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Wisconsin Department of Revenue
PREMIER
PO Box 8992
RESORT AREA
Madison WI 53708-8992
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TAX RETURN
SS# or FEIN
Enter
15-digit
Tax Account Number
Period Begin Date
Period End Date
Due Date
Tax
Account
Number
To enter dates above, use the following format: MM DD YYYY
Check if this is an AMENDED return
Enter name and address. Hit "Enter" to start
each new line of the name and/or address.
Check if name/address change
(Note changes on the back of the form)
Check if business discontinued
(Note changes on the back of the form)
Complete form using BLACK INK
Premier Resort Area Taxable Sales
To Page 2
BAYFIELD
1a.
EAGLE RIVER
1b.
LAKE DELTON
1c.
Tax Calculation
WISCONSIN DELLS
1d.
0.00
0.00
Total Sales
2a.
x .005 = 2b.
3. Retailer’s discount (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . 3.
0.00
4. Net premier resort tax (subtract line 3 from line 2b) . . . . . . . . . . . . . . . 4.
5. Interest and penalty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.
0.00
6. TOTAL DUE (add lines 4 and 5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.
Contact Name (please print)
Signature
Date
Phone
(
)
FOR DEPARTMENT USE ONLY
*S1PR06993*
.
To Page 2
Mail return and remittance to:
Premier Resort Tax Processing
Phone:
(608) 266-2776
Wisconsin Department of Revenue
PO Box 8992
E-Mail:
sales10@dor.state.wi.us
Madison WI 53708-8992
Website:
PRA-012i (R. 9-06)