Form Pa-130 - Form Of Objection To Classification Decision (Page 2 of 2) in pdf

BOA#___-____-CL__-___

FORM OF OBJECTION

(For Dept. Use Only)

TO CLASSIFICATION DECISION

SECTION 1: PROPERTY OWNER AND PROPERTY INFORMATION (ALL MUST BE COMPLETED)

Name of Property Owner:

IT IS REQUESTED THAT THIS OBJECTION BE

REVIEWED

Mailing Address:

Signature of Owner/Authorized Agent (*):

Date:

* If agent, attach written authorization to this form.

City, State & Zip Code:

Print Name and Title:

Street Address of Property:

Mailing Address:

Taxation District (Municipality):

City, State & Zip Code:

County:

Telephone Number:

Fax Number:

SECTION 2: PROPERTY/BUSINESS OWNER COMPLETE THIS INFORMATION (ALL MUST BE COMPLETED)

Property Was Previously Classified as (Check What Applies):

Manufacturing ____________

Non-Manufacturing ____________

Provide Date of Department of Revenue’s Letter Determining Classification (Attach Two Copies of Letter): __________________________

Describe Business Activity, Final Product, Customers, and SIC (Standard Industrial Classification) Code (additional sheet should be used and

attached if needed):

State How Property/Business Should be Classified and Why (additional sheet should be used and attached if needed) (Attach Two Copies of

Supporting Documentation):

SECTION 3: MUNICIPALITY COMPLETE THIS INFORMATION (ALL MUST BE COMPLETED)

Property Was Previously Classified as (Check What Applies):

Manufacturing ____________

Non-Manufacturing ____________

Provide Date of Department of Revenue’s Letter Determining Classification (Attach Two Copies of Letter): __________________________

State How Property/Business Should be Classified and Why (additional sheet should be used and attached if needed) (Attach Two Copies of

Supporting Documentation):

ATTACH TWO DATED COPIES OF THE GOVERNING BODY’S AUTHORIZATION FOR FILING THIS OBJCECTION

SECTION 4: ALL APPELLANTS COMPLETE THIS INFORMATION (ALL MUST BE COMPLETED)

If you would like to discuss your objection informally prior to the BOA action, please contact the district office where the property is located.

Section 70.995 (8)(c)2, Wis. Stats., allows you to submit additional information within 60 days of your appeal to the BOA to consider in reviewing

the appeal. In order for the BOA to expedite the appeal process for you, answer the following questions:

Do you intend to submit supplemental information to support documentation provided in Section 2 or 3 to the BOA within 60 days of the appeal

date? (circle one)

Yes

If Yes, when will the supplemental information be supplied? (date)________________________ (If yes, please mail all supplemental

information to the BOA office at address listed on page 1.)

PA-130 (R. 05-11)

Page 2

Wisconsin Department of Revenue

Form Pa-130 - Form Of Objection To Classification Decision Page 2

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