Form Pc-201 - Request For Charge Back Of Rescinded Or Refunded Taxes
ADVERTISEMENT
1
2Request for Charge Back of Rescinded or Refunded Taxes
(Section 74.41, Wis. Stats.)
DOR USE ONLY
CASE NO.
Please read the instructions on the reverse side before completing this form.
1
Assessment Year
Co Mun Code
County
This is the correct
-
municipality name.
Is this parcel in a TID?
2
Real Estate Parcel No.
Personal Property Account No.
No
Yes
TID #
3
Name of Property Owner
Personal Property Category
(see instructions)
4
Real Estate
Assessment BEFORE Adjustment
Assessment AFTER Adjustment
(g)
Total Assessment
(a)
(b)
(c)
(d)
(e)
(f)
Class
Difference (c - f)
Land
Improvement
Total (a + b)
Land
Improvement
Total (d + e)
0
0
0
0
0
Totals
0
5
Personal Property
BEFORE Adjustment
AFTER Adjustment
Difference
Non-Manufacturing
Manufacturing
0
(c) = (a) x .20
(a)
(b) = (a) x .80
6
Total manufacturing interest refund/rescinded
0
0
Net Taxes Rescinded or Refunded to be Charged Back to Taxing Jurisdictions – EXCLUDING INTEREST
7
Code
Name of Taxing Jurisdictions
Net Tax
a.
State of Wisconsin
b.
County
–
Special Dist.
c.1
–
c.2
Special Dist.
d.
Local
e.
School Dist.
See Help
–
–
f.
Union High School Dist.
g.
Technical College Dist.
Total Net Tax Rescinded or Refunded – EXCLUDING INTEREST
h.
This amount is after School Levy Tax Credit.
Please explain why taxes were rescinded or refunded. Be specific and include the section of Wisconsin Statutes under which it
8
was done.
(If space is insufficient, attach additional sheets. Please type or print clearly.)
Statute No(s).
I hereby certify to the best of my knowledge and belief this form is complete and correct and, in the case of refunded tax, the tax has been refunded to
the property owner.
9
Preparer's Name
Check here if not providing an e-mail address
Email Address
Signature not required if electronically filed.
Signature
Daytime Telephone Number
PC-201 (R. 1-10)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial