2015 Statement of Assessment for Adams County · STATEMENT OF ASSESSMENT FOR 2015 CO MUN...

80
STATEMENT OF ASSESSMENT FOR 2015 CO MUN LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53) 01 002 TOWN OF ACCT NO 0001 Check if this is an Amended Return ADAMS FOR Town - Village - City Municipality Name County Name ADAMS COUNTY REMARKS OF Page 1 WHEN COMPLETING THIS DOCUMENT DO NOT WRITE OVER X's OR IN SHADED AREAS Line No. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 AGRICULTURAL FOREST - Class 5m TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14) NO. OF ACRES WHOLE NUMBERS ONLY TOTAL VALUE OF LAND AND IMPROVEMENTS LOCALLY ASSESSED MANUFACTURING MERGED REAL ESTATE (See Lines 18 - 22 for other Real Estate) PARCEL COUNT RESIDENTIAL - Class 1 COMMERCIAL - Class 2 MANUFACTURING - Class 3 AGRICULTURAL - Class 4 UNDEVELOPED - Class 5 FOREST LANDS - Class 6 OTHER - Class 7 TOTAL - ALL COLUMNS NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1 MACHINERY,TOOLS AND PATTERNS - Code 2 FURNITURE, FIXTURES AND EQUIPMENT - Code 3 ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F) MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F BOARD OF REVIEW DATE OF FINAL ADJOURNMENT Name of Assessor Telephone # TOTAL LAND Col. A IMPROVEMENTS Col. B Col. C VALUE OF LAND Col. D VALUE OF IMPROVEMENTS Col. E Col. F 1,319 900 2,979 20,559,500 66,907,200 87,466,700 31 24 224 1,049,500 2,614,700 3,664,200 187 4,452 544,500 544,500 387 3,520 2,769,200 2,769,200 96 1,063 1,197,800 1,197,800 528 8,516 18,960,600 18,960,600 24 24 273,300 2,334,700 60 2,608,000 2,574 949 45,373,800 72,831,800 20,829 118,205,600 152 0 218,700 49,500 1,803,400 2,071,600 120,299,800 05/20/2015 JAMES WARZYNSKI (608) 293-3308 2 1 15 19,400 975,200 994,600 0 0 10,500 229,200 10,600 60,100 1,500 1,804,900 22,600 2,094,200 The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is .979545615 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service Commission FINAL - EQUATED

Transcript of 2015 Statement of Assessment for Adams County · STATEMENT OF ASSESSMENT FOR 2015 CO MUN...

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

01 002

TOWN OF

ACCT NO

0001Check if this is an Amended Return

ADAMS FOR

Town - Village - City Municipality Name County Name

ADAMS COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

1,319 900 2,979 20,559,500 66,907,200 87,466,700

31 24 224 1,049,500 2,614,700 3,664,200

187 4,452 544,500 544,500

387 3,520 2,769,200 2,769,200

96 1,063 1,197,800 1,197,800

528 8,516 18,960,600 18,960,600

24 24 273,300 2,334,700 60 2,608,000

2,574 949 45,373,800 72,831,800 20,829 118,205,600

152

0

218,700

49,500

1,803,400

2,071,600

120,299,800

05/20/2015 JAMES WARZYNSKI (608) 293-3308

2 1 15 19,400 975,200 994,600

0 0

10,500 229,200

10,600 60,100

1,500 1,804,900

22,600 2,094,200

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is .979545615 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 01 002 0001

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

43 1,699.16 4,332,900 132 3,953.57 10,083,000

79 2,606.75 6,405,900

2,283.46 485.09 306.33

FRIENDSHIP LAKE DISTRICT018060 0005 10,165,400

10,165,400

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

01MUN

002

ACCT NO

0001

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

010014 0017 SCH D OF ADAMS FRIENDSHIP AREA 119,282,600

119,282,600

001400 0013 MID-STATE TECHNICAL COLLEGE WRAP 119,282,600

119,282,600

1,017,200 120,299,800

1,017,200 120,299,800

1,017,200 120,299,800

1,017,200 120,299,800

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

NO

TE

: P

lease s

up

ply

an

y c

orr

ecti

on

to

th

e n

am

e a

nd

ad

dre

ss.

JO

YC

E J

EF

FE

RS

ON

TO

WN

OF

AD

AM

S

19

09

13

TH

DR

IVE

FR

IEN

DS

HIP

, W

I 5

39

34

- 9

50

6

Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

01 004

TOWN OF

ACCT NO

0002Check if this is an Amended Return

BIG FLATS FOR

Town - Village - City Municipality Name County Name

ADAMS COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

1,600 1,171 4,917 29,451,500 44,539,400 73,990,900

17 13 66 502,600 1,878,500 2,381,100

83 2,394 333,900 333,900

118 732 680,200 680,200

30 456 590,500 590,500

293 5,654 14,467,700 14,467,700

14 16 86,300 695,300 21 781,600

2,155 1,200 46,112,700 47,113,200 14,240 93,225,900

137

0

105,900

30,900

406,800

543,600

93,769,500

05/18/2015 ASSOCIATED APPRAISAL SERIVCE (800) 721-4157

0 0 0 0 0 0

0 0

0 105,900

0 30,900

0 406,800

0 543,600

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.065439006 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 01 004 0002

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

232 9,028.74 23,473,700 117 3,898.64 10,038,500

10 394.05 1,024,500 91 2,736.43 7,099,100

290.09 21.46 116.64

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

01MUN

004

ACCT NO

0002

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

010014 0017 SCH D OF ADAMS FRIENDSHIP AREA 93,769,500

93,769,500

001400 0013 MID-STATE TECHNICAL COLLEGE WRAP 93,769,500

93,769,500

93,769,500

93,769,500

93,769,500

93,769,500

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

NO

TE

: P

lease s

up

ply

an

y c

orr

ecti

on

to

th

e n

am

e a

nd

ad

dre

ss.

MA

RY

O'N

EIL

TO

WN

OF

BIG

FL

AT

S

73

3 C

OU

NT

Y R

D C

HA

NC

OC

K,

WI

54

94

3

Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

01 006

TOWN OF

ACCT NO

0003Check if this is an Amended Return

COLBURN FOR

Town - Village - City Municipality Name County Name

ADAMS COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

387 262 1,863 6,519,800 13,829,900 20,349,700

0 0 0 0 0 0

213 6,530 894,800 894,800

242 2,247 1,369,600 1,369,600

68 735 886,500 886,500

159 3,027 7,262,300 7,262,300

28 66 344,500 12,697,100 94 13,041,600

1,097 328 17,277,500 26,527,000 14,496 43,804,500

32

0

400

61,900

379,900

442,200

44,246,700

05/21/2015 JAMES WARZYNSKI (608) 296-3308

0 0 0 0 0 0

0 0

0 400

0 61,900

0 379,900

0 442,200

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.005542829 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 01 006 0003

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

1 82.06 246,200

3 90.7 272,100 49 1,659.13 4,977,500

44 1,535.21 4,555,400

5,020 4.61 3.63

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

01MUN

006

ACCT NO

0003

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

010014

396335

694375

0017

0232

0429

SCH D OF ADAMS FRIENDSHIP AREA

SCH D OF WESTFIELD

SCH D OF TRI-COUNTY AREA (PLAINFIELD)

43,726,300

416,900

103,500

44,246,700

001400 0013 MID-STATE TECHNICAL COLLEGE WRAP 44,246,700

44,246,700

43,726,300

416,900

103,500

44,246,700

44,246,700

44,246,700

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

NO

TE

: P

lease s

up

ply

an

y c

orr

ecti

on

to

th

e n

am

e a

nd

ad

dre

ss.

GW

EN

PIE

RC

E

TO

WN

OF

CO

LB

UR

N

78

4 6

TH

AV

EN

UE

HA

NC

OC

K,

WI

54

94

3

Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

01 008

TOWN OF

ACCT NO

0004Check if this is an Amended Return

DELL PRAIRIE FOR

Town - Village - City Municipality Name County Name

ADAMS COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

1,452 951 3,283 39,296,400 102,530,800 141,827,200

72 49 647 4,488,200 8,018,400 12,506,600

262 5,036 611,600 611,600

147 841 1,148,200 1,148,200

99 1,328 2,655,800 2,655,800

267 4,915 18,961,700 18,961,700

17 32 208,500 1,541,900 31 1,750,400

2,320 1,033 67,607,300 112,102,100 16,179 179,709,400

95

66,700

403,500

177,100

160,100

807,400

180,516,800

05/22/2015 RIGLEMON APPRAISAL SERVICE (608) 378-3003

4 1 98 236,900 11,000 247,900

0 66,700

0 403,500

0 177,100

0 160,100

0 807,400

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.099029054 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 01 008 0004

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

12 325.28 1,301,100 64 1,597.01 5,282,000

2 48 192,000 24 697.88 2,783,800

633.84 3.62 183.8

FAWN LAKE PROTECTION DISTRICT018080 0561 8,268,800

8,268,800

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

01MUN

008

ACCT NO

0004

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

566678 0338 SCH D OF WISCONSIN DELLS 180,268,900

180,268,900

000400 0004 MADISON AREA TECHNICAL COLLEGE MADN 180,268,900

180,268,900

247,900 180,516,800

247,900 180,516,800

247,900 180,516,800

247,900 180,516,800

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

NO

TE

: P

lease s

up

ply

an

y c

orr

ecti

on

to

th

e n

am

e a

nd

ad

dre

ss.

JO

NI

GE

HR

KE

TO

WN

OF

DE

LL

PR

AIR

IE

10

05

GE

M C

OU

RT

WIS

CO

NS

IN D

EL

LS

, W

I 5

39

65

Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

01 010

TOWN OF

ACCT NO

0005Check if this is an Amended Return

EASTON FOR

Town - Village - City Municipality Name County Name

ADAMS COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

1,156 771 4,361 19,278,100 43,781,100 63,059,200

16 10 73 488,500 958,600 1,447,100

269 6,872 791,700 791,700

221 1,214 660,600 660,600

110 1,614 1,937,700 1,937,700

225 4,581 10,413,300 10,413,300

58 56 372,900 2,923,200 97 3,296,100

2,055 837 33,942,800 47,662,900 18,812 81,605,700

91

0

230,900

18,700

66,000

315,600

81,921,300

06/06/2015 RIGLEMON APPRAISAL SERVICE (608) 378-3003

0 0 0 0 0 0

0 0

0 230,900

0 18,700

0 66,000

0 315,600

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is .970735031 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 01 010 0005

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

4 160 336,000 79 2,405.6 5,456,500

23 847.11 1,763,700

411.16 16.48 200.04

EASTON LAKE DISTRICT018020 0001 4,942,700

4,942,700

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

01MUN

010

ACCT NO

0005

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

010014 0017 SCH D OF ADAMS FRIENDSHIP AREA 81,921,300

81,921,300

001400 0013 MID-STATE TECHNICAL COLLEGE WRAP 81,921,300

81,921,300

81,921,300

81,921,300

81,921,300

81,921,300

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

NO

TE

: P

lease s

up

ply

an

y c

orr

ecti

on

to

th

e n

am

e a

nd

ad

dre

ss.

LIZ

AL

LE

N

TO

WN

OF

EA

ST

ON

11

64

CO

UN

TY

RO

AD

A

AD

AM

S,

WI

53

91

0

Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

01 012

TOWN OF

ACCT NO

0006Check if this is an Amended Return

JACKSON FOR

Town - Village - City Municipality Name County Name

ADAMS COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

1,692 1,157 2,764 65,318,900 91,791,100 157,110,000

33 21 362 1,323,700 1,345,900 2,669,600

348 8,129 1,087,500 1,087,500

264 1,964 2,112,900 2,112,900

96 1,331 2,306,900 2,306,900

201 3,413 11,233,300 11,233,300

42 41 256,300 2,009,700 70 2,266,000

2,677 1,220 83,662,100 95,189,600 18,043 178,851,700

47

1,500

76,500

33,000

367,200

478,200

179,330,700

05/23/2015 RIGLEMON APPRAISAL SERVICE (608) 378-3003

1 1 10 22,600 42,900 65,500

0 1,500

500 77,000

200 33,200

100 367,300

800 479,000

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.03149059 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 01 012 0006

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

3 10 115,800 95 2,200.41 7,816,800

1 38.19 133,700 39 971.41 3,025,200

334.27 62.51 214.97

PEPPERMILL LAKE MANAGEMENT DISTRICT

JORDAN LAKE MANAGEMENT DISTRICT

GOOSE LAKE WATERSHED DISTRICT

018090

018100

018120

0562

0573

0597

14,402,100

45,745,800

13,214,900

14,402,100

45,745,800

13,214,900

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

01MUN

012

ACCT NO

0006

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

010014

396335

566678

0017

0232

0338

SCH D OF ADAMS FRIENDSHIP AREA

SCH D OF WESTFIELD

SCH D OF WISCONSIN DELLS

66,136,100

59,595,500

53,532,800

179,264,400

000400

001400

0004

0013

MADISON AREA TECHNICAL COLLEGE MADN

MID-STATE TECHNICAL COLLEGE WRAP

53,532,800

125,731,600

179,264,400

66,300

66,202,400

59,595,500

53,532,800

66,300 179,330,700

66,300

53,532,800

125,797,900

66,300 179,330,700

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

NO

TE

: P

lease s

up

ply

an

y c

orr

ecti

on

to

th

e n

am

e a

nd

ad

dre

ss.

CA

ND

AC

E P

EG

LE

R

TO

WN

OF

JA

CK

SO

N

31

6 F

ISH

CT

OX

FO

RD

, W

I 5

39

52

Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

01 014

TOWN OF

ACCT NO

0007Check if this is an Amended Return

LEOLA FOR

Town - Village - City Municipality Name County Name

ADAMS COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

232 212 553 3,061,200 13,091,400 16,152,600

8 7 46 230,700 865,400 1,096,100

353 10,369 1,245,000 1,245,000

460 4,305 2,865,100 2,865,100

63 476 600,400 600,400

227 2,847 7,573,900 7,573,900

143 141 429,600 9,193,200 579 9,622,800

1,486 360 16,005,900 23,150,000 19,175 39,155,900

14

0

50,100

7,600

111,200

168,900

39,324,800

06/24/2015 HOLLOWAY APPRAISAL SERVICE (608) 374-4207

0 0 0 0 0 0

0 0

0 50,100

0 7,600

0 111,200

0 168,900

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.061638806 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 01 014 0007

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

1 80.06 191,100

1 40 114,000 35 924.91 2,075,700

35 979.36 2,140,900

2,411.16 131.99 22.08

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

01MUN

014

ACCT NO

0007

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

694375 0429 SCH D OF TRI-COUNTY AREA (PLAINFIELD) 39,324,800

39,324,800

001400 0013 MID-STATE TECHNICAL COLLEGE WRAP 39,324,800

39,324,800

39,324,800

39,324,800

39,324,800

39,324,800

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

NO

TE

: P

lease s

up

ply

an

y c

orr

ecti

on

to

th

e n

am

e a

nd

ad

dre

ss.

NA

NC

Y G

AS

PE

RIC

TO

WN

OF

LE

OL

A

12

7 A

PA

CH

E L

AN

E

PL

AIN

FIE

LD

, W

I 5

49

66

Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

01 016

TOWN OF

ACCT NO

0008Check if this is an Amended Return

LINCOLN FOR

Town - Village - City Municipality Name County Name

ADAMS COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

308 243 328 1,398,200 15,336,800 16,735,000

3 1 87 188,300 32,400 220,700

347 9,635 1,263,100 1,263,100

377 1,749 1,248,500 1,248,500

142 1,203 1,433,900 1,433,900

391 5,795 14,089,700 14,089,700

33 102 189,100 3,860,000 56 4,049,100

1,601 346 19,810,800 19,229,200 18,853 39,040,000

7

0

1,000

0

44,100

45,100

39,085,100

05/28/2015 SCOTT ZILLMER (715) 754-2287

0 0 0 0 0 0

0 0

0 1,000

0 0

0 44,100

0 45,100

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is .955798849 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 01 016 0008

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

11 308.9 766,800 51 1,635.91 3,791,300

2 119.81 261,300 58 1,728.39 4,089,600

260 16.35 131.65

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

01MUN

016

ACCT NO

0008

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

010014 0017 SCH D OF ADAMS FRIENDSHIP AREA 39,085,100

39,085,100

001400 0013 MID-STATE TECHNICAL COLLEGE WRAP 39,085,100

39,085,100

39,085,100

39,085,100

39,085,100

39,085,100

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

NO

TE

: P

lease s

up

ply

an

y c

orr

ecti

on

to

th

e n

am

e a

nd

ad

dre

ss.

PA

TT

I N

EL

SO

N

TO

WN

OF

LIN

CO

LN

22

05

4T

H D

RIV

E

WE

ST

FIE

LD

, W

I 5

39

64

Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

01 018

TOWN OF

ACCT NO

0009Check if this is an Amended Return

MONROE FOR

Town - Village - City Municipality Name County Name

ADAMS COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

979 618 1,765 29,006,700 48,738,400 77,745,100

10 8 34 272,000 902,400 1,174,400

76 1,539 197,800 197,800

78 455 287,900 287,900

59 631 747,800 747,800

117 1,910 4,542,300 4,542,300

8 8 119,300 569,200 18 688,500

1,327 634 35,173,800 50,210,000 6,352 85,383,800

30

7,000

2,600

6,500

403,900

420,000

85,803,800

07/07/2015 BA PAULS AND ASSOCIATES (715) 848-9300

0 0 0 0 0 0

0 7,000

0 2,600

0 6,500

0 403,900

0 420,000

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is .970630124 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 01 018 0009

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

76 3,333.48 7,146,600 51 1,541.92 3,475,400

32 875.27 1,792,300

253.96 11,219.04

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

01MUN

018

ACCT NO

0009

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

010014 0017 SCH D OF ADAMS FRIENDSHIP AREA 85,803,800

85,803,800

001400 0013 MID-STATE TECHNICAL COLLEGE WRAP 85,803,800

85,803,800

85,803,800

85,803,800

85,803,800

85,803,800

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

NO

TE

: P

lease s

up

ply

an

y c

orr

ecti

on

to

th

e n

am

e a

nd

ad

dre

ss.

DA

RL

EN

E F

ER

GU

SO

N

TO

WN

OF

MO

NR

OE

11

00

17

TH

DR

IVE

AR

KD

AL

E,

WI

54

61

3

Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

01 020

TOWN OF

ACCT NO

0010Check if this is an Amended Return

NEW CHESTER FOR

Town - Village - City Municipality Name County Name

ADAMS COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

1,358 832 2,169 18,166,300 42,565,100 60,731,400

35 20 52 220,900 2,841,000 3,061,900

242 5,977 771,400 771,400

271 1,732 860,000 860,000

79 907 1,157,400 1,157,400

304 3,594 9,067,000 9,067,000

55 54 1,499,700 14,902,900 254 16,402,600

2,345 907 31,753,800 60,386,200 14,686 92,140,000

38

0

252,500

86,700

540,300

879,500

93,038,000

05/18/2015 JAMES WARZYNSKI (608) 296-3308

1 1 1 11,100 77,200 88,300

0 0

15,000 267,500

400 87,100

3,100 543,400

18,500 898,000

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.007828928 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 01 020 0010

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

10 336.47 858,100 65 2,181.43 5,563,100

3 75.27 191,900 22 644.47 1,643,800

983.5 316.06 75.92 440.19

PATRICKS LAKE DISTRICT

MCGINNIS PUBLIC INLAND LAKE AND REHAB DIST

018030

018110

0002

0596

9,667,700

8,461,400

9,667,700

8,461,400

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

01MUN

020

ACCT NO

0010

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

010014

396335

0017

0232

SCH D OF ADAMS FRIENDSHIP AREA

SCH D OF WESTFIELD

92,278,600

652,600

92,931,200

001400 0013 MID-STATE TECHNICAL COLLEGE WRAP 92,931,200

92,931,200

106,800

92,385,400

652,600

106,800 93,038,000

106,800 93,038,000

106,800 93,038,000

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

NO

TE

: P

lease s

up

ply

an

y c

orr

ecti

on

to

th

e n

am

e a

nd

ad

dre

ss.

RO

BIN

HA

NS

EN

TO

WN

OF

NE

W C

HE

ST

ER

P.O

. B

OX

69

GR

AN

D M

AR

SH

, W

I 5

39

36

Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

01 022

TOWN OF

ACCT NO

0011Check if this is an Amended Return

NEW HAVEN FOR

Town - Village - City Municipality Name County Name

ADAMS COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

413 299 574 11,835,200 22,161,600 33,996,800

16 13 98 457,800 1,233,600 1,691,400

398 8,935 959,600 959,600

288 2,016 1,796,900 1,796,900

165 1,954 3,350,800 3,350,800

133 1,671 5,366,800 5,366,800

94 91 796,600 6,029,400 163 6,826,000

1,507 403 24,563,700 29,424,600 15,411 53,988,300

57

0

161,600

36,400

243,100

441,100

54,429,400

06/04/2015 RIGLEMON APPRAISAL SERVICE (608) 378-3003

0 0 0 0 0 0

0 0

0 161,600

0 36,400

0 243,100

0 441,100

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is .98747993 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 01 022 0011

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

2 23 73,600 80 2,048.71 6,474,100

48 1,226.23 3,552,700

297.94 349.85 9.58

LAKE MASON MANAGEMENT DISTRICT018070 0556 17,638,100

17,638,100

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

01MUN

022

ACCT NO

0011

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

396335

566678

0232

0338

SCH D OF WESTFIELD

SCH D OF WISCONSIN DELLS

210,800

54,218,600

54,429,400

000400

001400

0004

0013

MADISON AREA TECHNICAL COLLEGE MADN

MID-STATE TECHNICAL COLLEGE WRAP

54,218,600

210,800

54,429,400

210,800

54,218,600

54,429,400

54,218,600

210,800

54,429,400

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

NO

TE

: P

lease s

up

ply

an

y c

orr

ecti

on

to

th

e n

am

e a

nd

ad

dre

ss.

KE

NN

ET

H C

RO

TH

ER

S

TO

WN

OF

NE

W H

AV

EN

38

90

CO

UN

TY

RO

AD

G

WIS

DE

LL

S,

WI

53

96

5

Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

01 024

TOWN OF

ACCT NO

0012Check if this is an Amended Return

PRESTON FOR

Town - Village - City Municipality Name County Name

ADAMS COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

1,827 1,196 2,763 35,354,300 77,830,800 113,185,100

29 23 168 1,102,400 2,629,700 3,732,100

146 3,157 391,300 391,300

51 284 209,300 209,300

60 901 1,388,200 1,388,200

238 5,585 13,877,700 13,877,700

27 26 94,400 981,500 56 1,075,900

2,382 1,249 52,560,700 84,172,600 12,947 136,733,300

34

0

98,700

41,500

85,800

226,000

137,165,300

05/11/2015 RIGLEMON APPRAISAL SERVICE (608) 378-3003

4 4 33 143,100 2,730,600 2,873,700

0 0

64,600 163,300

65,000 106,500

76,400 162,200

206,000 432,000

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.002338293 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 01 024 0012

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

42 1,631.15 3,864,000 141 4,538.05 10,035,600

1 85.3 238,800 50 1,580 3,860,300

1,130.81 236.72 193.58

BIG ROCHE-A-CRI LAKE DISTRICT

FRIENDSHIP LAKE DISTRICT

018050

018060

0004

0005

31,936,100

9,718,200

31,936,100

9,718,200

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

01MUN

024

ACCT NO

0012

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

010014 0017 SCH D OF ADAMS FRIENDSHIP AREA 134,085,600

134,085,600

001400 0013 MID-STATE TECHNICAL COLLEGE WRAP 134,085,600

134,085,600

3,079,700 137,165,300

3,079,700 137,165,300

3,079,700 137,165,300

3,079,700 137,165,300

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

NO

TE

: P

lease s

up

ply

an

y c

orr

ecti

on

to

th

e n

am

e a

nd

ad

dre

ss.

SC

OT

T S

OR

EN

SE

N

TO

WN

OF

PR

ES

TO

N

17

39

11

TH

AV

EN

UE

FR

IEN

DS

HIP

, W

I 5

39

34

Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

01 026

TOWN OF

ACCT NO

0013Check if this is an Amended Return

QUINCY FOR

Town - Village - City Municipality Name County Name

ADAMS COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

2,512 1,692 2,441 53,814,100 98,917,000 152,731,100

27 25 89 1,932,300 2,802,500 4,734,800

143 3,676 465,300 465,300

134 1,076 567,400 567,400

54 853 1,046,500 1,046,500

225 3,438 8,669,800 8,669,800

50 50 233,500 1,238,600 71 1,472,100

3,145 1,767 66,728,900 102,958,100 11,644 169,687,000

137

0

15,900

129,200

2,314,800

2,459,900

172,146,900

05/20/2015 RIGLEMON APPRAISAL SERVICE (607) 378-3003

0 0 0 0 0 0

0 0

0 15,900

0 129,200

0 2,314,800

0 2,459,900

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is .990756989 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 01 026 0013

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

18 700.98 1,600,000 55 1,627.01 3,556,200

2 54.31 124,900 24 642.96 1,344,100

2,702.84 143.12 5,725.45

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

01MUN

026

ACCT NO

0013

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

010014 0017 SCH D OF ADAMS FRIENDSHIP AREA 172,146,900

172,146,900

001400 0013 MID-STATE TECHNICAL COLLEGE WRAP 172,146,900

172,146,900

172,146,900

172,146,900

172,146,900

172,146,900

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

NO

TE

: P

lease s

up

ply

an

y c

orr

ecti

on

to

th

e n

am

e a

nd

ad

dre

ss.

WA

ND

A A

BF

AL

L

TO

WN

OF

QU

INC

Y

25

99

CO

UN

TY

RD

Z

FR

IEN

DS

HIP

, W

I 5

39

34

- 9

61

7

Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

01 028

TOWN OF

ACCT NO

0014Check if this is an Amended Return

RICHFIELD FOR

Town - Village - City Municipality Name County Name

ADAMS COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

167 141 395 1,612,100 8,424,000 10,036,100

4 4 10 40,000 2,177,500 2,217,500

271 7,518 1,140,900 1,140,900

430 5,460 2,319,200 2,319,200

88 978 1,412,900 1,412,900

253 2,847 8,113,000 8,113,000

67 68 289,100 3,875,900 83 4,165,000

1,281 214 14,959,000 15,512,600 17,300 30,471,600

19

0

29,400

15,400

334,500

379,300

30,850,900

05/18/2015 ASSOCIATED APPRAISAL SERIVCE (800) 721-4157

1 1 9 31,800 1,035,200 1,067,000

0 0

0 29,400

0 15,400

0 334,500

0 379,300

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.06696878 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 01 028 0014

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

6 230.18 644,600

5 200 596,000 85 2,653.78 8,054,200

6 149 331,600 52 1,667.83 4,864,400

143.85 23.96 313.27

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

01MUN

028

ACCT NO

0014

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

010014

396335

0017

0232

SCH D OF ADAMS FRIENDSHIP AREA

SCH D OF WESTFIELD

28,611,700

1,172,200

29,783,900

001400 0013 MID-STATE TECHNICAL COLLEGE WRAP 29,783,900

29,783,900

1,067,000

29,678,700

1,172,200

1,067,000 30,850,900

1,067,000 30,850,900

1,067,000 30,850,900

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

NO

TE

: P

lease s

up

ply

an

y c

orr

ecti

on

to

th

e n

am

e a

nd

ad

dre

ss.

TA

NY

A B

UR

RO

WS

TO

WN

OF

RIC

HF

IEL

D

15

3 C

UM

BE

RL

AN

D A

VE

CO

LO

MA

, W

I 5

49

30

Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

01 030

TOWN OF

ACCT NO

0015Check if this is an Amended Return

ROME FOR

Town - Village - City Municipality Name County Name

ADAMS COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

6,254 4,269 5,640 217,039,900 361,718,800 578,758,700

78 64 906 3,962,400 14,632,500 18,594,900

21 674 75,700 75,700

179 2,759 1,094,400 1,094,400

5 170 200,800 200,800

244 4,566 9,453,200 9,453,200

6 6 99,100 393,600 13 492,700

6,793 4,344 232,348,300 377,955,200 14,755 610,303,500

88

9,500

1,106,900

677,800

394,400

2,188,600

612,530,800

06/01/2015 ASSOCIATED APPRAISAL SERVICE (920) 749-1995

6 5 27 422,800 1,210,300 1,633,100

0 9,500

20,100 1,127,000

15,100 692,900

3,500 397,900

38,700 2,227,300

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.053723495 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 01 030 0015

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

269 10,705.94 21,900,200 126 4,088.89 8,833,400

3 120 259,200 42 1,351.53 2,914,800

530.28 424.52 5,335

TRI-LAKES MANAGEMENT DISTRICT018040 0003 493,230,000

493,230,000

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

01MUN

030

ACCT NO

0015

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

694375

713906

0429

0439

SCH D OF TRI-COUNTY AREA (PLAINFIELD)

SCH D OF NEKOOSA

220,300

610,638,700

610,859,000

001400 0013 MID-STATE TECHNICAL COLLEGE WRAP 610,859,000

610,859,000

1,671,800

220,300

612,310,500

1,671,800 612,530,800

1,671,800 612,530,800

1,671,800 612,530,800

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

NO

TE

: P

lease s

up

ply

an

y c

orr

ecti

on

to

th

e n

am

e a

nd

ad

dre

ss.

TE

RR

I A

ND

ER

SO

N

TO

WN

OF

RO

ME

11

56

AL

PIN

E D

R

NE

KO

OS

A,

WI

54

45

7 -

86

16

Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

01 032

TOWN OF

ACCT NO

0016Check if this is an Amended Return

SPRINGVILLE FOR

Town - Village - City Municipality Name County Name

ADAMS COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

1,518 1,109 4,052 18,530,700 57,257,934 75,788,634

22 18 181 747,800 2,242,400 2,990,200

314 7,661 854,800 854,800

210 1,325 1,302,700 1,302,700

151 1,953 2,509,900 2,509,900

300 6,319 15,179,000 15,179,000

61 58 153,000 2,018,700 87 2,171,700

2,576 1,185 39,277,900 61,519,034 21,578 100,796,934

181

4,500

146,700

94,400

593,200

838,800

101,635,734

10/08/2015 RIGLEMON APPRAISAL SERVICE (608) 378-3003

0 0 0 0 0 0

0 4,500

0 146,700

0 94,400

0 593,200

0 838,800

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is .990086388 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 01 032 0016

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

2 80 240,000

20 663.19 1,605,600 126 3,333.18 7,643,500

52 1,608.34 3,732,800

250.06 35.81 86.51

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

01MUN

032

ACCT NO

0016

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

010014

566678

0017

0338

SCH D OF ADAMS FRIENDSHIP AREA

SCH D OF WISCONSIN DELLS

60,606,410

41,029,324

101,635,734

000400

001400

0004

0013

MADISON AREA TECHNICAL COLLEGE MADN

MID-STATE TECHNICAL COLLEGE WRAP

41,029,324

60,606,410

101,635,734

60,606,410

41,029,324

101,635,734

41,029,324

60,606,410

101,635,734

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

NO

TE

: P

lease s

up

ply

an

y c

orr

ecti

on

to

th

e n

am

e a

nd

ad

dre

ss.

BE

RN

IEC

E J

TA

NG

NE

Y

TO

WN

OF

SP

RIN

GV

ILL

E

15

40

FE

RN

AV

E

WIS

CO

NS

IN D

EL

LS

, W

I 5

39

65

Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

01 034

TOWN OF

ACCT NO

0017Check if this is an Amended Return

STRONGS PRAIRIE FOR

Town - Village - City Municipality Name County Name

ADAMS COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

2,104 1,421 2,442 57,409,600 111,577,900 168,987,500

29 25 252 1,951,700 4,804,800 6,756,500

450 9,651 1,183,300 1,183,300

221 926 576,700 576,700

241 2,922 3,980,700 3,980,700

261 4,568 11,584,100 11,584,100

109 109 956,800 5,886,900 227 6,843,700

3,415 1,555 77,642,900 122,269,600 20,988 199,912,500

29

46,000

457,200

133,100

507,700

1,144,000

201,056,500

05/16/2016 RIGLEMON APPRAISAL SERVICE (608) 378-3003

0 0 0 0 0 0

0 46,000

0 457,200

0 133,100

0 507,700

0 1,144,000

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.086538171 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 01 034 0017

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

3 118.22 283,700 83 2,262.54 5,413,600

59 1,535.56 3,643,300

140.53 720.87 5,698.2

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

01MUN

034

ACCT NO

0017

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

010014 0017 SCH D OF ADAMS FRIENDSHIP AREA 201,056,500

201,056,500

001400 0013 MID-STATE TECHNICAL COLLEGE WRAP 201,056,500

201,056,500

201,056,500

201,056,500

201,056,500

201,056,500

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

NO

TE

: P

lease s

up

ply

an

y c

orr

ecti

on

to

th

e n

am

e a

nd

ad

dre

ss.

LO

RI

HE

NT

HO

RN

E

TO

WN

OF

ST

RO

NG

S P

RA

IRIE

15

88

ST

AT

E R

OA

D 2

1

AR

KD

AL

E,

WI

54

61

3 -

00

69

Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

01 126

VILLAGE OF

ACCT NO

0018Check if this is an Amended Return

FRIENDSHIP FOR

Town - Village - City Municipality Name County Name

ADAMS COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

345 255 167 5,134,100 15,000,900 20,135,000

45 41 17 801,200 6,164,600 6,965,800

0 0 0 0

0 0 0 0

0 0 0 0

1 37 66,800 66,800

0 0 0 0 0 0

394 298 6,155,400 22,531,200 280 28,686,600

77

2,200

202,200

716,500

278,900

1,199,800

30,701,000

05/19/2015 BA PAULS AND ASSOCIATES (715) 848-9300

3 2 59 153,300 1,365,700 1,519,000

0 2,200

771,400 973,600

20,200 736,700

23,000 301,900

814,600 2,014,400

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.152167467 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 01 126 0018

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

1 22 43,100

8.6 46.11 73.22

FRIENDSHIP LAKE DISTRICT018060 0005 5,440,200

5,440,200

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

01MUN

126

ACCT NO

0018

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

010014 0017 SCH D OF ADAMS FRIENDSHIP AREA 28,367,400

28,367,400

001400 0013 MID-STATE TECHNICAL COLLEGE WRAP 28,367,400

28,367,400

2,333,600 30,701,000

2,333,600 30,701,000

2,333,600 30,701,000

2,333,600 30,701,000

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

NO

TE

: P

lease s

up

ply

an

y c

orr

ecti

on

to

th

e n

am

e a

nd

ad

dre

ss.

KA

TH

LE

EN

M.

PIE

RC

E

VIL

LA

GE

OF

FR

IEN

DS

HIP

PO

BO

X 2

06

FR

IEN

DS

HIP

, W

I 5

39

34

- 0

20

6

Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

01 201

CITY OF

ACCT NO

0019Check if this is an Amended Return

ADAMS FOR

Town - Village - City Municipality Name County Name

ADAMS COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

757 657 237 5,382,400 37,007,100 42,389,500

141 116 126 2,974,900 20,910,100 23,885,000

3 29 4,700 4,700

6 65 38,500 38,500

0 0 0 0

24 456 909,900 909,900

0 0 0 0 0 0

942 782 9,841,700 64,480,300 1,023 74,322,000

156

0

1,071,573

1,991,101

242,978

3,305,652

79,991,952

10/20/2015 UPNORTH ASSESSMENTS LLC (715) 845-2022

11 9 110 531,300 6,563,100 7,094,400

0 0

1,862,100 2,933,673

96,700 2,087,801

405,500 648,478

2,364,300 5,669,952

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is 1.022332167 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 01 201 0019

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

6 140.62 293,600

2.98 4.16 269.62

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

01MUN

201

ACCT NO

0019

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

010014 0017 SCH D OF ADAMS FRIENDSHIP AREA 70,533,252

70,533,252

001400 0013 MID-STATE TECHNICAL COLLEGE WRAP 70,533,252

70,533,252

9,458,700 79,991,952

9,458,700 79,991,952

9,458,700 79,991,952

9,458,700 79,991,952

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

NO

TE

: P

lease s

up

ply

an

y c

orr

ecti

on

to

th

e n

am

e a

nd

ad

dre

ss.

JA

NE

T W

INT

ER

S

CIT

Y O

F A

DA

MS

PO

BO

X 1

00

9

AD

AM

S,

WI

53

91

0 -

10

09

Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS

STATEMENT OF ASSESSMENT FOR 2015 CO MUN

LGSSOA101WI - PA-521C (R.9-10) (Sec. 70.53)

01 291

CITY OF

ACCT NO

0020Check if this is an Amended Return

WISCONSIN DELLS FOR

Town - Village - City Municipality Name County Name

ADAMS COUNTY

REMARKS

OF

Page 1

WHEN COMPLETING THIS DOCUMENTDO NOT WRITE OVER X's OR IN SHADED AREAS

LineNo.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

AGRICULTURAL FOREST - Class 5m

TOTAL OF PERSONAL PROPERTY NOT EXEMPT (Total of Lines 11-14)

NO. OF ACRESWHOLE

NUMBERS ONLY

TOTAL VALUE OF LANDAND IMPROVEMENTS

LOCALLY ASSESSED MANUFACTURING MERGED

REAL ESTATE(See Lines 18 - 22 for

other Real Estate)

PARCEL COUNT

RESIDENTIAL - Class 1

COMMERCIAL - Class 2

MANUFACTURING - Class 3

AGRICULTURAL - Class 4

UNDEVELOPED - Class 5

FOREST LANDS - Class 6

OTHER - Class 7

TOTAL - ALL COLUMNS

NUMBER OF PERSONAL PROPERTY ACCOUNTS IN ROLL

BOATS AND OTHER WATERCRAFT NOT EXEMPT - Code 1

MACHINERY,TOOLS AND PATTERNS - Code 2

FURNITURE, FIXTURES AND EQUIPMENT - Code 3

ALL OTHER PERSONAL PROPERTY NOT EXEMPT - Codes 4A, 4B, 4C

AGGREGATE ASSESSED VALUE OF ALL PROPERTY SUBJECT TO THE GENERAL PROPERTY TAX (Total of Lines 9F and 15F)MUST EQUAL TOTAL VALUE OF THE SCHOOL DISTRICTS (K-12 PLUS K-8) - Line 50, Col. F

BOARD OF REVIEWDATE OF FINAL ADJOURNMENT

Name of Assessor Telephone #

TOTAL LAND

Col. A

IMPROVEMENTS

Col. B Col. C

VALUE OFLAND

Col. D

VALUE OFIMPROVEMENTS

Col. E Col. F

71 17 55 1,180,500 2,666,800 3,847,300

325 298 359 11,908,700 85,449,500 97,358,200

9 175 25,600 25,600

1 4 3,400 3,400

2 8 14,700 14,700

3 39 169,500 169,500

0 0 0 0 0 0

411 315 13,302,400 88,116,300 640 101,418,700

309

0

1,149,000

1,753,600

117,600

3,020,200

104,438,900

06/25/2015 ASSOCIATED APPRAISAL SERVICE (920) 749-1995

0 0 0 0 0 0

0 0

0 1,149,000

0 1,753,600

0 117,600

0 3,020,200

The Assessment Ratio to be used in calculating the estimated Fair Market Value on tax bills for this tax district is .991490974 This ratio should be used to convert assessed values to "Calculate Equalized Values" in Step 1 of the Lottery and Gaming Credit Calculations. This ratio should be used in the "Computation of Tax Equivalent" schedule of the Annual Reports filed by the municipal electric, gas and water utilities with the Public Service

Commission

FINAL - EQUATED

LGSSOA101WI-PA - 521C (R. 9-10) (Sec. 70.53)

FOREST CROP AND OTHER EXEMPT LAND

Do not confuse FOREST LANDS (Line 7) with FOREST CROPS (in this section) - They are NOT the sameYEAR CO MUN ACCT NO

2015 01 291 0020

$1.87

$8.27

18

19

20

21

22

23

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

(a) PARCELS (b) ACRES (c) ASSESSED VALUE

Page 2

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

(a) County Forest Cropland Acres (b) Federal Acres (c) State Acres (d) County (NOT FOREST CROP) Acres (e) Other Acres

Assessed Value of Omitted Property From Prior Years (Sec. 70.44)

(a) REAL ESTATE (b) PERSONAL

Assessed Value of Sec. 70.43 Corrections of Errors by Assessors(c1) REAL ESTATE (c2) PERSONAL

Manufacturing Equated Value of Omitted Property From Prior Years (Sec. 70.995)(d) REAL ESTATE (e) PERSONAL

Mfg. Equated Value of Sec.70.43 Corrections of Errors by Assessors(f1) REAL ESTATE (f2) PERSONAL

SPECIAL DISTRICTS

LineNo.

Enter 6-digitSpecial DistrictCode (Col. A)

AccountNumber(Col. B)

Special District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

24

25

26

27

28

29

30

31

32

33

34

35

327.79 .88 117.17

Private Forest Crop - Reg Class @ 10¢ per acre Private Forest Crop - Reg Class @

Private Forest Crop - Special Class @ 20¢ per acre

Entered Before 2005 Managed Forest - OPEN @ Entered Before 2005 Managed Forest - CLOSED @

Entered After 2004 Managed Forest - OPEN @ Entered After 2004 Managed Forest - CLOSED @

$2.52 per acre

$.79 per acre per acre

$2.14 $10.68per acre per acre

(d) PARCELS (e) ACRES (f) ASSESSED VALUE

Entered Before 2005 Managed Forest - Ferrous Mining CLOSED @ per acre

YEAR

2015CO

01MUN

291

ACCT NO

0020

Page 3

SCHOOL DISTRICTS

LineNo.

Enter 6-digitSchool DistrictCode (Col. A)

AccountNumber(Col. B)

School District Name

(Col. C)

Locally Assessed Valueof Real Estate and

Personal Property (Col. D)

Mfg Value of Real Estateand Personal Property

(Col. E)

Merged Value ofReal Estate and

Personal Property (Col. F)

A. SCHOOL DISTRICTS (K-8 and K-12)

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50 TOTAL ASSESSED VALUE OF SCHOOL DISTRICTS (K-8 and K-12)

B. UNION HIGH SCHOOL DISTRICTS

51

52

53

54

55

C. TECHNICAL COLLEGE DISTRICTS

56

57

58

59 TOTAL ASSESSED VALUE OF TECHNICAL COLLEGES

I hereby certify, to the best of my knowledge and belief, this form is complete and correct.

Print name of preparer

Signature of preparer

Title

Contact Telephone Number

( ) -

Date (MM / DD / CCYY)

E-mail address

LGSSOA101WI -PA-521C (R. 9-10) (Sec. 70.53)

TOTAL ASSESSED VALUE OF UNION HIGH SCHOOLS

566678 0338 SCH D OF WISCONSIN DELLS 104,438,900

104,438,900

000400 0004 MADISON AREA TECHNICAL COLLEGE MADN 104,438,900

104,438,900

104,438,900

104,438,900

104,438,900

104,438,900

INSTRUCTIONS FOR STATEMENT OF ASSESSMENT INCLUDING SPECIAL DISTRICT PART

HIGHLIGHTS

1. Complete the Statement of Assessment after the Board of Review. Reflect any changes made there.2. Use black ink to complete.3. Line 16 must equal Line 50, Col D.4. Line 55 must equal the total of K-8 schools listed on

lines 36-49. Do not include K-12 schools in this comparision.5. Line 59, Col. D must equal Line 16.6. Special District, School District and Technical College District values must include both real estate and personal property. Examples of Special districts are: town sanitary districts, public inland lake protection and rehabilitation districts, and metropolitan sewerage districts.7. DO NOT INCLUDE Manufacturing property values.DOR will print these values on the final SOA.8. Accuracy of this form is very important. The values reported directly affect the equalized value DOR calculates for school and special districts.

Page 1:If not prefilled, enter the tax year,county and municipal code,municipal type, municipal name and county name on the top of form.Check the Amended box, if filing an amended / corrected SOA.Report the parcel count, acres and assessed value of taxable general property, total parcel count, (real and personal), total acres, and values from final figures set by the Board of Review.A. Real Estate - land and improvements (buildings, etc.) is reported on lines 1 - 8, total line 9.B. Personal Property is reported on lines 11 - 14, Column D, total line 15.C. To complete this report, use the computer produced summary of the assessment roll that shows these amounts.D. Use whole numbers only.E. Add each line across and each column down to verify entries.

Page 2:A. Report Special Items (not subject to general property tax). 1. Private Forest Croplands and Managed Forest Lands are reported on lines 18,19, 20 and 21. Be sure to report assessed values NOT taxes. 2. You should have copies of the orders of entry, orders of withdrawal, etc., to update your assessment roll. 3. Show hundredths of acres (e.g. 39.75). 4. Tax exempt lands are reported on line 22. 5. Omitted property and sec. 70.43, Wis. Stats., corrections of errors by assessor are reported on line 23. Report real estate and personal property separately. These should be for prior years, not something found on the current assessment roll after the board of review.B. Special District (Lines 24-35) Include the value of both real and personal property. The Department of Revenue (DOR) preprints much of the information regarding names and codes for schools, special districts,etc. If a district is not listed, enter the name and value only, DOR will enter the proper code.

Page 3 School Districts:Include the value of both real and personal property.Report School District (regular, elementary, union high school, and technical college). 1. Regular (K-12) and Elementary (K-8) school values are reported on lines 36-49, total on line 50. 2. Union High School (UHS) (use only if elementary schools are listed on lines 36-49) are reported on lines 51-54. UHS total value (line 55) must equal to the total elementary school values reported on lines 36-49. Do not include K-12 schools in this comparison. 3. Technical College values are reported on lines 56-58, total on line 59. 4. Use the computer summary that shows these amounts to complete this report.

This form is due the second Monday in June. File this report only after your Board of Review is complete. If you have questions: Return forms to: Email: [email protected] Wisconsin Department of Revenue Call: (608) 261-5341 Local Government Services Section 6-97 Fax number: (608) 264-6887 PO Box 8971 Madison WI 53708-8971

NO

TE

: P

lease s

up

ply

an

y c

orr

ecti

on

to

th

e n

am

e a

nd

ad

dre

ss.

NA

NC

Y R

. H

OL

ZE

M

CIT

Y O

F W

ISC

ON

SIN

DE

LL

S

30

0 L

A C

RO

SS

E S

TR

EE

T

WIS

DE

LL

S,

WI

53

96

5

Page 4

LGSSOA101WI - PA-521C (R. 9-10) (Sec. 70.53) IPAS