LEGAL RESIDENCE (DOMICILE) QUESTIONNAIRE
47
400-00-5483
Please
You
Spouse
2/1/2012
MN
✔
(state)
(date)
(Nonresident alien; please indicate country)
If you changed your legal residence from Wisconsin during 2011 or 2012 and you did not previously complete a questionnaire
for that change, answer the following questions.