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

Page 4

FinCEN Form103 (Instructions 6-08)

Part II. Amount and Type of Transaction(s)

$10,000, enter the amounts in Items 31 and 32 and

File above). For proper format, see the instructions for

report on a single Form 103.

Item 13 above.

Part II identifies the type of transaction(s) reported

and the amount(s) involved. You must complete all

Example 1. Person A purchases $11,000 in

Item 34. Foreign currency.—If foreign currency is

items that apply.

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

involved, identify the country of issuance by entering

receives currency from a $6,000 redemption of chips

the appropriate two-letter country code. If multiple

Item 30. Multiple transactions.—Check this box if

and a $2,000 credit card advance (two Cash Out

foreign currencies are involved, identify the country

multiple currency transactions, none of which

entries). Complete Form 103 as follows:

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

individually exceeds $10,000, comprise this report.

Cash In of “$11,000” is entered in Item 31a (purchase

exchanged.

of chips) and also in the Total Cash In entry at the

Items *31 and *32. Cash in and cash out.— Enter in

bottom of Item 31. No entry is made for Cash Out. The

Part III. Casino Reporting Transaction(s)

the appropriate spaces provided in Items 31 and/or

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

32, the specific currency amount for each “type of

does not meet the BSA reporting threshold.

Item *35. Casino’s trade name.—Enter the name by

transaction” for a reportable Cash In or Cash Out. If

which the casino does business and is commonly known.

the casino engages in a Cash In or a Cash Out

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

Do not enter a corporate, partnership, or other entity

transaction that is not listed in Items 31a through 31h or

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

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

Items 32a through 32i, specify the type of transaction

to pay off an outstanding credit balance (two Cash In

is commonly known.

and the amount of currency in Item 31z or 32z,

entries); receives $7,000 in currency from a wire transfer

respectively. Enter the total amount of the reportable

(one Cash Out entry); and presents $2,000 in small

Item *36. Casino’s legal name.—Enter the legal name

Cash In transaction(s) in Item 31 in the space provided.

denomination U.S. Currency to be exchanged for an

as shown on required tax filings. This name will be

Enter the total amount of the reportable Cash Out

equal amount in U.S. $100 bills. Complete Form 103 as

defined as the name indicated on a charter or other

transaction(s) in Item 32 in the space provided.

follows:

document creating the entity, and which is identified

If less than a full dollar amount is involved increase

with the casino’s established EIN.

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

Cash In of “$5,000” is entered in Item 31b (deposit),

currency total is $20,500.25, show it as $20,501.00.

“$10,000” is entered in Item 31c (payment on credit),

Item *37. Employer identification number (EIN).—

“$2,000” is entered in Item 31g (currency exchange),

Enter the casino’s EIN.

If there is a currency exchange, list it separately

and Cash In Total of “$17,000” is entered in Item 31 in

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

the space provided for “total Cash-in.” In determining

Items *38, *39, *40, and *41. Address.—Enter the

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

whether the transactions are reportable, the currency

street address, city, state, and ZIP code of the casino

on the day of the transaction.

exchange is aggregated with both the Cash In and the

(or branch) where the transaction occurred. Do not

Cash Out amounts. The result is a reportable $17,000

use a P .O. box number.

Payment(s) on credit, Item 31c, includes all forms

Cash In transaction. No entry is made for Cash Out.

of cash payments made by a customer on a credit

The total Cash Out amount only equals $9,000, which

Item *42. Type of gaming institution.—Check the

account or line of credit, or in redemption of markers

does not meet the BSA reporting threshold.

appropriate box to indicate the type of gaming

or counter checks. Currency received from wire

institution. Check box “a” for a land-based or riverboat

transfer(s) out, Item 31e, applies to cash received

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

casino that is duly licensed by a state, territory or

from a customer when the casino sends a wire transfer

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

insular possession of the United States; check box “c”

on behalf of a customer.

to pay off an outstanding credit balance (two Cash In

to indicate a tribal casino (e.g., a Class III gaming

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

operation or a Class II gaming operation using video

Bills inserted into gaming devices (Item 31h), includes

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

lottery terminals). Check box “b” for a card club, gaming

the amount of all paper currency inserted into a bill

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

club, and card room or gaming room (including one

validator on a slot machine, video lottery terminal, or

(three Cash Out entries); and presents Canadian dollars

operating on Indian lands). If you check box “z” for

other electronic gaming device, used in conjunction with

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

“other” specify the type of gaming institution

a customer’s “slot club account” (magnetic strip card),

equivalent. Complete Form 103 as follows:

(e.g.,racino).

aggregated by that account and which is posted to a

casino’s slot monitoring system.

Cash In of “$7,000” is entered in Item 31b (deposit),

Items 43 and 44. Title and signature of approving

“$9,000” is entered in Item 31c (payment on credit),

official.—The official who is authorized to review and

Redemptions of chips, tokens, TITO tickets and

“$1,500” is entered in Item 31g (currency exchange),

approve Form 103 must indicate his/her title and sign

other gaming instruments, Item 32a, includes all cash

and a Cash In total of “$17,500” is entered in Item 31

the form.

redemptions of slot machine or video lottery tickets to

in the space provided for “total Cash-in.” Cash Out of

a customer. Payments on wagers, Item 32d, includes

“$2,500” is entered in Item 32b (withdrawal of deposit),

Item 45. Date the form is signed.—The approving

all cash paid on race book or sports pool betting tickets

“$2,500” is entered in Item 32e (wire transfer), “$7,500”

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

to a customer. Currency paid from wire transfer(s) in,

is entered in Item 32f (negotiable instrument cashed),

proper format, see the instructions for Item 13 above.

Item 32e, applies to cash paid to a customer when the

“$1,500” is entered in Item 32g (currency exchange)

casino receives a wire transfer on behalf of a customer.

and a Cash Out Total of “$14,000” is entered in Item

Item 46. Preparer’s name.—Type or print the full

Travel and complimentary expenses and gaming

32 in the space provided for “total Cash-out.” In this

name of the individual preparing Form 103. The preparer

incentives, Item 32h, includes reimbursements for a

example, both the Cash In and Cash Out totals exceed

and the approving official may be different individuals.

customer’s travel and entertainment expenses and cash

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

complementaries (“comps”).

Items 47 and 48. Contact person/telephone

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

number.—Type or print the name and commercial

Determining Whether Transactions

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

telephone number of a responsible individual to contact

Meet The Reporting Threshold

Cash In entries); and later receives currency for an

concerning any questions about this Form 103.

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

Only cash transactions that, alone or when

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

Paperwork Reduction Act Notice.—The requested

information is useful in criminal, tax, and regulatory

aggregated, exceed $10,000 should be reported on

Form 103 as follows:

investigations and proceedings. Financial institutions are

Form 103. A casino must report multiple currency

required to provide the information under 31 U.S.C. 5313

transactions when it has knowledge that such transactions

Cash In of “$10,000” is entered in Items 31a and

and 31 CFR Part 103, commonly referred to as the Bank

have occurred. This includes knowledge gathered

31d and a Cash In total of “$20,000” is entered in Item

Secrecy Act (BSA). The BSA is administered by the U.S.

through examination of books, records, logs, information

31 in the space provided for “total Cash-in.” Cash Out

Department of the Treasury’s Financial Crimes Enforcement

retained on magnetic disk, tape or other machine-

of “$18,000” is entered in Item 32a (redemption of

Network (FinCEN). You are not required to provide the

readable media, or in any manual system, and similar

chips), “$20,000” is entered in Item 32d (payment on

requested information unless a form displays a valid OMB

documents and information that the casino maintains

bets) and a Cash Out Total of “$38,000” is entered in

control number. The time needed to complete this form will

pursuant to any law or regulation or within the ordinary

Item 32 in the space provided for “total Cash-out.” In

vary depending on individual circumstances. The estimated

course of its business.

this example, both the Cash In and Cash Out totals

average time is 30 minutes.

Send comments regarding this

exceed $10,000, and each must be reflected on Form

burden estimate, including suggestions for reducing the

Cash In and Cash Out transactions for the same

103.

burden, to the Office of Management and Budget, Paperwork

customer are to be aggregated separately and must

Reduction Project, Washington, DC 20503

and to the

not be offset against one another. If there are both

Item *33. Date of transaction.—Enter the gaming

Financial Crimes Enforcement Network, Attn.: Paperwork

Cash In and Cash Out transactions which each exceed

day on which the transaction occurred (see What To

Reduction Act, P .O. Box 39, Vienna VA 22183-0039.

Fincen Form 103 - Currency Transaction Report By Casinos Page 4

Related Articles

Related forms

Related Categories