Assessment Data Request Form
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Contact Information:
(Please Print)
Requesting Organization / Company Name (If Applicable): ________________________________________
Last Name __________________________________ First Name _________________________________
Address
__________________________________ City ______________ State ______ Zip __________
Phone
__________________________________ Email _____________________________________
Authorization:
(The following signature represents and warrants that s/he is authorized to execute this
document on behalf of the requesting organization/ entity)
Requestor Signature __________________________________________
Date ____________________
Data Identification:
(Please Identify the Data being Requested)
Hard Copy Data Request:
(Please check appropriate boxes)
# of Documents
Total
Assessors Work Roll (Per Municipality)
_________ x 20.00 = _________
Alpha List (Per Municipality)
_________ x 10.00 = _________
Physical Address List (Per Municipality)
_________ x 10.00 = _________
Sanitary List (Per District)
_________ x 5.00 = _________
Alpha List (County)
_________ x 60.00 = _________
Physical Address List (County)
_________ x 60.00 = _________
Labels
_________ x
.05 = _________
Change File Edit List
_________ x 25.00 = _________
Digital Data Request:
(Please check appropriate boxes)
Total
Assessment Information
35.00 = _________
(Per Municipality)
Assessment Information
50.00 = _________
(Per County)
Applications
Total
Combine Tax Parcel Form
20.00 = _________
Choose Delivery Method:
Email
FTP
Postal
Pick Up
Remit Payment to:
Postage = _________
Oconto County (LIS) Land Information Systems
$0.00
Total Amount Due = _________
301 Washington St.
Oconto, WI 54153
Staff Purposes Only
Request Received by:
__________________________________________ Date ___________________
Authorized by:
__________________________________________ Date ___________________
Bill Applicant
Paid - Receipt Number: _____________________________
Request Completed by: __________________________________________ Date ___________________
Request Delivered Via:
Pick Up
Postal
FTP
Email
CD
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Parent category: Business