Form Pa-137 - Property Owner'S Objection To Change In Reported Exempt Computers Page 2
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2BOA#___-____-CE__-___
PROPERTY OWNER’S OBJECTION TO CHANGE IN
(For Dept. Use Only)
REPORTED EXEMPT COMPUTERS
SECTION 1: PROPERTY OWNER AND PROPERTY INFORMATION (ALL MUST BE COMPLETED)
Name of Property Owner on Assessment Notice:
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: MANUFACTURER COMPLETE THIS INFORMATION (ALL MUST BE COMPLETED)
Provide State Identification Number of Property Being Appealed: __ __ - __ __ - ___ ___ ___ - P __ __ __ __ __ __ __ __ __
* “County of” on Assessment Notice is “AA” and “Co” (eg. 76-13)
* AA
* CO
Taxation District
DOR Account Number
Provide Date of Department of Revenue’s Notice of Assessment (Attach Two Copies of Notice): __________________________
Provide Date Form M-P, Manufacturing Personal Property Return was Filed (Attach Two Copies of Form): _________________
SECTION 3: NON-MANUFACTURER COMPLETE THIS INFORMATION (ALL MUST BE COMPLETED)
Provide Local Account # of Property Being Appealed: ___________________________________________________________
Provide Date of Assessor’s Notice of Change to Reported Exempt Computers (Attach Two Copies of Notice): _______________
Provide Date Form PA-003, Statement of Personal Property was Filed (Attach Two Copies of Form): _____________________
SECTION 4: ALL APPELLANTS COMPLETE THIS INFORMATION (ALL MUST BE COMPLETED)
A. State the Original Value of Exempt Computers as Provided on Form M-P or PA-003:
B. What Value(s) were Changed to Taxable:
C. What Do You Think the Value Should Be: $__________________. Why Do You Disagree With the Change:
D. Why Do You Think the Personal Property Should Be Exempt Under Sec. 70.11(39), Wis. Stats.:
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 4, C and D to the BOA within 60 days
of the appeal date? (circle one)
Yes
No
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.)
If you would like to discuss your objection informally prior to the BOA’s action, please contact the DOR district office where the
property is located.
PA-137 (R. 05-11)
Page 2
Wisconsin Department of Revenue
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