Wisconsin Department of Revenue Post Office Box 8908 Madison, Wisconsin 53708-8908
Credit Union Declaration of Exempt Status
Name of Credit Union
Number and Street
For Income Year
Year of Incorporation
Federal Employer I.D. Number
Wis. Employer I.D. (Withholding) Number
Seller's Permit or Use Tax Number
INSTRUCTIONS Purpose of Form CU Credit unions which are exempt from the Wisconsin franchise or income tax under the provisions of Ch. 71, Wis. Stats., should file Form CU instead of filing a Wisconsin corporation franchise or income tax return, Form 4. Thereafter, the credit union need not file a corporation tax return (Form 4) or Form CU for any subsequent year unless requested to do so by the Department of Revenue or unless in a subsequent year the credit union acts as a public depository. Note: Credit unions that do not derive income from public deposits are exempt from the Wisconsin tax on unrelated business taxable income, as computed under section 512 of the Internal Revenue Code. When to File Form CU must be filed on or before March 15 of the year following the income year for which the return is filed.
Where to File Mail Form CU to the Wisconsin Department of Revenue, Post Office Box 8908, Madison, Wisconsin 53708-8908.
DECLARATION I, the undersigned authorized officer of the credit union for which this declaration of exempt status is made, declare that the above named credit union had no deposits of public funds during the income year shown above and I understand that a Wisconsin franchise or income tax return must be filed for any future year for which the credit union's deposits include public funds.
IC-081 (R. 10-91)