Form Pc-220 - Tax Exemption Report - 2008
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2TAX EXEMPTION REPORT FOR 2008
1. NAME OF ORGANIZATION
4. DATE ACQUIRED
2. ADDRESS OF ORGANIZATION
5. LOCATION OF PROPERTY
CITY
VILLAGE
TOWN OF
COUNTY OF
6. ADDRESS OF PROPERTY
3. PARCEL NUMBER, LEGAL DESCRIPTION, NUMBER OF ACRES
7. PURPOSE OF ORGANIZATION
9. ESTIMATED FAIR MARKET VALUE OF PARCEL
Check box that best
approximates the value of all improvements and land of property described in
Question 8.
1. $1.00 - $10,000
6. $1,000,001 - $3,000,000
2. $10,001 - $100,000
7. $3,000,001 - $6,000,000
3. $100,001 - $200,000
8. $6,000,001 - $12,000,000
4. $200,001 - $500,000
9. $12,000,001 - $25,000,000
Check the box that best describes the property. See
8. PURPOSE/USE OF PROPERTY
instructions if parcel has more than one building put to different uses.
5. $500,001 - $1,000,000
10. OVER $25,000,000
Exemption Under
Wis. Stat.
Was any portion of this property leased during the
10. LEASING OF PROPERTY
CHURCH/RELIGIOUS
preceding two years?
PLACE OF WORSHIP . . . . . . . . . . . . . . . . . . . . . . . . . s. 70.11(4)
YES
NO
OTHER ____________________________________ s. 70.11(__)
(Explain)
If yes, describe portion leased, percentage of property, lessee, and how
lease payment was used. (Attach additional sheets if necessary.)
EDUCATIONAL (Incl. religious)
GRADES K-12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . s. 70.11(4)
PRIVATE COLLEGE . . . . . . . . . . . . . . . . . . . . . . . . . . s. 70.11(3)
OTHER ____________________________________ s. 70.11(__)
(Explain)
MEDICAL FACILITY
NON-PROFIT HOSPITAL (Incl. religious) . . . . . . . . . s. 70.11(4m)
MEDICAL RESEARCH FOUNDATION . . . . . . . . . . . s. 70.11(25)
OTHER _____________________________________ s. 70.11(__)
(Explain)
HOUSING
NURSING HOME (Incl. religious) . . . . . . . . . . . . . . . . ss. 70.11(4),(19)
RETIREMENT HOME (Incl. religious) . . . . . . . . . . . . ss. 70.11(3a),(4)
OTHER _____________________________________ ss. 70.11(3a),(18),(19),(__)
(Explain)
PUBLIC BENEFIT
YMCA/YWCA, SCOUTS, BOYS' CLUB, YOUTH HOCKEY,
ss. 70.11(10),(12),(32)
LIONS CAMP, BIBLE CAMP, CAMP FOR HANDICAPPED,
ss. 70.11(10m),(11),(22)
WOMEN'S CLUB, HISTORICAL SOCIETY, LIBRARY ASSOC.,
ss. 70.11(4),(31m)
FRATERNAL, LABOR/FARMERS' TEMPLE, AGRI FAIR,
ss. 70.11(4),(5),(16),(17)
NONPROFIT RADIO, THEATRE, ART GALLERY,
ss. 70.11(14),(29),(29m)
SPORTS AND ENTERTAINMENT FACILITY/STADIUM,
ss. 70.11(31)(36)
HUMANE SOCIETY,
ss. 70.11(28)
HISTORICAL SITE, PUBLIC TRUST
ss. 70.11(9),(20),(34),(35)
OTHER ________________________________________ ss. 70.11(__)
(Explain)
11. UNRELATED TRADE OR BUSINESS
Was this property used in an unrelated trade or business for which the owner
was subject to taxation under section 511 to 515 of the Internal Revenue Code?
YES
NO
12. NAME and TITLE
13. SIGNATURE
14. TELEPHONE
15. ADDRESS
16. DATE
THIS FORM MUST BE FILED WITH THE LOCAL CLERK NO LATER THAN MARCH 31, 2008.
PC-220 (R. 10-07)
Wisconsin Department of Revenue
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