PA-003 (R. 10-21) Wisconsin Department of Revenue
Statement of Personal Property
Assessment date – January 1, 2022
Due date
March 1, 2022
2022
Filing Instructions – you must file this completed return with your local assessor on or before March 1, 2022. (sec. 70.35, Wis. Stats.) Report personal
property not reported to the Wisconsin Department of Revenue’s Manufacturing & Utility Bureau.
Confidentiality – under sec. 70.35(3), Wis. Stats., personal property returns filed with the local assessor are confidential records of the assessors office.
Failure to File – if you do not file, your local assessor will estimate your property’s value using the best information available. You will also be denied
appeal rights with the Board of Review (BOR), under sec. 70.35(4), Wis. Stats.
Questions? – if you have questions on filing this form, contact your local assessor.
For Office Use Only
School district TID no.
Assessor name
Assessor address
Preparer and Owner Information/Signature
I, the undersigned declare under penalties of law that I have personally examined this return and its completed schedules. To the best of my knowledge and belief,
this return is true, correct and complete.
Preparer
Name (please print)
Address
Owner
Name (please print)
Address
Email
Signature Date
Email
Signature Date
Phone Fax
( ) -
( ) -
Phone Fax
( ) - ( ) -
- - - -
Property Owner and Property Information
(agent, consignee or other representative)
Owner is: (check box that applies) Sole Proprietorship Partnership Corporation LLC LLP
New owner informationcomplete this section if there was a
change in ownership or the business is no longer in operation.
Type of change: (check box that applies)
Discontinued Sold Incorporated Moved
Date of change:
- -
New owner name
Property address
Mailing address
Phone no. ( )
Email
-
Business type:
Property address:
(if different from above)
FEIN Account no.
NAICS code
County Municipality
Town Village City
Schedule A – Personal Property Return (Assessment Summary as of January 1, 2022)
This schedule summarizes all taxable personal property from Schedules B through H. Line10, Col. 3 is the total value of your taxable personal
property within this municipality.
1. Boats and watercraft (from Sch. B)
2. Furniture, fixtures and equipment (from Sch. D)
3. Multifunction fax machines, copiers, postage meters... (from Sch. D2)
4. Total of Lines 2, 3
5. Building on leased land (from Sch. E)
6. Leased equipment (property in charge of but not owned) (from Sch.F)
7. Supplies (from Sch. G)
8. All other personal property (from Sch. H)
9. Total of Lines 6, 7, 8
10. Total Assessable add Lines 1, 4, 5, 9
Col. 1
Property Type
Col. 3
Total
Col. 2
Subtotal
Col. 4Class
For Office Use Only
1
3
4A
4B
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PA-003 (R. 10-21) - 2 - Wisconsin Department of Revenue
Col. 1
Description of Boats and Watercraft
Col. 4
Conversion
Factor
Col. 3
Original
Cost
Col. 6
For Oce
Use Only
Report: All boats and watercraft subject to general property taxation. Review the Composite Conversion Factors and Composite Useful Lives Table
on various equipment https://www.revenue.wi.gov/Pages/Report/Home.aspx.
Col. 2
Acquisition
Year
2022
Schedule B – Boats and Watercraft
Col. 5
Declared Value
January 1
Total Declared Value
Enter Col. 5 Total on Sch. A, Line1, Col. 3
Note: Attach additional sheets if needed
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
All prior years
Total
.925
.794
.688
.602
.517
.443
.377
.327
.280
.240
.144
Col. 5
Conversion
Factor
(10-yr)
Col. 2
Total Original Cost
as of Jan. 1, 2021
Col. 7
For Oce
Use Only
Report: All furniture, xtures and equipment (e.g., oce, store and professional furniture, xtures and equipment, business and professional
libraries, other assets related to the sales and administration of your business). Original Cost in Col. 4, should contain all costs of installation and
freight, add-ons and sales tax.
Col. 1
Acquisition
Year
2022
Schedule D – Furniture, Fixtures and Equipment
Col. 6
Indexed Net Value
(Full Value) on Jan. 1, 2022
(Col. 4 x Col. 5)
Enter Col. 6 Total on
Sch. A, Line 2, Col. 2
Col. 3
Additions, Disposals, Transfers
at Cost Since Jan. 1, 2021
Col. 4
Net Total Original Cost
as of Jan. 1, 2022
(Col. 2 +/- Col. 3)
2021
2020
2019
2018
2017
2016
All prior years
Total
.875
.663
.507
.391
.296
.225
.124
Col. 5
Conversion
Factor
(6-yr)
Col. 2
Total Original Cost
as of Jan. 1, 2021
Col. 7
For Oce
Use Only
Report: All multifunction faxes, copiers, postage meters, telephone systems (PBXs), equipment with embedded computerized components.
Col. 1
Acquisition
Year
2022
Col. 6
Indexed Net Value
(Full Value) on Jan. 1, 2022
(Col. 4 x Col. 5)
Enter Col. 6 Total on Sch. A, Line 3, Col. 2
Col. 3
Additions, Disposals, Transfers
at Cost Since Jan. 1, 2021
Col. 4
Net Total Original Cost
as of Jan. 1, 2022
(Col. 2 +/- Col. 3)
Schedule D2 – Multifunction Faxes, Copiers, Postage Meters, Phone Systems, Computerized Equipment
Col. 1
Property Description
Col. 3
Original
Cost
Col. 5
For Oce Use Only
Report: Buildings, structures and other improvements you own, but are located on land you do not own. They are valued in the same manner as
improvements located on land owned by you. Enter your opinion of value in Col.4.
Col. 2
Acquisition
Year
2022
Schedule E – Buildings on Leased Land
Col. 4
Opinion of Value
January 1
Total Declared Value
Enter Col. 4 Total on Sch. A, Line5, Col. 3
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PA-003 (R. 10-21) - 3 - Wisconsin Department of Revenue
2022
Schedule F – Leased Equipment (Property in charge of but not owned)
Col. 1
Name and Address
of Leasing Company*
Col. 4
Installation
Year
Col. 7
For Oce
Use Only
Report: All leased equipment (e.g., business furniture, fixtures, equipment, machines, postage meters, tools, advertising devices) and similar items
loaned, leased, stored or otherwise held and not owned by you. These items may or may not be assessed to you. Often, leases state whether the
owner or the lessee is responsible for the personal property taxes. Review the Composite Conversion Factors and Composite Useful Lives on various
equipment https://www.revenue.wi.gov/Pages/Report/Home.aspx.
Col. 3
Gross Annual
Rent
Col. 6
Indexed Value Taxable
Equipment
Total
Col. 5
Original
Cost
Col. 2
Equipment Type
and Lease No.
Enter Col. 6 Total on
Sch. A, Line 6, Col. 2
* Leasing Companies: To avoid duplication of assessment, provide the same
information requested on this schedule including name and location of lessees.
Supplies inventory – January 1, 2022 ......................................................... $
Report: Your supplies inventory. Report items in your possession on January1 and are expensed, not subject to resale, but are necessary in the
conduct of business and are consumed in the operations of providing customer services. Supplies include: Items used for selling and advertising,
oce, shipping, medical, dental, janitorial and cleaning.
2022
Schedule G – Supplies
Enter amount on Sch. A, Line7, Col. 2
Col. 2
Property Description
Report: All leasehold improvements and other personal property not previously reported on other schedules. Report improvements on exempt
land and privately owned structures, billboards, cable television towers or special taxed land. Review the Composite Conversion Factors and Composite
Useful Lives Table on various equipment https://www.revenue.wi.gov/Pages/Report/Home.aspx.
Leasehold improvements – any alterations, additions or improvements, adding value, made by a tenant to leased or rented premises. Enter the
total improvement cost in Col.3.
2022
Schedule H – All Other Personal Property, Leasehold Improvements, Signs, Billboards, Logs and Forest
Products, Improvements on Exempt Land, Improvements on Forest Cropland or Managed Forest Land
Col. 4
Conversion
Factor
Col. 3
Acquisition
Cost
Col. 6
For Oce
Use Only
Col. 1
Acquisition
Year
Col. 5
Declared Value
January 1
Total
Enter Col. 5 Total
on Sch. A, Line8, Col. 2
Lease or Asset Information
For each property you are leasing, provide the following: (attach additional sheets if necessary)
Rent includes: (check all that apply) Electric Heat Real estate taxes Parking Common area maintenance
Other (describe)
Property
Square footage – leased area
Sq. Ft.
Annual base rent
$
(mm-yyyy)
Start End
Term
(mm-yyyy)
Sales/rent
If your sales are the basis for your rent, enter percentage of sales you pay as rent. %
Amount paid$
Include: Logs and other forest products belonging to persons whose principal activity is not related to the buying, selling or manufacturing that type
of property.
Exclude: Merchants or manufacturing stock.
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