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Wisconsin Department of Revenue
Required Attachments for Electronic Filing
M.I. Your social security number M.I. Spouse's social security number
Taxpayer Information (USE BLACK INK ONLY)
Your legal last name Legal first name
If joint return, spouse's legal last name
Spouse's legal first name
Home address (number and street)
Daytime phone number
City or post office
Check the applicable box(es) to identify the attachments.
Homestead credit (Schedule H or H-EZ) Attach required documents (W-2s, W-2Gs, 1099-Rs, original rent
certificate(s), tax bill(s), legal documents, and statements).
Angel investment credit (Schedule VC) Attach a copy of the new business venture certification form provided by the Department of Commerce and the tax credit verification form issued by the Department of Commerce or a copy of your Schedule 3K-1 or 2K-1. Dairy manufacturing facility investment credit (Schedule DM) Attach a copy of your Department of Commerce certification or Schedule 5K-1, 3K-1, or 2K-1. Development zone credit (Schedule DC) Attach a copy of your certification to claim tax benefits and the verification of expenses from the Department of Commerce. Also attach a statement from the Department of Commerce verifying the amount of credit for environmental remediation and for job creation or retention. If credit is from a pass-through entity, attach Schedule 5K-1, 3K-1, or 2K-1 instead. Early stage seed investment credit (Schedule VC) Attach a copy of the certification issued by the Department of Commerce to the business and to the fund manager and a statement from the fund manager containing (1) name and address of the fund manager and (2) for each investment, the date, total amount of investment, amount invested in a qualified new business venture, and amount of tax credit or a copy of your Schedule 5K-1, 3K-1, or 2K-1. Eligible veterans and surviving spouses property tax credit Attach real estate tax bill(s) for all taxes paid in 2008, proof of payment and your Wisconsin Department of Veterans Affairs verification, if required. Enterprise zone jobs credit (Schedule EC) Attach a copy of your certification to claim tax benefits and
PAPER CLIP required attachments here
the verification of your expenses from the Department of Commerce or a copy of your Schedule 5K-1, 3K-1, or 2K-1.
Farmland preservation credit (Schedule FC) Attach required documents (W-2s, W-2Gs, 1099-Rs and all Schedule FC attachments listed in the 2008 Schedule FC instructions). Film production company investment credit (Schedule FP) Attach a copy of the certification from the
Department of Commerce that the credits claimed are for expenses related to establishing a film production company in Wisconsin or a copy of your Schedule 5K-1, 3K-1, or 2K-1.
Film production services credits (Schedule FP) Attach a copy of the approved application from the Department of Commerce or a copy of your Schedule 5K-1, 3K-1, or 2K-1. Health insurance risk-sharing plan assessments credit Attach a copy of your Schedule 5K-1 or 3K-1. Historic rehabilitation credit (Schedule HR) See Schedule HR for the required attachments.
I-041i (R. 10-08)
Refer to instructions on back.
Your legal name
Social security number
Internet equipment credit (Schedule IE) Attach a copy of your certification to claim tax benefits and the verification of your expenses, which you obtain from the Department of Commerce or a copy of your Schedule 5K-1, 3K-1, or 2K-1. Commerce.
Manufacturing investment credit (Schedule MI) Attach a copy of the certification from the Department of Minnesota reciprocity Attach Form W-222 and a copy of your Minnesota income tax return.
Model Form for legislators who make the sec. 162(h) election If using electronic filing software that does not submit the SPL-01 Model Form as part of the electronic return, attach a copy of the 2008 Model Form. Tax paid to another state (Schedule OS) Attach a copy of your income tax return from the other state or a
copy of your Schedule 3K-1 or 5K-1 if credit based on tax paid by a pass-through entity.
Technology zone credit (Schedule TC) Attach a copy of your certification for tax benefits issued by the Department of Commerce and a statement from the Department of Commerce verifying the amount of your credits for property taxes paid, capital investments made, and wages paid for jobs created in a technology zone or a copy of your Schedule 5K-1, 3K-1, or 2K-1. Other Attach any other documents you were instructed to attach when e-filing.
Preparer Information Complete if form submitted by person other than the taxpayer
Preparer's PTIN Date Daytime phone E-mail address
Firm's name (yours, if self-employed) and address
Purpose of Form Use Form W-RA to submit supporting documentation when you electronically file an income tax return and claim any of the credits or items listed. You may also be instructed to submit Form WRA when using Wisconsin efile. Legislators making the special section 162(h) election must mail the Model Form to the department when using electronic filing software that does not submit the Model Form as part of the electronic return. Paper clip your attachments to Form W-RA. Refunds can be processed faster if you use paper clips instead of staples.
Where to File
Send Form WRA and all attachments to one of the addresses listed below. Failure to mail timely to the correct address with all attachments will result in refund delays. Homestead credit claims If sending attachments required for homestead credit, send the Form W-RA and attachments to: Wisconsin Department of Revenue PO Box 8977 Madison WI 537088977 The Form WRA for any return including homestead credit should be mailed to the above address regardless of any other credits that may also be claimed. Others If you are not claiming homestead credit, send the Form WRA and attachments to: Wisconsin Department of Revenue PO Box 8967 Madison WI 537088967 Note If you use a mail service provider that is not the U.S. Postal Service, deliver to: Wisconsin Department of Revenue, Mail Stop 1151, 2135 Rimrock Road, Madison WI 53713.
When to File
The W-RA and required attachments must be mailed to the department within 48 hours of receipt of your Wisconsin acknowledgment. Refunds may not complete processing until the W-RA and attachments have been received.
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