

P .O. box number.

receives a wire transfer on behalf of a customer. Travel

dollars which are exchanged for $1,500 in U.S. dollar

and complimentary expenses and gaming incentives,

equivalent. Complete Form 103 as follows:

Items 41 and 42. Title and signature of

Item 31h, includes reimbursements for a customer’s

Cash In of “$7,000” is entered in Item 30b (deposit),

approving official.—The official who is authorized

travel and entertainment expenses and cash

“$9,000” is entered in Item 30c (payment on credit),

to review and approve Form 103 must indicate his/her

complementaries (“comps”).

“$1,500” is entered in Item 30g (currency exchange),

title and sign the form.

and a Cash In total of “$17,500” is entered in Item

Determining Whether Transactions

30i. Cash Out of “$2,500” is entered in Item 31b

Item 43. Date the form is signed.—The approving

Meet The Reporting Threshold

(withdrawal of deposit), “$2,500” is entered in Item

official must enter the date the Form 103 is signed. For

31e (wire transfer), “$7,500” is entered in Item 31f

proper format, see the instructions for Item 12 above.

Only cash transactions that, alone or when

(negotiable instrument cashed), “$1,500” is entered

Item 44. Preparer’s name.—Type or print the full

aggregated, exceed $10,000 should be reported on

in Item 31g (currency exchange) and a Cash Out

name of the individual preparing Form 103. The

Form 103. A casino must report multiple currency

Total of “$14,000” is entered in Item 31k. In this

preparer and the approving official may be different

transactions when it has knowledge that such

example, both the Cash In and Cash Out totals exceed

individuals.

transactions have occurred. This includes knowledge

$10,000, and each must be reflected on Form 103.

gathered through examination of books, records, logs,

Items 45 and 46. Contact person/telephone

information retained on magnetic disk, tape or other

Example 4. Person D purchases $10,000 in chips

number.—Type or print the name and commercial

machine-readable media, or in any manual system,

with currency and places a $10,000 cash bet (two

telephone number of a responsible individual to

and similar documents and information that the

Cash In entries); and later receives currency for an

contact concerning any questions about this Form

casino maintains pursuant to any law or regulation

$18,000 redemption of chips and $20,000 from a

103.

or within the ordinary course of its business.

payment on a cash bet (two Cash Out entries).

Cash In and Cash Out transactions for the same

Complete Form 103 as follows:

Paperwork Reduction Act Notice.—The requested

customer are to be aggregated separately and must

Cash In of “$10,000” is entered in Items 30a and

information is useful in criminal, tax, and regulatory

not be offset against one another. If there are both

30d and a Cash In total of “$20,000” is entered in

investigations and proceedings. Financial institutions

Cash In and Cash Out transactions which each exceed

Item 30i. Cash Out of “$18,000” is entered in Item

are required to provide the information under 31

$10,000, enter the amounts in Items 30 and 31 and

31a (redemption of chips), “$20,000” is entered in

U.S.C. 5313 and 31 CFR Part 103, commonly referred

report on a single Form 103.

Item 31d (payment on bets) and a Cash Out Total of

to as the Bank Secrecy Act (BSA).

“$38,000” is entered in Item 31k. In this example,

The BSA is administered by the U.S. Department

Example 1. Person A purchases $11,000 in chips

both the Cash In and Cash Out totals exceed $10,000,

of the Treasury’s Financial Crimes Enforcement

with currency (one Cash In entry); and later receives

and each must be reflected on Form 103.

Network (FinCEN). You are not required to provide

currency from a $6,000 redemption of chips and a

the requested information unless a form displays a

$2,000 slot jackpot win (two Cash Out entries).

Item 32. Date of transaction.—Enter the gaming day

valid OMB control number. The time needed to

Complete Form 103 as follows:

on which the transaction occurred (see What To File

complete this form will vary depending on individual

Cash In of “$11,000” is entered in Item 30a

above). For proper format, see the instructions

circumstances. The estimated average time is 19

(purchase of chips) and Cash In Total of “$11,000” is

forItem 12 above.

minutes.

Send comments regarding this burden

entered in Item 30i. No entry is made for Cash Out.

estimate, including suggestions for reducing the

The two Cash Out transactions equal only $8,000,

Item 33. Foreign currency.—If foreign currency is

burden, to the Office of Management and Budget,

which does not meet the BSA reporting threshold.

involved, identify the country of issuance by entering

Paperwork Reduction Project, Washington, DC 20503

Example 2. Person B deposits $5,000 in currency

the appropriate two-letter country code. If multiple

and to the Financial Crimes Enforcement Network,

to his front money account and pays $10,000 in

foreign currencies are involved, identify the country

Attn.: Paperwork Reduction Act, P .O. Box 39, Vienna

currency to pay off an outstanding credit balance

for which the largest amount in U.S. dollars is

VA 22183-0039.

(two Cash In entries); receives $7,000 in currency

exchanged.

Fincen Form 103 - Currency Transaction Report By Casinos Page 4

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