Fillable Printable 2015 I-041 Wisconsin Form W-Ra, Required Attachments For Electronic Filing (Fillable)
Fillable Printable 2015 I-041 Wisconsin Form W-Ra, Required Attachments For Electronic Filing (Fillable)
2015 I-041 Wisconsin Form W-Ra, Required Attachments For Electronic Filing (Fillable)
Required
Attachments for
Electroni c Filing
PAPER CLIP required attachments here
FORM
W-RA
2015
Wisconsin
Department of Revenue
Homestead credit (Schedule H or H-EZ) – Attach required documents (W-2s, W-2Gs, 1099-Rs, 1098-Ts, original rent
ce rt i ficate(s), tax bill (s), leg a l do cument s , an d statement s).
Tax pa id to anoth er state (Sch edule OS) – Att ach a c opy of your inc ome t ax r eturn f rom th e other st ate and wit hhold ing
statem e nt s o r a copy of your Schedul e 3K-1 o r 5K-1 if credit b as e d o n t ax pai d by a pas s-t h r ou g h ent i ty.
Request for closing certificate for fiduciaries (Schedule CC) – Estates – Attach a copy of the decedent’s will and the
probate inventory. Trusts – Attach a copy of the trust instrument and three years of accountings. (Submit attachments
and For m W -RA only if S chedu le C C wa s el e ctro ni cally fil e d.)
Amended return filed on Form 1 , 1A, 1NPR, WI-Z or X-NOL – Attach forms, documents and/or schedules that support the
item(s) changed, as needed.
Angel investment credit (Schedule VC) – Attach a copy of the new business venture certif ication form provided by the
WEDC a n d t he ta x c r e di t verific at i o n f o rm iss ue d by th e W E D C o r a copy of your Schedul e 3K-1 o r 2 K-1.
Community rehabilitation program credit (Schedule CM) – Attach signed Part II of Schedule CM or a copy of your
Sch e du le 5K-1, 3K-1, or 2K-1.
Development zones credit (Schedule DC) – Attach a copy of your certification to claim tax benefits and the verification of
expenses fro m WEDC. Also attach a state ment from WEDC verifyi ng the am o u nt of credit for environment al remed i ation
and jo b creati o n o r r etent i o n. I f c r e di t i s f r o m a pa s s-t h r ou g h ent i ty, attach S c h e du l e 5 K-1, 3K-1, or 2K-1 instead.
Ear ly stage se ed invest ment credit (Sc hedule VC) – Att ach a co py of the c er tif icatio n issued by WED C to the busine ss
and to th e fund m anage r and a st atement f rom th e fund m anage r co ntaini ng (1) name and addr ess of t he fun d manag er
and (2) for eac h invest ment, the date, tot al amount of investm ent, amount i nvested in a qu alif ied new busin ess venture,
and amo u nt of t ax cr e di t o r a copy of your Sc h e du l e 5 K-1, 3K-1, or 2K-1.
Economic development credit (Schedule ED) – Attach a copy of your certification and the notice of eligibility to receive tax
benefit s f r o m t h e W E D C o r a copy of your Sc h e du l e 5 K-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 2015,
pro of of payment , your W isc ons in De part ment of Veterans Aff air s ce r t if ic at ion, i f requi red, an d any other d oc ument ati on
reque s ted i n t h e in st ruc t i o ns.
Enterprise zone jobs credit (Schedule EC) – Attach a copy of your certification to claim tax benefits and the verification of
your expens e s f r o m WEDC or a copy of your S c h e du le 5K-1, 3K-1, or 2K-1.
Farmland preservation credit (Schedule FC or FC-A) – See the instructions for the schedule you are filing for the required
attachments.
Histo ric reh ab i li t at i o n credi t (Sch e dul e HR) – See Sch e dul e HR for t h e re qu ir e d att ac h m ent s .
Job s tax c redit – At tac h a co py of your c er tif ic atio n to claim t ax be nefit s issue d by WEDC and t he notic e of eligi bilit y to
rec e i ve t ax ben efit s t hat r e p o rts the am o unt of tax b e n efit f r o m W ED C o r a copy of your S c h e dul e 5K-1, 3K-1, or 2K-1.
Check the applicable box(es) to identify the attachments.
I -041i (R. 10-15)
Refer to instr u c ti o ns on back.
Attachments – S ubmit t h i s fo rm only if you electronically filed your return or homestead credit claim.
Do NOT sub mit this form if you ar e fili ng a p a per re t u rn or ho m e s t e a d c r e d i t c l ai m .
Your legal last name Legal rst name M.I. Your social security number
If joint return, spouse’s legal last name Spouse’s legal rst name M.I. Spouse’s social security number
Address (number and street) Apt. no. Daytime phone number
City or post ofce State Zip code Email address
Taxpayer Infor m at ion
(
Use BLACK Ink O n l y
)
Legal name of estate, trust, partnership, or corporation FEIN
Tab to navigate within form. Use mouse to check
applicable boxes, press spacebar or press Enter.
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Manu f ac t uring an d a gric u ltu re credi t (Sch e du le MA-M or M A-A) – Att a c h a copy of your S c h e du le 5K-1, 3K-1, or 2K-1.
Manufacturing investment credit (Schedule MI) – Attach a copy of the certification from the DOC or a copy of your Sched-
ule 5 K-1, 3K-1, or 2K-1.
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 o f t he e l e ctro ni c r eturn, at tach a copy of th e 2015 Model Form.
Tech n ology zone cr e d it (Sc h edule TC) – At tach a copy of your certif i cati on for t ax ben efits issu ed by WEDC and a s tate-
ment from WEDC verifying the amount of your credits for property taxes paid, capital investments made, and wages paid
for jo b s c r e ate d in a te chnol o g y zo n e o r a copy of your Sc h e du l e 5 K-1, 3K-1, or 2K-1.
Ot he r – A ttach any other d o cument s you we re i ns t ructe d to att ach whe n e- fili ng.
Your l e g a l n am e So c i a l se c u r i ty nu m b e r o r FEI N
Purpose of Form
Use For m W-R A to submit suppor ting documentation when
you elect ron ically f ile a n inc ome or f ran chise t ax re t ur n a nd
claim any of the credits or items listed. Many of the above
items require documentation from the Wisconsin Economic
Development Corporat ion (W EDC). Leg islators ma k ing t he
spe cial section 162(h) election must mail t he Model For m 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 inste a d of st aples.
Note: Use Form W-RA on ly t o subm it supporting documen-
tat ion required for the box(es) checked. Do not submit ot her
correspondence or app e als or a paper copy of you r ta x r e turn
or homeste ad credit clai m w it h For m W-RA.
When to F ile
The W-RA and required attachments must be mailed to the
department within 48 hours of receipt of your Wisconsin
acknowl edgment. Refunds may not complete processing until
the W-RA a nd attachme nt s h ave been r e c eived.
Note Individuals and tax practitioners filing on behalf of
ind ividuals require d to send the Form W-R A att achments t o
the department may transmit this data in an electronic file
over the Internet. Further information can be found on the
departme nt’s website at: http://tap.revenue.wi.gov/services/.
Where to File
Send Form W-RA a nd a l l attachments to:
Wisconsin De partme nt of Revenue
PO Box 8977
Madison WI 53708-8977
F ailure to mail Form W -RA timely to the correct address with
all attachment s wil l r e s u lt i n a d elay in i ss uing a r efund.
Do not send t his for m if you are f il ing a pap er ret ur n or
pape r home st e ad credit clai m.
Note If you use a mail service provider that is not the U.S.
Postal Service, deliver to: Wisconsin Department of Rev enue,
Mail Sto p 1-151, 2135 Rimrock Road, Madison WI 53713.
2015
Form W-RA Page 2 of 2