Format for Letter of Intent Real State by hbh21072

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									            Tax Incremental District (TID) Environmental Remediation (ER) Forms

  The following updated Excel forms should be used by all city and village governments for a TID
  Environmental Remediation creation, under sec. 66.1106, Wis. Stats. You should save a copy of
  this file to your computer in a location you remember and with an appropriate file name (i.e. City of
  Badger TID 3ER). Fill in the PE-606 form first. The information you enter here will flow through
  to other forms. Be brief on your entries (i.e. no need to add the word "district" on the form.
  Where necessary, the forms have been formulated to total values. Upon completion email this
  file, along with the rest of your creation submission to tif@revenue.wi.gov.



  Note: Complete all forms. If you have no information for a particular form, type "NONE" on the
  form and still submit it. Instructions for each form are on the Form Instructions Tab below. For
  additional information on creating a TID go to: http://www.revenue.wi.gov/slf/tif.html.

  If you have any TID questions or problems with the Excel forms, please call Susan Plakus at
  (608) 261-5335 or Mary Lou Clayton at (608) 266-5708 or send an email to tif@revenue.wi.gov

  Form No.             Form Title
  Form Instructions

  PE-606               Equalized Value Determination Request              FILL THIS FORM IN FIRST
  PE-605               City/Village Legal Requirements Base Year

  PE-608               TID Parcel List - Locally Assessable Property
  PE-601A              TID Base Year - Personal Property List
  PE-619               TID Parcel List - Municipal Owned Property
  PE608M               TID Manufacturing Real Property List
  PE-608MP             TID Manufacturing Personal Property List
  PE-615A              Statement of Assessment                     FILL THIS IN BEFORE PE-617A
  PE-617A              Tax Incremental District Assessor's Final Report - Base Year Valuation

  Clerk                Clerk Signature Form*
  Assessor             Assessor Signature Form*

                       *The Clerk and Assessor Signature forms must be completed in order
                       for the packet to be accepted.




(R. 1-11) Excel                                                            Wisconsin Department of Revenue
                                                      INSTRUCTIONS

GENERAL

Complete the PE-606 form first. Information entered here will flow through to the other forms.

If the TID does not contain parcels for a specific form, write "NONE" in the first row (i.e. No manufacturing or personal
property).

If you need more lines on the parcel forms, use the button at the bottom of the form to add additional lines.

If assessed parcels in the TID lie in more than one county or there is an annexation, complete another Excel workbook to
report each municipality separately.

WARNING - Failure to provide information for any local or state assessed parcels included within the TID boundaries
could result in an inaccurate base value certification.

PE-608 - Return to Form

PARCEL NUMBER COLUMN - List all locally assessable parcels that are located in the TID. Include all official parcel
numbers (from assessment roll) for exempt property OTHER THAN TAX-EXEMPT MUNICIPAL- OWNED property (e.g.,
county courthouse). Tax-exempt municipal owned property will be listed separately on its own parcel list (Municipal
Owned Property, PE-619). State assessed manufacturing property is also listed on a separate parcel list (TID
Manufacturing Real Property List, PE-608M).

If your map contains key numbers that correspond to the parcel numbers on the form, insert an additional worksheet
labeled "Parcel Key" with that specific information.

CLASSIFICATION COLUMN - In this column choose the appropriate assessment classification number for each parcel.
● Class 1 - Residential
● Class 2 - Commercial
● Class 4 - Agricultural
● Class 5 - Undeveloped
● Class 5m - Agricultural Forest
● Class 6 - Forest
● Class 7 - Other*
● Class X - Exempt**

Classes 4, 5 5m or 6 must not have improvement values.

*The 'other' class is used for farm buildings and the land on which they are located.
**Include all local exempt property (i.e., church, school, etc.).

OTHER TAXING DISTRICTS COLUMNS - For each of the next six columns (school district through county):

a. The column heading will list the number entered on the PE-606 for the taxing jurisdiction in which the TID lies.
b. In the boxes below place an "X" in the columns that apply for each parcel.

If any other districts are involved (e.g. a second sanitary district, a third school district, etc.), notify DOR and we will send a
customized form for your use.

OVERLAPPING TID COLUMN - Use this column only: if the newly-created or amended TID has boundaries that overlap
an existing TID. ER TID's cannot have overlapping boundaries. In the column list the overlapped TID number.

LAND AND IMPROVEMENTS COLUMNS - For each parcel, list the value of the land and improvements, the total will
automatically calculate.
                                                               -2-
ANNEXED PARCELS REQUIRE SPECIAL TREATMENT - If any portion of the district was annexed to the city or village
after the assessment date in the creation year or amendment year, the parcel(s) involved should be entered on a
separate copy of this Excel workbook for each annexation. The entire workbook needs to be filled out. The classification
and assessed values will have to be obtained from the municipality in which the property was located prior to the
annexation.

PE-601A - Return to Form

List all personal property in parcels located in the TID.

OWNER'S NAME & SITE STREET LOCATION COLUMNS (#1 & #2) - List the name of the owner that appeared on the
assessment roll. Identify the physical site location by street not by PO Box or the owner's address.

TYPE OF BUSINESS COLUMN (#3) - Provide a brief description of the business.

OVERLAPPING TID COLUMN (#4) - Use this column only, if the newly-created or amended TID has boundaries that
overlap an existing TID and some or all of the personal property parcels also overlap. ER TID's cannot have overlapping
boundaries. In the column list the overlapped TID number.

COLUMNS (#5, #6, #7, #8) - Enter the appropriate assessed values. Column 9 will automatically calculate for you.

PE-619 - Return to Form

The assessor is required to value all property owned by the municipality, except for that specifically excluded in s.
66.1105(5)(bm), Wis. Stats. or s. 60.85(5)(c), Wis. Stats.. Parcels must be valued as of January 1 of the district’s creation
or amendment year. This value will be included in the tax incremental base value. [See s. 66.1105(4)(k), Wis. Stats. or s.
60.85(3)(L), Wis. Stats.].

PARCEL NUMBER COLUMN - List the office parcel numbers (from assessment roll) of all municipal owned properties in
the TID.

CLASSIFICATION COLUMN - Although municipal owned property is generally tax-exempt, property owned by the
municipality, but not used by the municipality, at the time of the creation year or amended year, should be classified as if
the property was assessable for property tax purposes. For these properties, choose the appropriate assessment
classification number.
● Class 1 - Residential
● Class 2 - Commercial
● Class 4 - Agricultural
● Class 5 - Undeveloped
● Class 5m - Agricultural Forest
● Class 6 - Forest
● Class 7 - Other*
● Class X - Exempt**

Classes 4, 5 5m or 6 must not have improvement values.

*The 'other' class is used for farm buildings and the land on which they are located.
**All municipality-owned and municipality-used property.

OTHER TAXING DISTRICTS COLUMNS - For each of the next six columns (school district through county):

a. The column heading will list the number entered on the PE-606 for the taxing jurisdiction in which the TID lies.
b. In the boxes below place an "X" in the columns that apply for each parcel.


                                                             -3-
If any other districts are involved (e.g. a second sanitary district, a third school district, etc.), notify DOR and we will send a
customized form for your use.

OVERLAPPING TID COLUMN - Use this column only if the newly-created or amended TID has boundaries that overlap
an existing TID. ER TID's cannot have overlapping boundaries. In this column list the overlapped TID number.

VALUATION COLUMNS - The assessor must determine land, improvement and personal property values for those
municipal owned properties which do not meet the statutory exclusion [s. 66.1105(4)(k), Wis. Stats. or s. 60.85(3)(L), Wis.
Stats.]. Enter the values of the land, improvements and personal property.

ACRE/LOT SIZE COLUMN - If the parcel is not excluded under s. 66.1105(5)(bm), Wis. Stats. or s. 60.85(5)(c), Wis.
Stats., enter the number of acres or lot size (e.g., 100' x 200')

PROPERTY'S CURRENT USE COLUMN - Describe how the municipality is currently using this parcel (e.g. municipal
hall, fire station, well site, industrial park, vacant, etc.). Include this information for each parcel.

PE-608M - Return to Form

List all parcels in the TID that are assessed by the state. Do not include the state manufacturing values.

OWNER'S NAME & SITE STREET LOCATION COLUMNS (#1 & #2) - List the name of the owner that appeared on the
assessment roll. Identify the physical site location by street not by PO Box or the owner's address.

LOCAL PARCEL NUMBER COLUMN (#3) - List the parcel number that appears on the left hand side of the
manufacturing assessment roll (R157 Form).

DOR PARCEL NUMBER COLUMN (#4) - List the DOR Parcel Number (9 digits) that appears in the second column of
the manufacturing real estate assessment roll (R157 Form).




OVERLAPPING TID COLUMN (#5) - Use this column only, if the newly-created or amended TID has boundaries that
overlap an existing TID. ER TID’s cannot have overlapping boundaries. In the column list the overlapped TID number.

ACRES COLUMN (#6) - Enter the number of acres in the parcel.

LAND, IMPROVEMENTS and TOTAL COLUMNS (#7, #8, & #9) - Do not include values as this is State assessed
property and DOR will complete.

PE-608MP - Return to Form

List personal property in all parcels in the TID that are assessed by the state. Do not include the state manufacturing
values.

BUSINESS NAME & SITE STREET LOCATION COLUMNS (#1 & #2) - List the name of the owner that appeared on the
assessment roll. Identify the physical site location by street not the owner’s address.

DOR ACCOUNT NUMBER (9 digits) COLUMN (#3) - List the DOR Account Number that appears on the second column
of the manufacturing personal property assessment roll (R156- Form).
                                                          -4
OVERLAPPING TID COLUMN (#4) - Use this column only, if the newly-created or amended TID has boundaries that
overlap an existing TID and some or all of the personal property parcels overlap also. ER TID’s cannot have overlapping
boundaries. In the column list the overlapped TID number.

COLUMNS (#5, #6, #7, #8 AND #9) - Do not include values as this is State assessed property and DOR will complete.

PE-615A - Return to Form

The municipal clerk should complete this report and it should only include property within the TID (do not include
values for municipal-owned parcels or split parcels). Be certain that all items below line 15 (first page) are completed and
reflect the local assessed value of all general property (subject to the general property tax) located within the particular tax
incremental district. Do not include Class 3 (Manufacturing) Real and Personal Property values on the Statement of
Assessment form. If no special districts apply to the TID, write - NONE - in the appropriate area.

Information entered on lines 1-15 will automatically fill-in the first table on the PE-617A.

PE-617A - Return to Form

BASE YEAR VALUATION SECTION (first table) - This will fill-in from the PE-615A. The other tables on this form will not fill-
in automatically due to possible multiple school/special districts in the TID.

SCHOOL DISTRICT SECTION (required) - Enter the total assessed value of the general taxable property of the School
District that is located within the TID boundaries. If the area within the TID contains territory of two or more School
Districts, determine the assessed value of each School District and complete the Additional School or Special District
section (if more than two schools districts, contact DOR).

SPECIAL DISTRICT (required if in TID) - Contains valuation areas for Sanitary or Sewerage and Lake & Management
Districts. If all or a portion of the TID contains territory in a Special District, enter only the total assessed value of the
Special District property which is located within the TID. Enter the name and number of the district (check the appropriate
box.) If the TID contains territory in more than one Special District, complete the Additional School or Special District
section.

ADDITIONAL SCHOOL OR SPECIAL DISTRICT - Use this section if you have additional districts that are in the TID.




                                                              -5-
                                      EQUALIZED VALUE DETERMINATION REQUEST
                                            ENVIRONMENTAL REMEDIATION CREATION
                                            EFFECTIVE CREATION DATE: JANUARY 1, 2011


County
                                                                                                               Return To:
                                                                                                               Wisconsin Dept. of Revenue
    Town            Village          City
                                                                                                               Tax Incremental Finance
Municipality                                                                                                   tif@revenue.wi.gov

CoMun Code
http://www.revenue.wi.gov/pubs/slf/municode.pdf

TID Number



PART I. TAXING JURISDICTIONS AFFECTED
Identify all taxing jurisdictions authorized to levy taxes on property within the tax incremental district. Include the name of the
jurisdiction and its identifying number (located on property tax bill). If the TID is in more than one county or has an
annexation, a complete separate set of forms are required.
                                                   Name of Jurisdictions
                                              Name of TaxingTaxing Jurisdictions                                  Jurisdiction Number
Municipality
School District(s) *If more than two
districts, notify DOR.


Technical College
County
Union High School
Special District (i.e. Lake, Sanitary,
Sewer) *If more than one district, notify
DOR.
PART II. DECLARATION
I declare that this application and attachments have been examined by me and, to the best of my knowledge and belief, are true, correct, and complete. I
hereby request the Department of Revenue to determine the equalized value of this tax incremental district.
Clerk's name                                                                                           Telephone Number


E-mail address                                                                                         Date


PART III. INDIVIDUAL TO CONTACT FOR ADDITIONAL INFORMATION
Name and Title                                                                   E-mail address


Address                                                                          Telephone number



       ALL FORMS AND ATTACHMENTS MUST BE COMPLETE AND CORRECT TO THE SATISFACTION OF THE
                                   DEPARTMENT OF REVENUE




       PE-606 (R. 1-11) Excel                                                                                   Wisconsin Department of Revenue
 County                                               ENVIRONMENTAL REMEDIATION (ER)
                                                           LEGAL REQUIREMENTS
     Town         Village     City                             BASE YEAR
 Municipality Name                                                Created under Wis. Stats. s. 66.1106


 CoMun Code

 Tax Incremental District Number




                                            Requirements
 Date the other taxing jurisdictions were notified of intent to recover remediation costs with tax
 incremental finance and provided a statement of the estimated costs. 4(b)

 Date the written proposal was approved by the governing body of the political subdivision.

 See the Project plan (checklist – PE-
 109 at:                               http://www.revenue.wi.gov/forms/govtif/pe-109.pdf)

 Date the Dept. of Natural Resources certified the site investigation report.


 Date the Dept. of Natural Resources approved the remedial action plan.


 Date the Joint Review Board approved the written proposal.




PE-605 (R.1-11) Excel                                                                           Wisconsin Department of Revenue
 EDIATION (ER)
EMENTS
AR
 s. 66.1106




                       Dates




              PE-605 (R.1-11) Excel   Wisconsin Department of Revenue
County                                                                                                                                                    Page 1
                                                                       TID PARCEL LIST
Municipality                                                    LOCALLY ASSESSABLE PROPERTY

CoMun Code                                                      Effective Creation Date: January 1,          2011
                                                            (Assessed value of real property as of the above date.)
TID Number

                                                                                                                                                 Instructions
Jursidiction Numbers
                         Classification




                                                                                                             Overlapping
Parcel Number (from                                                         Union




                                                                                                             TID #
assessment roll, no                       School     School                 High      Special                                     Improve-
   key numbers)                           District   District    VTAE      School     District    County                   Land    ments             Total




Totals


PE-608 (R. 1-11) Excel                                                                                                            Wisconsin Department of Revenue
County                                                                                                                                         Page 1
                                                              TID BASE YEAR
Municipality                                              PERSONAL PROPERTY LIST

CoMun Code                                           Effective Creation Date: January 1, 2011

TID Number
                                                                                                                                         Instructions

         Column 1                Column 2             Column 3       Column 4    Column 5     Column 6     Column 7        Column 8         Column 9
                                                                      Over-      Boats &     Machinery,   Furniture,       All Other
                                                                     lapping      Other       Tools &     Fixtures, &      Personal
   Owner's Name            Site Street Location   Type of Business    TID #     Watercraft    Patterns    Equipment        Property          Total




Totals

 PE-601A (R. 1-11) Excel                                                                                                Wisconsin Department of Revenue
 County                                                                                                                                                             Page 1
                                                                               TID PARCEL LIST
 Municipality                                                            MUNICIPAL-OWNED PROPERTY

 CoMun Code
                                                                       Effective Creation Date: January 1, 2011
 TID Number

                                                                                                                                                           Instructions
 Jursidiction Numbers
                         Classification




                                                                                                       Overlapping
    Parcel Number
  (from assessment                                                        Union




                                                                                                       TID #
      roll, no key                        School     School               High     Special                                  Improve- Personal Acres/Lot     Property's
       numbers)                           District   District   VTAE     School    District   County                 Land    ments   Property   Size       Current Use




 Totals

PE-619 (R. 1-11) Excel                                                                                                                      Wisconsin Department of Revenue
County                                                                                                                                      Page 1
                                                               TID MANUFACTURING
Municipality                                                   REAL PROPERTY LIST

CoMun Code                                    Effective Creation Date: January 1, 2011

TID Number

School District

Special District                                                                                                                      Instructions

                                                                                                     Do not put any values in columns 7-9, Revenue
                                                                                                                     will complete.
         Column 1               Column 2            Column 3         Column 4    Column 5 Column 6     Column 7         Column 8        Column 9
                                                                                  Over-
                                                  Local Parcel      DOR Parcel   lapping                              Improve-
    Owner's Name           Site Street Location     Number           Number       TID #    Acres        Land           ments              Total




Totals



 PE-608M (R. 1-11) Excel                                                                                             Wisconsin Department of Revenue
County                                                                                                                                       Page 1
                                                            TID MANUFACTURING
Municipality                                              PERSONAL PROPERTY LIST

CoMun Code
                                                     Effective Creation Date: January 1, 2011
TID Number

School District

Special District                                                                                                                         Instructions

                                                                                  Do not put any values in coluns 5-9, Revenue will complete.
         Column 1                 Column 2           Column 3     Column 4   Column 5      Column 6        Column 7       Column 8      Column 9
                                                                    Over-                  Machinery       Furniture      All Other
                                                    DOR Account    lapping Boats & Other    Tools, &       Fixtures &     Personal
   Business Name             Site Street Location     Number        TID #   Watercraft      Patterns      Equipment       Property        Total




Totals

   PE-608MP (R.1-11) Excel                                                                                            Wisconsin Department of Revenue
                                                                                                        TOWN
STATEMENT OF ASSESSMENT - YEAR                                          2011                            VILLAGE           of
                                                                                                        CITY
                                       If you have zero values and they are not showing up, go to
INSTRUCTIONS                           Tools > Options > View Tab > check Zero values, then click          COUNTY of
                                       OK.                                                                 TID No.
When completing this document do not write over shaded areas.
                                                 PARCEL COUNT         # of Acres       Value of            Value of                  Total
 Line                                                    Improve-        Only           Land             Improvements          Value of Land and
 No.                                            Land      ments       Whole No.                                                 Improvements
                                               (Col. A)   Col. B)      (Col. C)        (Col. D)                (Col. E)             (Col. F)

   1      Residential - Class 1
   2      Commercial - Class 2
   4      Agricultural - Class 4
   5      Undeveloped - Class 5
  5m      Agricultural Forest - Class 5m
   6      Forest - Class 6
   7      Other - Class 7
   8      TOTAL ALL COLUMNS
   9      Number of Personal Owners in Roll
  10      Boats and Other Watercraft not Exempt                                    NOTE: If lines 10
                                                                                      through 13
  11      Machinery, Tools and Patterns
                                                                                     contain any
  12      Furniture, Fixtures and Equipment                                        values please fill
                                                                                       in line 9.
  13      All Other Personal Property Not Exempt
  14      TOTAL OF PERSONAL PROPERTY, TOTAL OF LINES 10 Through 13
          AGGREGATE ASSESSED VALUE OF ALL PROPERTY ON THIS ROLL SUBJECT TO THE GENERAL PROPERTY
  15      TAX (Total of Lines 8 & 14). Must Agree With Total Value of School District(s) Listed Below
              School                                                                                                            Assessed Values of
              District                                                                                                         School Districts in TID
                                                                                                                                Assessed Value of
              Codes                                                                                                              General Property
                                                    SCHOOL DISTRICT NAMES                                                         (Real Estate &
                                                                                                                                Personal Property)
                                                                                                                               Subject to the General
                                                                                                                                   Property Tax

               (Col. A)                                          (Col. B)                                                             (Col. C)

  16
  17
  18
  19
  20      TOTAL COL. C (must equal line 15 above.)
          SEPARATE UNION HIGH SCHOOL DISTRICTS (In addition to and independent of school districts entered above).
  21
          VOCATIONAL AND TECHNICAL SCHOOL DISTRICTS (In addition to and independent of school districts entered above.)
  22
  23
                                                                                                                                 Assessed Value of
                                                                                                                                  General Property
          Special District                             SPECIAL DISTRICT NAMES                                                  (Include Real Estate &
               No.                                                                                                               Personal Property)

  24
  25




       PE-615A (R. 1-11) Excel                                                                             Wisconsin Department of Revenue
TAX INCREMENTAL DISTRICT                                                                                    TOWN
ASSESSORS FINAL REPORT                                     2011                                             VILLAGE           of
BASE YEAR VALUATION                                                                                         CITY
                                       If you have zero values and they are not showing up, go to
                                       Tools > Options > View Tab > check Zero values, then click              COUNTY of
INSTRUCTIONS                           OK.                                                                     TID No.
When completing this document do not write over shaded areas.
                                                PARCEL COUNT             # of Acres        Value of            Value of                  Total
 Line                                                   Improve-            Only            Land             Improvements          Value of Land and
 No.                                           Land      ments           Whole No.                                                  Improvements
                                              (Col. A)   Col. B)          (Col. C)         (Col. D)                (Col. E)             (Col. F)

   1      Residential - Class 1
   2      Commercial - Class 2
   4      Agricultural - Class 4
   5      Undeveloped - Class 5
  5m      Agricultural Forest - Class 5m
   6      Forest - Class 6
   7      Other - Class 7
   8      TOTAL ALL COLUMNS
   9      Number of Personal Owners in Roll
  10      Boats and Other Watercraft not Exempt                                        NOTE: If lines 10
                                                                                          through 13
  11      Machinery, Tools and Patterns
                                                                                         contain any
  12      Furniture, Fixtures and Equipment                                            values please fill
                                                                                           in line 9.
  13      All Other Personal Property Not Exempt
  14      TOTAL OF PERSONAL PROPERTY, TOTAL OF LINES 10 Through 13
          AGGREGATE ASSESSED VALUE OF ALL PROPERTY ON THIS ROLL SUBJECT TO THE GENERAL PROPERTY
  15      TAX (Total of Lines 8 & 14). Must Agree With Total Value of School District(s) Listed Below


SCHOOL DISTRICT                                                 School District Name


                                                PARCEL COUNT             # of Acres        Value of            Value of                  Total
 Line                                                   Improve-            Only            Land             Improvements          Value of Land and
 No.                                           Land      ments           Whole No.                                                  Improvements
                                              (Col. A)   Col. B)          (Col. C)         (Col. D)                (Col. E)             (Col. F)

   1      Residential - Class 1
   2      Commercial - Class 2
   4      Agricultural - Class 4
   5      Undeveloped - Class 5
  5m      Agricultural Forest - Class 5m
   6      Forest - Class 6
   7      Other - Class 7
   8      TOTAL ALL COLUMNS
   9      Number of Personal Owners in Roll
  10      Boats and Other Watercraft not Exempt                                        NOTE: If lines 10
                                                                                          through 13
  11      Machinery, Tools and Patterns
                                                                                         contain any
  12      Furniture, Fixtures and Equipment                                            values please fill
                                                                                           in line 9.
  13      All Other Personal Property Not Exempt
  14      TOTAL OF PERSONAL PROPERTY, TOTAL OF LINES 10 Through 13
          AGGREGATE ASSESSED VALUE OF ALL PROPERTY ON THIS ROLL SUBJECT TO THE GENERAL PROPERTY
  15      TAX (Total of Lines 8 & 14). Must Agree With Total Value of School District(s) Listed Below




       PE-617A (R. 1-11) Excel                                                                                 Wisconsin Department of Revenue
SPECIAL DISTRICT
(check one)                                     Sanitary or Sewerage District                                Lake & Management District

                                         Name

                                                    PARCEL COUNT           # of Acres       Value of             Value of              Total
 Line                                                       Improve-          Only           Land              Improvements      Value of Land and
 No.                                               Land      ments         Whole No.                                              Improvements
                                                  (Col. A)   Col. B)        (Col. C)        (Col. D)              (Col. E)            (Col. F)

  1      Residential - Class 1
  2      Commercial - Class 2
  4      Agricultural - Class 4
  5      Undeveloped - Class 5
 5m      Agricultural Forest - Class 5m
  6      Forest - Class 6
  7      Other - Class 7
  8      TOTAL ALL COLUMNS
  9      Number of Personal Owners in Roll
 10      Boats and Other Watercraft not Exempt                                          NOTE: If lines 10
                                                                                           through 13
 11      Machinery, Tools and Patterns
                                                                                          contain any
 12      Furniture, Fixtures and Equipment                                              values please fill
                                                                                            in line 9.
 13      All Other Personal Property Not Exempt
 14      TOTAL OF PERSONAL PROPERTY, TOTAL OF LINES 10 Through 13
         AGGREGATE ASSESSED VALUE OF ALL PROPERTY ON THIS ROLL SUBJECT TO THE GENERAL PROPERTY
 15      TAX (Total of Lines 8 & 14). Must Agree With Total Value of School District(s) Listed Below


ADDITIONAL SCHOOL OR SPECIAL DISTRICT

(check one)                School District       Union High               Sanitary/Sewerage District                    Lake & Management District
                                         Name


                                                    PARCEL COUNT           # of Acres       Value of             Value of              Total
 Line                                                       Improve-          Only           Land              Improvements      Value of Land and
 No.                                               Land      ments         Whole No.                                              Improvements
                                                  (Col. A)   Col. B)        (Col. C)        (Col. D)              (Col. E)            (Col. F)

  1      Residential - Class 1
  2      Commercial - Class 2
  4      Agricultural - Class 4
  5      Undeveloped - Class 5
 5m      Agricultural Forest - Class 5m
  6      Forest - Class 6
  7      Other - Class 7
  8      TOTAL ALL COLUMNS
  9      Number of Personal Owners in Roll
 10      Boats and Other Watercraft not Exempt                                          NOTE: If lines 10
                                                                                           through 13
 11      Machinery, Tools and Patterns
                                                                                          contain any
 12      Furniture, Fixtures and Equipment                                              values please fill
                                                                                            in line 9.
 13      All Other Personal Property Not Exempt
 14      TOTAL OF PERSONAL PROPERTY, TOTAL OF LINES 10 Through 13
         AGGREGATE ASSESSED VALUE OF ALL PROPERTY ON THIS ROLL SUBJECT TO THE GENERAL PROPERTY
 15      TAX (Total of Lines 8 & 14). Must Agree With Total Value of School District(s) Listed Below




      PE-617A (R. 1-11) Excel                                                                                    Wisconsin Department of Revenue
                               REQUIRED CLERK SIGNATURE




County                                                Instructions:
                                                      Print the filled out form and then sign it. It can
Municipality                                          then be scanned and included with the email
                                                      submission of the Excel forms. This will take
CoMun Code                                            the place of your signature on the individual
                                                      forms, but serve the same purpose: to
TID Number                                            acknowledge that you have reviewed the
                                                      documents and that they are correct.




  I,                                        , clerk for the                        of

                                          do hereby swear and attest that I have
       reviewed the preceding documents and verified the accuracy of the information
       contained therein.




                              Signature                                                       Date


       Board of Review Date of Final Adjournment
                              REQUIRED ASSESSOR SIGNATURE




County                                                   Instructions:
                                                         Print the filled out form and then sign it. It can
Municipality                                             then be scanned and included with the email
                                                         submission of the Excel forms. This will take
CoMun Code                                               the place of your signature on the individual
                                                         forms, but serve the same purpose: to
TID Number                                               acknowledge that you have reviewed the
                                                         documents and that they are correct.




  I,                                           , assessor for the                      of

                                          do hereby swear and attest that I have
       reviewed the preceding documents and verified the accuracy of the information
       contained therein.



       According to my best skill and judgment, an equitable valuation of
       municipal owned property on the PE-619 [not excluded by s.
       66.1105(5)(bm) or s. 60.85(5)(c)] at this percent level of fair market value:


       The PE-617A (Assessor's Final Report) requires a percent (%) of fair
       market ratio to the assessment value, at what percent of full value are you
       assessing all General Property?




       E-mail Address




                               Signature                                                         Date



       Company Name

								
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