Required
Attachments for
Electronic Filing
Form
W-RA
2019
Wisconsin
Department of Revenue
I-041 (R. 11-19)
Refer to instructions on back.
Taxpayer Information
(
Use BLACK Ink Only
)
Attachments – Submit this form only if you electronically filed your return or homestead credit claim.
Do NOT submit this form if you are filing a paper return or homestead credit claim.
Your legal last name Legal rst name M.I. Your social security number
If joint return, spouse’s legal last name Spouse’s legal rst name M.I. Spouse’s social security number
Address (number and street) Apt. no. Daytime phone number
City or post oce State Zip code Email address
Legal name of estate, trust, partnership, or corporation FEIN
PAPER CLIP required attachments here
Check the applicable box(es) to identify the attachments.
Amended return filed on Form 1, 1NPR, or X‑NOL Attach forms, documents and/or schedules that support the item(s)
changed, as needed.
Angel investment credit (Schedule VC) Attach a copy of the new business venture certification form provided by the
Wisconsin Economic Development Corporation (WEDC) and the tax credit verification form issued by the WEDC. If credit
is from a pass‑through entity, attach a copy of your Schedule 5K‑1, 3K‑1, or 2K‑1 instead.
Business development credit (Schedule BD) Attach a copy of the certification form and the tax credit verification from
WEDC. If credit is from a pass‑through entity, attach a copy of your Schedule 5K‑1, 3K‑1, or 2K‑1 instead.
Community rehabilitation program credit (Schedule CM) – Attach signed Part II of Schedule CM. If credit is from a pass
through entity, attach a copy of your Schedule 5K‑1, 3K‑1, or 2K‑1 instead.
Development zones credit (Schedule DC) Attach a copy of your certification to claim tax benefits and the verification of
expenses from WEDC. Also attach a statement from WEDC verifying the amount of credit for environmental remediation and
job creation or retention. If credit is from a pass‑through entity, attach a copy of your Schedule 5K‑1, 3K‑1, or 2K‑1 instead.
Early stage seed investment credit (Schedule VC) Attach a copy of the certification issued by WEDC to the business
and to the fund manager and a statement from the fund manager containing (1) name and address of the fund manager
and (2) for each investment, the date, total amount of investment, amount invested in a qualified new business venture,
and amount of tax credit. If credit is from a pass‑through entity, attach a copy of your Schedule 5K‑1, 3K‑1, or 2K‑1 instead.
Economic development credit (Schedule ED) – Attach a copy of your certification and the notice of eligibility to receive tax
benefits from the WEDC. If credit is from a pass‑through entity, attach a copy of your Schedule 5K‑1, 3K‑1, or 2K‑1 instead.
Electronics and Information Technology Manufacturing Zone Credit (Schedule EIT) – Attach a copy of your tax benefit certifi-
cation issued by the WEDC. If credit is from a pass‑through entity, attach a copy of your Schedule 5K‑1, 3K‑1, or 2K‑1 instead.
Eligible veterans and surviving spouses property tax credit Attach real estate tax bill(s) for all taxes paid in 2019,
proof of payment, your Wisconsin Department of Veterans Affairs certification, if required, and any other documentation
requested in the instructions.
Employee college savings account contribution credit (Schedule ES) If credit is from a pass‑through entity, attach a copy
of your Schedule 5K‑1, 3K‑1, or 2K‑1.
Enterprise zone jobs credit (Schedule EC) – Attach a copy of your certification to claim tax benefits and the verification of
your expenses from WEDC. If credit is from a pass‑through entity, attach a copy of your Schedule 5K‑1, 3K‑1, or 2K‑1 instead.
Farmland preservation credit (Schedule FC or FC‑A) – See the instructions for the schedule you are filing for the required
attachments.
Historic rehabilitation credit (Schedule HR) – See Schedule HR for the required attachments.
Homestead credit (Schedule H or HEZ) Attach required documents (W‑2s, W‑2Gs, 1099Rs, 1098Ts, original rent
certificate(s), tax bill(s), legal documents, and statements). Attach a copy of Schedule GL if using electronic software that
does not submit the Schedule GL as part of the electronic return.
Jobs tax credit (Schedule JT) – Attach a copy of your certification to claim tax benefits issued by WEDC and the notice of
eligibility to receive tax benefits that reports the amount of tax benefit from WEDC. If credit is from a pass‑through entity,
attach a copy of your Schedule 5K‑1, 3K‑1, or 2K‑1 instead.
Tab to navigate within form. Use mouse to check
applicable boxes, press spacebar or press Enter.
Save
Print
Clear
Your legal name Social security number or FEIN
2019 Form W‑RA
Page 2 of 2
Purpose of Form
Use Form W‑RA to submit supporting documentation when you electronically file an income or franchise tax return and claim any of the
credits or items listed. Many of the above items require documentation from the WEDC. Legislators making the special section 162(h)
election must mail the Model Form to the department when using electronic filing software that does not submit the Model Form as part of
the electronic return.
Paper clip your attachments to Form WRA. Refunds can be processed faster if you use paper clips instead of staples.
CAUTION Use Form WRA only to submit supporting documentation required for the box(es) checked. Do not submit other
correspondence or appeals or a paper copy of your tax return or homestead credit claim with Form W‑RA.
When to File
Form WRA and required attachments must be mailed to the department within 48 hours of receipt of your Wisconsin acknowledgment.
Refunds may not complete processing until Form W‑RA and attachments have been received.
Individuals and tax practitioners filing on behalf of individuals required to send the Form W‑RA attachments to the department may transmit
this data in an electronic file over the internet. To submit Form W‑RA attachments electronically, go to https://tap.revenue.wi.gov/WRA/.
Where to File
Send Form W‑RA and all attachments to: Wisconsin Department of Revenue, PO Box 8977, Madison WI 537088977
Failure to mail Form W‑RA timely to the correct address with all attachments will result in a delay in issuing a refund.
If you use a mail service provider that is not the U.S. Postal Service, deliver to: Mail Stop 1‑151, Wisconsin Department of Revenue,
2135 Rimrock Road, Madison WI 53713.
Low‑income housing credit (Schedule LI) – Attach a copy of the allocation certificate issued by Wisconsin Housing and Eco-
nomic Development Authority. If credit is from a pass‑through entity, attach a copy of your Schedule 5K‑1, 3K‑1, or 2K‑1 instead.
Manufacturing and agriculture credit (Schedule MAM or MA‑A) – If credit is from a pass‑through entity, attach a copy of
your Schedule 5K‑1, 3K‑1, or 2K‑1.
Manufacturing investment credit (Schedule MI) – Attach a copy of the certification from the Department of Commerce. If
credit is from a pass‑through entity, attach a copy of your Schedule 5K‑1, 3K‑1, or 2K‑1 instead.
Model Form for legislators who make the sec. 162(h) election – If using electronic filing software that does not submit the
SPL01 Model Form as part of the electronic return, attach a copy of the 2019 Model Form.
Request for closing certificate for fiduciaries (Schedule CC) Estates – Enter decedent’s social security number in the
box labeled “Your social security number” under Taxpayer Information above. Attach a copy of the decedent’s will and the
probate inventory. Trusts – Attach a copy of the trust instrument and three years of accountings. (Submit attachments
and Form W‑RA only if Schedule CC was electronically filed.)
Sale of investment in a qualified Wisconsin business (Schedule QI) – Attach information showing your computation of the
allocation of gain eligible for the exclusion.
Tax‑option (S) corporation, partnership, limited liability company, trust, or estate adjustments Attach a copy of your
Schedule 5K‑1, 3K‑1, or 2K‑1.
Tax paid to another state (Schedule ETOS) – Attach a copy of the tax‑option (S) corporation’s or partnership’s income or
franchise tax return(s) from the other state(s). If the entity is claiming credit for tax paid to another state on behalf of their
shareholder(s) or partner(s) on a composite income tax return, attach a copy of the composite income tax return from the
other state.
Tax paid to another state (Schedule OS) – Attach a copy of your income tax return from the other state(s) and withholding
statements or a copy of your Schedule 3K‑1 or 5K‑1 if credit is based on tax paid by a pass‑through entity.
Other – Attach any other documents you were instructed to attach when e‑filing.
Applicable Laws and Rules
This document provides statements or interpretations of the following laws and regulations in eect as of November 1, 2019:
Chapter 71, Wis. Stats.